Chapter #1

To obtain blood for diagnostic purposes & monitor

treatment
Venipuncture
- blood collection via a needle inserted in a vein

Capillary puncture
- blood collection via a lancet puncture of the skin

Phlebotomist
- anyone trained in blood collection

AIDET
- an acronym that helps you communicate with anxious
people
A-cknowledge
I-ntroduce
D-uration
E-xplanation
T-hank you
Chapter #1

Qualities of professionalism
- professional appearance
- integrity
- self-confidence
- compassion
- self-motivation
- dependability
- ethical behavior

Patients rights
It has been found that patients who are informed about
their treatments and prognoses are considered in the
decision making process are most satisfied with their
care
Chapter #6
The vascular system
Structures
H-shaped -70%
people
M-shaped -3090 people

Median cubical
median
Basi Ilic
CePhe - order
to
from
Kake

Red÷
CBC -

Complicit blood count

white blood cell

Hemoglobin
Platelets Hct .

differential
WB -
Whole Blood
Chapter 6

all cells
gravitate to
the
Plain
bottom when
settling
anticoagulant
'°*eᵈ

f.
I

fun
1-

← serum
no
clotting
¥←7
% Platters
← cells PWBC
¥8
④ ma
Redeem
Buffy coat

serum
it was
has
used
no
fibrinogen
to make the
because

clot

fibrinogen is a
protein to clot

let tests sit for 30 Miasto

fibrin before
Provint
putting it
In a
centrifuge
Ucsc
anticoagulant for CBC sample
 Chapter 6
55% of blood is fluid
45% is formed elements Cells )

Always collect 2- 5 times the

amount of blood as serum

or
pas ma for a sample

ex 2mL serum

+2Ém%ÉÉ
always collect 2
of blood
times the
of plattlects
amount

ex 2mL plattleefs
K2bk
4mL blood
 Chapter 6

artery s have the pause

venules awe the smallest

veins

whole blood doesnt have

fibrin

fibrin is found in Cotted

Samples

Midwives
Doctors
Nurse
%Tder
praotioners tests
Chapter #8

Step #2: approach, identify,& prepare patient

Step #3: verify diet restrictions & latex sensitivity
Step #4: sanitize hands
Step #5: position patient, apply tourniquet, and ask patient
to make a fist
Step #6: select vein, release tourniquet, and ask them to
open fist
Step #7: clean and air dry the site
Step #8: prepare equipment and put on gloves
Step #9: reapply tourniquet, uncap and inspect needle
Step # 10: ask patient to remake fist 'anchor vein, and
insert needle
Step #11: establish blood flow, release tourniquet,and ask
them to open fist
 Chapter #8

Step #12: fill, remove, and mix tubes immediately after

removal from the holder

Step #13: place gauze, remove needle, flip safety needle

guard and apply pressure

Step #14: discard collection unit into biohazards sharps

container

Step #15: label tubes

Step #16: observe special handling instructions
Step #17: check patients arm and apply bandage
Step #18: dispose of contaminated materials
Step #19: thank patient, remove gloves, sanitize hands
Step #20: transport specimen to the lab
Chapter #8
Label

name
Date
Collet ion

Time
Identification
number

Phildototnist
initials
 Chapter #7
Blood collecting equipment
- gloves/glove liners - Tourniquet
- gauze pads - vein-location device
- bandages - needles
- sharps disposal

Disinfectants - kills microorganisms, not safe for human

skin
Antiseptics - prevents sepsis, safe for human skin
Types of needles Parts of a needle
- bevel
- multisample system
- shaft
- hypodermic syringe - threaded hub
- winged infusion (butterfly) - rubber sleeve over needle

Lumen - hollow part of the needle shaft

Gauge - The diameter of the lumen

Green needle-21 gauge
Black needle - 22 gauge
Blue needle - 23 gauge(for children or hands
Ets - evacuated tube system
Parts of the ets When using the butterfly
- Needle and holder system prim the line with a
- evacuated tubes red topped tube
DUTIES AND RESPONSIBILITIES OF A PHLEBOTOMIST

Typical Duties

•Prepare patients and site for specimen collection following nationally recognized

standards and institution’s guidelines.

•Collect venipuncture and capillary specimens for testing following nationally

recognized standards and institutional procedures.

•Prepare specimens for proper transport, ensuring the integrity and stability of

the sample.

•Adhere to all HIPAA and confidentiality guidelines, including all Code of

Conduct and Integrity programs instituted by the employer.

•Transport and dispatch samples efficiently by prioritizing specimens to ensure

desired turnaround times.

•Comply with safety rules, policies, and guidelines for the area, department, and

institution.

•Provide quality customer service for all internal and external customers.
DUTIES AND RESPONSIBILITIES OF A PHLEBOTOMIST
Additional Duties as Required

•Assist in collecting and documenting monthly workload and record data.

•Perform quality-control protocols as specified in standard operating procedures,

and perform and document instrument and equipment maintenance.

•Participate in continuing education (CE) programs such as Quality, Safety,

Lean/Six Sigma, and Customer Service.

•Collect and perform POCT following all standard operating procedures.

•Prepare drafts of procedures for laboratory tests according to standard format.

•Perform appropriate laboratory computer information operations.

•Provide proper instruction to patients/customers for container specimen

collection.

•Perform front office duties required by institution including scheduling, coding,

itinerary updates, and obtaining Advance Beneficiary Notice (ABN).

•Train new technicians and students in duties and responsibilities.

Chapter #7
Anticoagulants (for plasma/whole blood samples)
- ethylenediaminetraacetic acid
A- IEDTA)* Precipitating calcium
- citrates
- heparin - Inhibiting formation of thrombin
- oxalates Precipitating calcium
- -

Glucose or alcohol tests

Hemolysis - The break down of red blood cells
Special - use anticoagulants
- acid citrate dextrose -immunohematology (DNA/HLA)
- citrate phosphate dextrose -CBS
- sodium polyanethol sultanate - blood cultures

Antiglycolytic agents
- prevents glycolysis - breakdown of glucose by blood cells
- sodium fluoride
Chapter #7

Clot activators Let tests for 30 minutes before

- SST- silica putting them in the centrifuge
- celite
Thrombin - clothing factors
Causes clotting within 5 minutes

CBC sits on a mixer for 2 minutes then anylised

Thinotropic gel separator
- prevents cells from continuing to metabolize substances
-When centrifuged, get moves between cells and fluid
Trace element-free tubes
- tubes made of materials free of trace elements

Red topped tubes have no additives

Lead testing
Chapter #7

1.Blood culture tube or bottles

2.Sodium citrate tube (e.g., light blue-top coagulation tube)

3.Serum tube with or without clot activator, with or

without gel (e.g., red, red/gray mottled, or gold stopper)

4.Heparin tube with or without gel (e.g., light or dark

green top, green/gray mottled)

5.EDTA tube with or without gel separator (e.g., lavender/

purple, pink, or white/pearl top)

6.Sodium fluoride/potassium oxalate glycolytic inhibitor

(e.g., gray top)
Chapter #9
Chapter #10
Capillary puncture equipment
Lancet incision devices
Micro collection container
Micro hematocrit tubes - Red and green are heprinized
You will get different results doing capillary punctures
verses venous punctures
-

Order of draw
Blood gas specimens (cbg)
EDTA specimens
Other additives specimens
d
Serum specimens
A
Calsanious

Bore
Glucose tests will be higher on a capillary test in the
neel
 Iatrogenic anemia - anemia caused by blood loss from
collection

Palmar surface of distal or end segment of the middle or

ring finger
Milit
Plantar surface of heel, on medal or lateral edge to avoid
the bone
-
Always wipe the first drop of blood to prevent contamination
from thromboplastin

All bilirubin tests are in amber coloured tubes to protect

from the sun

Empty a sharps container when it is 3/4 way full