CCMA Exam Domain 3 Leftovers: Phlebotomy

In general, what supplies are needed to perform a blood draw?

Alcohol wipes, gauze, adhesive bandages, sharps container, PPE, tourniquet, collection tubes, needle system

Evacuated system

consists of a double pointed needle, plastic needle, and collection tubes. Using this method is good for obtaining multiple types of blood with one stick. Vacutainer needles are usually 20-22 gauge with needle length of ¾ to 1.5 inches

Butterfly method

Consists of flexible wings attached to needle with 5-12 inches of tubing that connects the needle to the collection device. Best for small or fragile veins. Needles are typically 21-23 gauge with needle length of ½ to ¾ inch

Needle syringe system

needle and a syringe can be used to draw blood from a vein. Only small amount can be drawn so its not ideal. 16 gauge needle and syringe are used.

Order of draw

Yellow, light blue, red, red/gray, green, green/gray, lavender, gray

Yellow tube

Additive: sodium polyanethol sulfonate, prevents blood from clotting

Used for blood or body fluid cultures

Light blue tube

Additive: sodium citrate, removes calcium to prevent clotting

Used for coagulation testing

3-4 inversions

Red tube

No additives

Used for serum test, chemistry studies, blood bank, immunology

5 inversions

Red/gray tube

No anticoagulant but contains silica to enhance clot formation

Used for serum test, chemistry studies, immunology

5 inversions

Green tube

Additives: heparin, to prevent clotting

Used for chem tests

8 inversions

Green/gray tube

Additives: lithium heparin and gel for plasma separation

Used for plasma determinations

8 inversions

Lavender tube

Additives: EDTA, removes calcium

Used for hematology

8 inversions

Gray tube

Additives: potassium oxalate and sodium fluoride, removes calcium

Used for chem testing, glucose and alcohol levels

8-10 inversions

Site preparation

Cleanse the site with an antiseptic, allow it to air dry, tourniquet is reapplied after site is dry.

Common veins used

Median cubital vein, or basilic or cephalic

Venous sufficiency and when you can use a vein

Vein bounces back, is visible AND palpable, good blood flow

Removal technique

Release tourniquet

Remove tube

Withdraw needle smoothly (same angle as injecting) and simultaneously place gauze over injection

Apply pressure