Clinical Information & Laboratory Collection

What is the purpose of “Chain of custody”?

To allow clear documentation of specimen from the time of collection to the transfer of test results. It begins at the time of initial pt contact. It ensures there is clear and unique identification of the specimen.

What is CLIA-Waived Testing?

Simple tests approved by the CDC and FDA to be used for diagnosis, monitoring, medication dosage adjustment, or screening purposes. Must have current certificate in order to perform these types of tests.

What are some common CLIA-waived tests?

Blood glucose, urine, cholesterol, fecal occult blood, and pregnancy tests.

What is the normal range for Hemoglobin?

13.5-18 g/dL for males and 12-16 g/dL for females.

What is the normal range for hematocrit?

40%-54% for males and 38%-47% for females.

What is the normal range for fasting blood glucose?

80-100 mg/dL for both males and females.

What is the normal range for total cholesterol?

Below 200 mg/dL for both males and females.

What is the normal range for low density lipoprotein?

Below 130 mg/dL for both males and females.

What is the normal range for high density lipoprotein?

Above 50 mg/dL for both males and females.

What is the normal range for triglycerides?

Below 150 mg/dL for both males and females.

What is the normal range for erythrocyte sedimentation rate?

20 mm/hr for males and 30 mm/hr for females.

What is the normal range for international normalized ratio? (how long it takes for a person’s body to form a blood clot)

0.8-1.2 for both males and females.

What is the normal range for prothrombin time?

9.6-11.8 seconds for males and 9.5-11.3 seconds for females.

Snellen Test

A vision test that asks pt’s to read letters from 20ft away. There are 11 rows of letters and they get progressively smaller as the rows go down.

Ishihara colorblind test

A vision test where the pt is asked to read the number hidden in the dots on the page.

Tumbling “E” eye chart

A vision test for younger or pt’s who cannot read. They tell the MA or provider which direction the “e” is facing on each row.

Webber and Rinne Tests

Hearing tests that utilize a tuning fork to measure a pt’s hearing ability.

Spirometry Testing

A lung function test that measures how much air an individual can inhale and exhale, and how fast air is breathed in and out.

Peak flow meaurements

A lung function test that measures the rate and amount of air that can be forcefully exhaled from the lungs with a spirometer or peak flow meter.

Allergy testing

Typically done by a scratch, prick, or intradermal skin test to determine if the pt has a reaction to the antigen. May be ordered if the pt has a persistent runny nose, red eyes, skin rashes, asthma-like symptoms, or anaphylaxin.

What are some common blood draw equipment?

Gloves, sterile vacutainer blood tubes, syringe or winged infusion set, tourinqute, alcohol pads to clean site, gauze, specimen labels, lab forms, sharps container, and leak-proof bag for transportation.

What are site contrainidcations?

The chosen site should not be used due to injuries or medical devices which it should be free from, and another site should be selected. Some examples are central IV lines, bruising, loss of skin integrity, tumors, amputation, hematomas, medical devices, etc.

Tube order of draw

Blue blood culture, Yellow top blood culture, Yellow, Pink, Light Blue, Red, Gold/Tiger top, Green, Lavender, and Gray

Blue Blood Culture draw

Used for microbiology and has a sodium polyanethole sulfonate additive.

Yellow Top Blood Culture

Used for microbiology and has citric acid, dextrose, and trisodium citrate additives.

Pink Top Blood Culture

Used for hematology & Immunology and has Potassium EDTA additive.

Light Blue Top Blood Culture

Used for chemistry & hematology and has sodium citrate or CTAD additives.

Red Top Blood Culture

Used for immunohematology and serology and has no additives.

Gold or Tiger Top Blood Culture

Used for chemistry & serology and has a serum separator additive.

Green Top Blood Culture

Used for chemistry and has sodium or lithium heparin additives.

Lavender Top Blood Culture

Used for hematology and has potassium EDTA additive.

Gray Top Additive

Used for chemistry and has sodium fluoride and sodium or potassium oxalate additives.