introduction to blood collection

INTRODUCTION TO BLOOD COLLECTION

Blood Collection: A Short Course

Learning Objectives State the importance of correct blood

collection techniques in managing total patient care.

List the factors that influence the integrity of a blood specimen.

Discuss safety precautions as related to blood collection.

Differentiate between whole blood, plasma, and serum.

Learning Objectives Explain the action of anticoagulants to

prevent blood coagulation. Describe the appearance of a hemolyzed,

icteric, and lipemic specimen. Differentiate between arterial, venous, and

capillary blood. State the purpose of quality assurance in

blood collection.

Redesigning the Healthcare System

Shifting of phlebotomy responsibility. New skills required.

Blood Collection: A Short Course Purpose

Collection of quality specimens Instructive information Technique Procedures in accordance with the

Clinical and Laboratory Standards Institute, (CLSI) (Standard H3-A6) and Occupational Safety & Health Administration (OSHA) guidelines

Blood Collection: A Short Course Course Overview

Equipment Site selection Technique Complications Specimen handling Phlebotomy errors Venipuncture practice

IMPORTANCE OF CORRECT SPECIMEN COLLECTION AND HANDLING

QUALITY SPECIMENS = QUALITY RESULTS

Diagnosis Treatment Monitoring Laboratory results constitute 70% of the

objective information for health-care providers


Specimen Integrity Laboratory guidelines

Never hesitate to check with laboratory

Clinical Laboratory Improvement Amendments of 1988 (CLIA, 1988) Laboratory is responsible


Preanalytical Factors 56% of lab errors occur before the

specimen is tested Monitoring of specimen ordering Patient identification Patient communication and safety Patient preparation Timing of collections Collection technique Specimen labeling Specimen handling and transport

SAFETY PRECAUTIONSStandard Precautions

Personal protective equipment (PPE) Isolation Procedures Hand washing Properly activating needle safety devices Biohazard disposal Decontamination

Sodium hypochlorite (1:10)

SAFE

TY P

RECA

UTI

ON

S

SAFETY PRECAUTIONSAccidental Puncture

Significant exposure potential Report all needlesticks

Follow institution’s protocol for source and employee testing

SAFETY PRECAUTIONSSyringe-To-Tube Transfer

Recommended procedure Use blood-transfer device Removal of stoppers not

recommended Direct puncture of tube with syringe

needle not recommended

SAFETY PRECAUTIONSSpecimen Processing

Centrifugation Capped, balanced tubes

Separation Removal of stoppers Aerosol production

SAFETY PRECAUTIONSSpecimen Transport

Primary container Secondary container Labeling

TYPES OF SPECIMENSWhole Blood

Consists of: Erythrocytes Leukocytes Platelets Plasma

Use anticoagulated (unclotted) specimen

TYPES OF SPECIMENSPlasma

Liquid portion of unclotted blood Contains fibrinogen Use anticoagulated specimen

TYPES OF SPECIMENSSerum

Clotted blood Does not contain fibrinogen Use “clot” tube

TYPES OF SPECIMENSCentrifugation

TYPES OF SPECIMENSAnticoagulants

Calcium binding EDTA Sodium citrate Potassium oxalate

Thrombin inhibition Heparin

TYPES OF SPECIMENS

MIX ANTICOAGULATED SPECIMENS THOROUGHLY

IMMEDIATELY AFTER COLLECTION

TYPES OF SPECIMENSNormal Plasma & Serum

Appear clear & pale yellowHemolyzed Specimens

Appear pink-red Erythrocyte destruction

TYPES OF SPECIMENSIcteric Specimens

Appear dark yellow Increased bilirubin

Lipemic Specimens Appear milky Increased lipids

TYPES OF SPECIMENSVenous Blood Specimen of choice Used to establish Normal values

Arterial Blood Blood gases Require special collection training

TYPES OF SPECIMENSCapillary Blood Dermal puncture collection Mixture of arterial and venous blood Note on requisition if blood is collected by

dermal puncture