PHLEBOTOMY EQUIPMENTS

By: Nepthale P. Maceda, RMT

 THE METRIC SYSTEM
LENGTH VOLUME WEIGHT
Meter Liter Kilogram
Centimeter Deciliter Gram
Millimeter Milliliter Milligram
Cubic Centimeter
 Temperature Time
Measured in degrees Reported as a
Celsius 24-hour clock
98.6º Fahrenheit = 37º 6:00 p.m. = 1800
Celsius
SYRINGE AND NEEDLES
• One of the oldest methods known
that does not destroy the integrity
of the vein.
• Principle: Syringe creates a
vacuum when plunger is pulled
• The larger the syringe the greater
the amount of vacuum obtained.
SYRINGE AND NEEDLES
• Used for the difficult to draw
patients who have fragile, thin or
“rolly” veins that tend to collapse
when using evacuated system.
• Pediatric patients
• Geriatric patients
Pediatric Patient Geriatric Patient
PARTS OF SYRINGE
SYRINGE AND NEEDLES
• Hub
• Will see “flash” of blood in
needle hub when needle
enters vein
• Needle
• Length: 1 inch to 1 ½ inch
• Gauge
• Diameter of the lumen
SYRINGE AND NEEDLES

“The smaller the

gauge number the
larger the bore”
SYRINGE AND NEEDLES
Needle Needle Use
gauge
27 PPD skin tests
25 Intermuscular injections
23 Butterfly or syringe collection
22 Syringe or evacuated system collection
21 Syringe or evacuated system collection
20 Syringe or evacuated system collection
18 IV or blood donation
16 IV or blood donation
SYRINGE AND NEEDLES

Syringe with safety ne

edle sheath
EVACUATED SYSTEM

• Principle: a tube with vacuum is

inserted into a needle
 EVACUATED SYSTEM

Multisample needle Holder/Adapter Evacuated tube

Components of Evacuated tube system

EVACUATED SYSTEM
• Needle
• Double pointed
• Length: 1 inch to 1 ½ inch
• Rubber sleeve
• Valve that stops the flow of
blood when tube is removed
• Gauge:
• 20,21,22
EVACUATED SYSTEM

• Holder/adapter
• 2 sizes: Adult and Pediatric
EVACUATED SYSTEM
• Evacuated tubes
• Contain vacuum
• Varies in size
• Different additives
• Hemogard tube
• Tube with plastic tube over
the rubber stopper to contain
any aerosols
EVACUATED SYSTEM
• Evacuated tubes
• Tubes has expiration date
• Vacuum will not fill the
tube
• Additive will not be
effective
• Expired tubes
compromises the
integrity of the sample
EVACUATED SYSTEM
• Evacuated tubes
• Made of: Plastic or Glass
• Glass tube
• activate clot formation in the
tube
• Plastic tube
• Does not activate clot formation
• Clot activator can be added to
initiate clot (ex: thrombin,silica)
DIFFERENT ADDITIVES
1. Anticoagulant
2. Anti glycolytic agent
3. Clot activators
4. Separator Gel
ANTICOAGULANTS
• Prevents clotting of blood
• Stop clotting process by
removing calcium or by
stopping prothrombin to
thrombin reaction
 ANTICOAGULANTS
Anticoagulant Action
Potassium Oxalate Precipitates Calcium
Sodium Citrate Binds Calcium
Solution A and B (ACD) Binds Calcium
Sodium Polyanethol Binds Calcium and Allow
Sulfonate (SPS) bacterial growth
EDTA Binds Calcium
 ANTICOAGULANTS
Anticoagulant Action
Lithium Heparin Inhibits prothrombin to thrombin
Sodium Heparin Inhibits prothrombin to thrombin
Ammonium Heparin Inhibits prothrombin to thrombin
ANTIGLYCOLYTIC AGENT
• Inhibits the metabolism of
glucose by blood cells.
• Necessary if testing for
glucose level is delayed.
• Ex: Sodium Fluoride
CLOT ACTIVATOR
• Accelerates clotting process
and decreases specimen
preparation time.
• Ex:
• Glass
• Silica particles
• Thrombin
 SEPARATOR GEL
• Thixotropic gel
• Inert material that undergoes a
temporary change in viscosity
during centrifugation.
• Serves as a separation barrier
between the liquid (serum or
plasma) and cells
SEPARATOR GEL
EVACUATED TUBES
• Red top
• Contains: No additive (glass) or clot
activator (plastic)
• Specimen: Serum
• Inversion: 0 (glass), 5x (plastic)
• Blood Clotting time: 60 minutes
• Uses:
• Chemistry
• Immunology and serology
• Blood bank (Cross match)
EVACUATED TUBES
• Gold top
• Contains: Separating gel and clot
activator
• Specimen: Serum
• Inversion: 5x
• Blood clotting time: 30 minutes
• Uses:
• Chemistry
• Immunology and serology
• Also called :”SST”
EVACUATED TUBES
• Tiger top
• Contains: Clot activator and gel
• Specimen: Serum
• Inversion: 5x
• Blood clotting time: 30 minutes
• Uses:
• Chemistry
• Blood type screening
• Also called: “SST”
EVACUATED TUBES
• Dark green top
• Contains: Sodium heparin or
lithium heparin
• Specimen: Plasma
• Inversion: 8x
• Uses:
• Chemistry
• ABG
EVACUATED TUBES
• Light Green top
• Contains: Lithium
heparin and gel
• Specimen: Plasma
• Inversion: 8x
• Uses:
• Chemistry
• Also called “ PST”
EVACUATED TUBES
• Lavender/Purple top
• Contains: Liquid K3 EDTA
(glass),Spray coated K2 EDTA
(plastic)
• Specimen: Whole blood
• Inversion: 8x
• Uses:
• Hematology determinations
• Blood bank (K2)
EVACUATED TUBES
• Light blue top
• Contains: Sodium Citrate (3.2%)
• Specimen: Plasma
• Inversion: 3-4x
• Uses: Coagulation tests
• PT (Prothrombin time)
• PTT (Partial thromboplastin
time)
• TCT (Thrombin Clotting time)
• Notes: Maintain 1 AC:9 blood ratio
EVACUATED TUBES
• Dark blue/Royal blue top
• Contains: Heparin or K2 EDTA or clot
activator
• Specimen: Plasma or serum
• Inversion: 8x
• Uses:
• Toxicology and trace element testing
(Zinc, copper, lead, mercury)
• Drug level testing
EVACUATED TUBES
• Light Gray top
• Contains:
• Sodium Fluoride and Potassium
oxalate
• Specimen: Plasma
• Inversion: 8x
• Uses:
• Glucose determination
• Notes: Sodium Fluoride preserve
glucose for 3 days
EVACUATED TUBES
• Yellow top
• Contains: SPS (Sodium polyanethol
sulfonate)
• Effect: inhibit complement and
phagocytosis
• Specimen: Whole blood
• Inversion: 8x
• Uses:
• Blood culture collection
• Note: Sterile tube
EVACUATED TUBES
• Yellow top
• Contains: ACD (Acid citrate dextrose)
• Specimen: Whole blood
• Inversion: 8x
• Uses:
• Paternity testing
• DNA studies
• HLA phenotyping
EVACUATED TUBES
• Black top
• Contains: Sodium citrate (3.8%)
• Specimen: Whole blood
• Uses:
• ESR (Erythrocyte
sedimentation rate)
(westergren)
• Notes: Maintain 1 AC: 4 blood
ratio
 EVACUATED TUBES
• Pink top
• Contains: K2 EDTA
• Specimen: Plasma or whole blood
• Inversion: 8x
• Uses:
• Hematology determination
• Blood bank
• Special cross match label for patient
information
EVACUATED TUBES
• White top
• Contains: K2 EDTA and gel
• Specimen: Plasma
• Inversion: 8x
• Uses:
• Molecular diagnostic tests
EVACUATED TUBES
• Tan or brown top
• Contains: K2 EDTA (plastic)
• Inversion: 8x
• Specimen: Plasma
• Uses:
• Lead determination
 EVACUATED TUBES
• Orange top
• Contains: Thrombin-based clot activator with or
without gel
• Specimen: Serum
• Inversion: 5-6x (with gel), 8x (without gel)
• Blood clotting time: 5 minutes
• Uses:
• STAT serum chemistry
BUTTERFLY COLLECTION SYSTEM
• Winged infusion set
• Combines the benefits of the evacuated system
and the syringe system
• Used for small veins that are difficult to draw with
other systems
• Needle insertion: 5 degree angle
• A 21 or 23 gauge needle with attached plastic
wing on one end
BUTTERFLY COLLECTION SYSTEM
TOURNIQUETS
• Constricts the flow of blood in
the arm and makes the vein
more prominent.
• Size:
• 1 inch wide
• 15 to 18 inches long
• Soft, pliable, flat strip
• Made of: Non latex material
TOURNIQUETS
• Reuse:
• Contamination problem
• Application:
• 3-4 inches above the puncture
site
• Should be on the arm no
longer than 1 minute to
prevent hemoconcentration
TOURNIQUETS
• Blood pressure cuff
(sphygmomanometer)
• Alternative to a tourniquet
• Inflated to 40mmhg
• Use frequently with:
• Obese
• Pediatric
• Geriatric patient
TOURNIQUET PLACEMENT
MICROCOLLECTION EQUIPMENT
• Lancets
• used to puncture finger or
heel
• Non-retractable lancet
• Hazard: After it was used
the blade is still exposed
• Blade is seen by patient
• Retractable lancet
Lancets
MICROCOLLECTION EQUIPMENT

• Capillary tube
MICROCOLLECTION EQUIPMENT
• Micro-collection tube
• Small non-sterile, plastic
tubes
• Hold approx. 600 microliters
SAMPLE COLLECTION TRAY
• Phlebotomist needs sample
collection tray or cart to hold all
equipment necessary for proper
sample collection
• Should be disinfected once a
week, preferably with 10%
bleach solution.
 SAMPLE COLLECTION TRAY
• Alcohol swab • Butterfly collection set
• Gauze or cotton ball • Microcollection equipment
• Evacuated tube holders • Tourniquets
• Assorted evacuated tubes • Gloves
• Syringe • Sharps container
• Syringe transfer device • Marking pen
• Multisample needle
PHELEBOTOMY
MATERIALS
END OF
PRESENTATION
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