Blood Collection Equipment, Additives and Order of Draw

Black

Type of waste: noninfectious dry waste/non-biodegradable

Green

Type of waste: noninfectious wet waste/biodegradable

Yellow

Type of waste: infectious and pathologic waste

Yellow with black band

Type of waste: chemical waste with heavy metals

Orange

Type of waste: radioactive waste

Red

Type of waste: sharps and pressurized containers

20-23; 21

Appropriate gauge is ___, but the ideal gauge is ___

1 to 1.5

Length of the needle used for venipuncture is ____ inches

1:100

Environmental Protection Agency (EPA)- registered sodium hypochlorite with ____ dilution

1:10

For spills, ___ dilution is used

10

Disinfectants: contact time required is ____ minutes

Multi-sample

Hypodermic (syringe)

Winged Infusion (butterfly)

Three types of phlebotomy needles:

Syringe

Used for patients as an alternative method when drawing blood from patients with small or difficult veins.

Syringe

Traditional collection procedure that uses a syringe to draw blood from the patient and the collected specimen is transferred into tubes.

(1) syringe needle that has a reheating feature, and ● (2) a syringe which is divided into graduated barrel and plunger.

The components of syringe include:

Evacuated Tube System

Closed collection system that is considered the most efficient system for collecting blood samples.

Evacuated Tube System

Allows numerous tubes to be collected in a single venipuncture.

Evacuated Tube System

Composed of multi-sample needles, tube holders and evacuated tubes which prevent the exposure of the specimen from contaminants.

Evacuated Tube System

Evacuated tubes are color coded tubes filled with predetermined volume of blood by vacuum.

Winged Infusion (Butterfly)

This is used for difficult veins such as those of pediatric or elderly patients because it is more flexible than the needle or syringe.

23 to 25; 5 to 12

Winged Infusion (Butterfly): It is composed of ½ to ¾ inch stainless needles; ____ gauge, with ___ inches tubing.

Luer attachment

Winged Infusion (Butterfly): It has _____ for syringes or multisampler Luer adapter for ETS.

Anticoagulants

commonly called blood thinners and prevent blood clots. Two mechanism involved in anticoagulants: precipitation of calcium or by preventing thrombin formation.

Special-use anticoagulants

include acid citrate dextrose, citrate phosphate dextrose and sodium polyanethol sulfonate (SPS)

acid citrate dextrose (ACD)

____ is used for whole blood and erythrocyte survival, routinely used for blood storage. 21 days is the ideal shelf life.

citrate phosphate dextrose (CPD)

______ is used in apheresis procedure to prevent platelet activation and coagulation as blood moves throughout the unit.

sodium polyanethol sulfonate (SPS)

______ anticoagulant which inhibits the antimicrobial systems of blood.

Antiglycolytic Agents

prevent the breakdown of glucose by blood cells or glycolysis.

sodium fluoride

Antiglycolytic Agents: Most common is ___ which preservers glucose and prevents growth of bacteria

Antiglycolytic Agents

It is usually used with potassium oxalate for rapid response

Clot activators

enhance coagulation in serum specimen tubes

• Clotting factors such as thrombin.

• Substance that provide more surface for platelet activation such as glass (silica) particles and inert clays (celite).

two types of activators:

Thixotropic gel separator

inhibits cells from metabolizing substances and moves between cells and serum or plasma when centrifuged.

Trace element-free tubes

made of materials that are free of trace element contamination.

royal blue

Trace element-free tubes: They have ___ stoppers and are used for a variety of purposes such as trace element tests, toxicology studies and nutrient determination

additive

An ____ is any substance that is placed within the tube and they can be used in ETS tubes to prevent clotting and preserving the components.

Red

Specification: No additive

Orange

Specification: Coagulant and Separation Gel

Green

Specification: Heparin Sodium

Light Green

Specification: Heparin Lithium

Purple

Specification: EDTA Coagulant

Light Blue

Specification: Sodium Citrate 1:9 or 3.2%

Black

Specification: Sodium Citrate 1:4 or 3.8%

Gray

Specification: Potassium Oxalate Monohydrate and Sodium Flouride

heparin

occur naturally in the human blood

Order of Draw

Refers to the specific order that must be followed by a phlebotomist when collecting blood samples to prevent any cross-contamination especially when dealing with multiple collection tubes.

cross-contamination

Order of draw: Not following the prescribed sequence affects the test results due to ____

Blood Culture (sterile collections)

Tube stopper color: Yellow SPS

Coagulation Tube

Tube stopper color: Light blue

Glass non-additive tube and Plastic clot activator tube

Tube stopper color: Red

Serum separator tube (PSTs)

Tube stopper color: Red and gray rubber, gold plastic

Heparin tube

Tube stopper color: Green and gray rubber, light green plastic

EDTA Tube

Tube stopper color: lavender, pink or purple

Plasma-preparation tube (PPTs)

Tube stopper color: pearl top

Potassium oxalate/sodium fluoride

Tube stopper color: Gray