Phlebotomy

and
Preservation of
Blood
• Phlebo refers to veins, otomy
refers to cutting into
• Phlebotomy refers to
approaching avein to obtain a
venous blood sample using a
needle
• Phlebotomist is the person or
technician that performs
phlebotomy
Why Phlebotomy is performed???
• For diagnostic purpose
• Haematological values (CBC, ESR)
• Microbial culturing
• Serum hormone level (Thyroid profile etc)
• Serum antibody/antigen level (HCV, HAV etc)
• Serum chemistry (LFT, RFT, amylase, Lipid profile etc)
• And many others
• For blood transfusion
• For research purpose
 Venous Blood
Collection
Sites

• Mainly three veins in arm

are used for blood
collection
• Medial cubital vein
• Basilic vein
• Cephalic vein
• Back of hand can also be
used, but normally used
for IV catheterization
 Blood is perishable
• Blood sample remains viable for short time
• Can vary under various environmental conditions
• It is stored according to its purpose of collection and transportation if
required
• Either whole blood is required or serum or plasma
• Blood is collected for transfusion or some other test
• Depending on test, its storage requirements can differ
• If its not required to test immediately, then should be stored at 2C-6C
• Separated serum or plasma can be stored at freezing temperatures
 Blood Preservation
• Blood can be preserved according to need
• If whole blood or plasma is required, an anticoagulant can be added to halt coagulative process
• If serum is required, no additive is required
• Different type of anticoagulant agent has to be used for specific test
• Anticoagulant is an agent which disrupts the cascade of ongoing processes which
initiate clotting
• Commonly used anticoagulants
• Heparin Interferes with clotting factors
• Ethylene diamine tetra acetic acid (EDTA)
• Sodium Citrate
Chelates Ca++ ion
• Potassium Oxalate
• Sodium Fluoride Inhibits glycolytic enzymes
• Acid Citrate Dextrose
Choice for blood transfusion
 Vacutainers
• Vacuum containing tubes, sterilized and sealed
• Have negative pressure inside
• Just need to pass needle from rubber in cap, negative pressure inside tube
will cause tube to fill
• Vacutainers come with or without any additive
• Caps are colour coded for quick identification of additive
 Lavender Coloured
• Contains EDTA
• Used for
• CBC
• Blood smear
• HbA1C
 Green Coloured
• Contains heparin Na or Li
• Commonly used for
• Serum ammonia levels
• Serum insulin levels
• Other whole blood tests
 Blue Coloured
• Contains buffered sodium citrate
• Used specifically for coagulation screening
• Prothrombin time (PT)
• Activated partial thromboplastin time (APTT)
• Thrombin time (TT)
 Black Coloured
• Contains sodium citrate
• Used specifically for
• Erythrocyte Sedimentation Rate (ESR)
 Grey Coloured
• Contains potassium oxalate and sodium fluoride
• Potassium oxalate is anticoagulant
• Sodium fluoride is antiglycolytic agent
• Used specifically for
• serum glucose levels
• serum lactate levels
 Yellow Coloured
• Contains silica gel layer that activates clotting
• Clot activating gel
• Used to separate serum
• Also called Serum separating tube(SST)
• Used for
• Serum biochemistry
• Serum Urea and electrolytes levels
• LFT’s
• CRP
• Amylase
• Serum hormone levels
• Serum immunological assays
• And many more
 Red Coloured
• Doesn’t contains any additive
• Only a layer of silica
• Separates serum