LABORATORY MANUAL I

TOPIC: The Heart

OBJECTIVE: To know the parts and the importance of the heart.

REFLECTION:
I feel amazement and gratitude for the complexity of our bodies when I consider the
significance and complexity of the human heart. The significance of the heart goes beyond its
physiological role as a pump that circulates blood throughout our bodies. The heart is
frequently referred to as the crucial center of life and serves as a sobering reminder of our
mortality and the delicate balance required for our existence. It represents the fundamental
core of our humanity by standing for love, passion, and emotion. Beyond its metaphorical
implications, the heart plays a physiological role that is quite astonishing. The heart is made up
of numerous sections, each with a distinct function, and it functions as a well-oiled machine. To
ensure the appropriate flow of oxygenated and deoxygenated blood, the four chambers—two
atria and two ventricles—cooperate in perfect harmony. Understanding the significance of the
heart acts as a potent reminder of the duty we have to take care of our bodies. The atria take in
blood, while the ventricles pump it out to the lungs and the rest of the body. For heart health,
it's important to eat a balanced diet, exercise frequently, manage stress, and abstain from bad
habits like smoking. In addition to its physical functions, the heart is a symbol of empathy,
compassion, and connection. It serves as a reminder to look after our mental health and treat
other people nicely. In conclusion, nurturing emotional ties and committing acts of love nourish
our souls in the same way that the heart's rhythm keeps our bodies alive. Thinking about the
importance and intricacy of the heart also serves as a sobering reminder of our mortality.
Knowing how it works can motivate us to put our physical and emotional health first while also
motivating us to live a compassionate and loving life. The heart is a powerful emblem of life
itself and not just an organ.
LABORATORY MANUAL II

TOPIC: Antecubital fossa

OBJECTIVE: To know the importance of knowing the sites for venipuncture

REFLECTION:
The ability to recognize and be familiar with the proper venipuncture sites is crucial for
healthcare personnel who collect blood samples. I am aware of the value of site selection,
patient comfort, and the significance of achieving good blood collection as I think back on my
experiences.
The significance of selecting the proper place for venipuncture is one of the most important
lessons I've learnt. The choice of an appropriate vein is influenced by a number of variables,
including the patient's age, health, the availability of veins, and the required blood volume.
Knowing the various venipuncture locations, such as the basilic vein in the forearm or the
median cubital vein in the antecubital fossa, assists for quick identification and raises the
likelihood of a successful blood collection.
The large number of main veins that are plainly visible and palpable in the antecubital fossa is
one of the reasons it is recommended for venipuncture. The main vein targeted for blood
collection is frequently the median cubital vein, which is situated in the fossa's middle. If the
median cubital vein is difficult to access or has already been used, the cephalic and basilic veins,
which run along the sides of the fossa, are also frequently used.
LABORATORY MANUAL III

TOPIC: Blood Smear Preparation

OBJECTIVE:To identify the things to consider when doing a blood smear
CHECKLIST AND SUPPLIES:
Microscope slide with frosted end
Spreader slide
Capillary tubes
Pen (for labelling)
Blood collected in an EDTA tube
TECHNIQUE ASSESSMENT:
1. Mix blood thoroughly. Place a small drop of blood on one end of one glass slide. Hold the
frosted edge with your non-dominant hand
2. Using your dominant hand, place the edge pf the other slide at an approximately 35–45-
degree angle on the first slide, in front of the blood drop
3. To spread the blood, rapidly but gently push the top slide forward through the remainder of
the smear. It is important to keep gentle, equal pressure throughout the whole process, and do
not lift the top slide before it reaches the edge of the bottom slide.
4. After preparation, the smear should be labeled and dried.
REFLECTION:
A crucial step in laboratory diagnostics is the preparation of blood smears, which entails
applying a thin, even coating of blood to a glass slide for microscopic analysis. As I study the
procedure and its importance, I become aware of various crucial factors that must be taken into
account to guarantee the accuracy and quality of the blood smear. Using the right tools and
materials is one of the most important things to think about. Choosing the blood collection site
carefully is essential to getting the best blood smear. Due to its extensive capillary network, the
fingertip is frequently the chosen spot. When spreading the blood on the glass slide, it is
important to carefully regulate the angle and pace of the smear. To ensure a uniform and
smooth blood film, the slide should be held at a 30-degree angle. To promote accurate
differential counts and optimal observation of blood cell morphology, a uniformly distributed,
feathery edge is preferred. The thickness of the blood smear is also essential for proper
interpretation. Overlapping cells may prevent accurate identification and enumeration if the
smear is excessively thick. The blood smear should be thoroughly air dried after preparation
before staining or fixing is done. Labeling and documentation should then be done.
LABORATORY MANUAL IV

TOPIC: Tourniquet Application

OBJECTIVE: To know the proper tourniquet application
CHECKLIST AND SUPPLIES: Tourniquet
TECHNIQUE ASSESSMENT:
1. The tourniquet should be four fingers away from the antecubital fossa
2. Should be no longer than 1 minute in the arms
REFLECTION:
The use of a tourniquet during blood collection is an essential step in ensuring precise and
effective blood collection. It is crucial for you to comprehend the rationale behind and the right
way to apply a tourniquet during this procedure as a medical technology student.
The main objective of using a tourniquet is to temporarily occlude or restrict venous blood flow.
Venipuncture is made quicker and faster by doing this since the veins in the arm become more
noticeable and easier to find. The tourniquet aids in engorgement of the veins, enabling
successful blood sampling with the least amount of discomfort for the patient.
When using a tourniquet, it's crucial to use caution and follow specific instructions. The
tourniquet should be applied 3 to 4 inches above the desired puncture site, and it should be
tight enough to prevent venous return but not so tight as to restrict arterial blood flow or put
the patient through undue discomfort. Maintaining the tourniquet for an excessive amount of
time can cause hemoconcentration, which makes it more difficult to get reliable laboratory
results.
LABORATORY MANUAL V
TOPIC: Capillary Puncture
OBJECTIVE: To perform a proper capillary puncture
CHECKLIST AND SUPPLIES:
Lancets
Microtainer tubes
Gloves
Antiseptic
Gauze
TECHNIQUE ASSESSMENT:
1. Position the patient so that the hand is easily accessible.
2. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. Allow
thefinger to dry or wipe dry with a sterile 2×2 gauze.
3. Using a sterile lancet, puncture the fingertip in the fleshy part of the finger, slightly to the
sideof the center and across (perpendicular to) the grooves of the fingertip. This enables the
bloodto form as a drop on the fingertip. If the puncture is parallel to the lines of the fingerprint,
theblood will not form as a drop but will run down the finger making collection difficult.
4. Wipe away the first drop of blood with a sterile 2×2 gauze.
5. Allow another large drop of blood to form. Lightly touch the microtainer capillary
collectiondevice (or filter paper) to the LARGE drop of blood. Collect drops of blood into the
collectiondevice by gently massaging the finger. Avoid excessive pressure that may squeeze
tissue fluidinto the drop of blood. Fill the microtainer tube(s) as needed.
6. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding.
Applyan adhesive bandage.
7. Label all specimens per accepted guidelines.
REFLECTION:
Capillary puncture, sometimes referred to as a fingerstick or a heel stick, is a frequently
practiced medical technique that entails pricking the skin to acquire a little sample of blood for
diagnostic testing. After seeing this technique in action and considering its relevance, I can't
help but see its many benefits and the effect it has on patient care.
First, there are various advantages to capillary puncture over venous blood collection. It is less
intrusive, necessitating a smaller incision, and causes the patient the least amount of suffering.
Because of this, it is especially good for newborns, young children, and people with weak veins.
Additionally, because the operation is simple and quick, less time is spent overall in a hospital,
which is more convenient for both patients and healthcare workers.
In medical contexts, capillary puncture is a useful and often used method. It is especially
appropriate for several patient demographics and diagnostic purposes due to its minimally
invasive nature, low level of discomfort, and capacity to obtain enough blood samples. Capillary
puncture still plays a crucial part in providing good patient care, despite its drawbacks.
LABORATORY MANUAL VI

TOPIC: Venipuncture- Syringe System

OBJECTIVE: To properly perform a Venipuncture- syringe method
CHECKLIST AND SUPPLIES:
Collection tubes
Personal Protective Equipment
Needles and syringes
Tourniquets, Hand Sanitizer
Alcohol swabs
Tape or adhesive bandages
TECHNIQUE ASSESSMENT:
1. Apply the tourniquet, select a vein noting the location and direction of the vein.
2. Clean the venipuncture site with 70% isopropyl alcohol swab.
3. Proper hand position to hold a syringe.
4. Draw a patient’s skin taut with your non dominant thumb.
5. Perform venipuncture.
REFLECTION:
Using a syringe to extract blood from a vein is the syringe method of venipuncture. A trained
healthcare practitioner, such as a phlebotomist or nurse, is normally required to perform it.
While there are other techniques, such as evacuated tube systems, the syringe method has
some advantages and should be taken into account, as I saw during our practical. The main
advantages of the syringe method include the ability to regulate the amount of suction used
during blood collection. This enables a more precise and controlled extraction, particularly
when the patient has delicate veins or when taking just little amounts of blood is required. The
syringe approach is adaptable, making it appropriate for a range of clinical settings and patient
demographics.
LABORATORY MANUAL VII

TOPIC: Venipuncture- syringe using butterfly needle

OBJECTIVE: To perform the proper venipuncture- syringe using butterfly needle
CHECKLIST AND SUPPLIES:
Collection tubes
Personal Protective Equipment
Butterfly winged needle, syringes
Tourniquets, Hand Sanitizer
Alcohol swabs
Tape or adhesive bandages
TECHNIQUE ASSESSMENT:
1. Apply tourniquet
2. Feel the vein
3. Clean with alcohol swap in concentric circle
4. Hold skin taut with non-dominant thumb
5. When needles enter vein should see “flash” of blood
6. Using your dominant hand pull the syringe to extract blood
7. Release tourniquet, remove butterfly needly from arm
8. Activate safety shield

REFLECTION:
I've always been intrigued by venipuncture utilizing a butterfly needle as a medical technique. I was able
to observe it first-hand while working as a healthcare practitioner, and I was able to appreciate the
delicate skill and accuracy needed to carry out this method. When dealing with difficult veins or delicate
patients, the butterfly needle, with its thin, flexible tubing and narrow gauge, offers an alternate
technique for venipuncture. Based on my own experience, the degree of patient comfort that can be
provided during venipuncture with a butterfly needle stands out. The small needle and flexible tubing of
the butterfly needle lessens the possibility of vein trauma and discomfort. This is particularly
advantageous for people with weak veins or those who are afraid of needles. The patient has a more
comfortable experience thanks to the butterfly needle's smooth insertion and maneuverability, which is
essential for keeping their confidence and cooperation throughout the process.
LABORATORY MANUAL VIII

TOPIC: Venipuncture- Evacuated system

OBJECTIVE: To perform the proper venipuncture- Evacuated system
CHECKLIST AND SUPPLIES:
Tourniquet double sample needle
Adapter
Alcohol swab
Gloves
Collection tubes
Gauzepad
Hand sanitizer
TECHNIQUE ASSESSMENT:
1. Apply tourniquet
2. Feel the vein
3. Clean with alcohol swab in concentric circles
4. Hold skin taut with non- dominant thumb, insert needle at 15-degree angle with bevel up
5. Remove hand from drawing the skin taut
6. Insert tubes into holder in correct order of draw.
REFLECTION:
A sterile needle connected to a vacuum-sealed tube makes up the evacuated system, which is
used to collect blood from the patient's vein. Comparing this technology to conventional
syringe-based techniques has many benefits. First off, a faster and more precise blood collection
process is made possible by the vacuum inside the tube, which provides a continuous and
controlled flow of blood. The vacuum's pressure also aids in drawing a sufficient volume of
blood, decreasing the need for several punctures and the agony experienced by the patient. As I
was performing, I noticed that the evacuated system has many advantages over the alternative
technique, such as the fact that it removes the need to transfer blood from a syringe to separate
tubes, hence lowering the risk of contamination and guaranteeing sample integrity. Due to the
color-coding of the tubes based on the additives they contain, many sample types can be
collected using a single venipuncture. Both healthcare professionals and patients benefit from
the procedure' simplification and time savings. I value the evacuation system's effectiveness,
accuracy, and safety aspects as a healthcare practitioner. It gives me the assurance I need to
venipuncture patients while prioritizing their comfort and safety and obtaining high-quality
blood samples. I can collect several samples quickly thanks to the standardized color-coded
tubes, which is extremely useful when time is of the essence.
LABORATORY MANUAL IX

TOPIC: Venipuncture- Evacuated with butterfly

OBJECTIVE: To perform proper venipuncture- evacuated with butterfly
CHECKLIST AND SUPPLIES:
Tourniquet
Butterfly needle for evacuated
Adapter
Collection tubes
Alcohol swab
Cotton balls
Hand sanitizer
Gloves
TECHNIQUE ASSESSMENT:
1. Prepare your winged infusion set for blood draw
2. Look for the vein in the patient’s arm
3. Cleanse and disinfect the needle insertion site
4. Insert the butterfly needle into the superficial vein
5. Remove the tourniquet and needle once the tube is full
6. Proceed to the next tube according to order of draw.
REFLECTION:
Venipuncture has always fascinated and challenged me, especially when done using an
evacuated tube system and a butterfly needle. I now recognize the value of this method for
getting blood samples for diagnostic purposes as a healthcare provider. In circumstances where
accessing veins might be challenging, the butterfly needle offers a special advantage thanks to
its delicate design and flexibility. The level of accuracy needed throughout the venipuncture
procedure is one feature that particularly sticks out to me. The butterfly needle, which is
attached to an evacuated tube, enables a continuous and controlled blood flow. This reduces
the likelihood of hemolysis or clot formation in turn, guaranteeing correct laboratory results.
Due to the butterfly needle's delicate nature, it is imperative to use subtlety and a delicate
touch in order to maintain patient comfort while successfully access the vein.
LABORATORY MANUAL X

TOPIC: One Week Blood Pressure Monitoring

OBJECTIVE: To observe the blood pressure of your parents for 1 week
CHECKLIST AND SUPPLIES:
BP apparatus
Stethoscope
TECHNIQUE ASSESSMENT:
1. Close the valve on the blood pressure cuff.
2. Position the diaphragm of your stethoscope over the brachial artery.
3. Re-inflate the cuff 20-30 mmHg above the systolic blood pressure you previously estimated.
4. Then slowly deflate the cuff at around 2-3 mmHg per second.
5. Using your stethoscope, listen carefully for the onset of a pulsatile noise. The first of these
pulsatile noises is known as the first Korotkoff sound. The pressure at which the first Korotkoff
sound becomes audible represents the patient’s systolic blood pressure.
6. Continue to deflate the cuff, whilst listening through your stethoscope until the pulsatile
sound completely disappears. The final pulsatile noise you hear is known as the fifth Korotkoff
sound and represents the patient’s diastolic blood pressure.
7. If the patient’s blood pressure is outside of the normal range, you should repeat the
assessment on the same arm after a few minutes and consider assessing blood pressure using
the patient’s other arm.
REFLECTION:
One aspect of this chore that I value is that it requires me to check on my parents' blood
pressure every week. It is improving my ability to take blood pressure manually as well as
whether or not I am being watched. We check my parents' blood pressure to see if it is rising or
falling each day because my mother has a history of high blood pressure. Although the
procedure was quick and painless, it had a tremendous impact on how well I understood my
own health. It helped me recognize that blood pressure is an important gauge of cardiovascular
health rather than just a random number. The measurements gave me information about how
my blood pressure changes in response to various stressors, activities, and even sleep habits. To
underline how crucial it is for all of us to monitor our blood pressure, I wanted to present my
thoughts with you. We can help one another as a family in making better decisions and caring
for our cardiovascular health. We should all place a high priority on physical activity, a nutritious
diet, stress reduction, and checkups at regular intervals.