Phlebotomy Ch.14: Lecture 2

BC collection

  1. Prep site

scrub site w/ 70% alcohol to at least 1 1/2 in beyond puncture site

scrub w/ povidone iodine, then swab stick clean in concentric circles, inside to out and let dry

do not retouch site once cleaned

  1. Prepare collection equipment
  1. Collect samples and attend to pt

Blood donor collection

phleb. may be hired to work in blood banks as screeners and for collection

donors must be at least 17 yrs old, weigh at least 110 lbs, and not have donated blood in the past 8 weeks

screening includes registration, extensive interview and medical history, and a brief physical that includes a hemoglobin check

Volunteer

unit of blood is collected whose volume is about 450 cc

Autologous

blood donated by a pt for his/her own use during surgery

Therapeutic

the removal of blood as tx for polycythemia, too many rbc's, or hemochromatosis, excess iron in blood

Special Collections

Warm

cold agglutinin

test for antibodies to mycoplasma pneumonia

collect in prewarmed, red glass tube

test must be kept warm until serum is separated from rbc's or the antibodies in the serum will reattach to the rbc's and the test will be falsely lowered

chilled

chilling slows down metabolic processes that can alter test results

done by transporting the specimen in crushed ice, slurry, and delivery to the lab immed. for test

most common tests: ABG's, GBG's, and ammonia levels

Light Sensitive

exposure to light can cause some blood elements to break down and alter test results

for protection from light, wrap the tube in aluminum foil immed. after collection

most common tests: bilirubin, beta carotene, vitamin A, and B6 and porphyrins

Legal and Forensic Specimens

forensic types are those that may be used in legal proceedings; alcohol, drugs, DNA analysis, paternity

a chain of custody, COC, is the legal paper trail that maintains the integrity of the specimen from time of collection through testing process

legal alcohol collection

site must not be cleaned with alcohol of ANY kind

use a non alcoholic antiseptic, povidone iodine or chlorhexidine, or soap and water

fill the tube to minimize escape of alcohol into dead space

keep specimen capped until testing to prevent alcohol loss

Blood Smears

can be made from a dermal puncture or from a fresh EDTA tube not older than 2 hrs

are examined to differentiate the types of wbc's, to examine shape of RBC's, to count reticulocytes and for special staining

STEPS

  1. prepare smear by placing a small drop about 1 in. from end of slide
  1. place edge of "spreader" slide in front of the drop using a 25-30 degree angle

When blood spreads along the slide, move the spreader forward in one fluid motion produce a smear that goes from thick to thin, covering about 2/3 of the slide and with a feathered edge

Malaria smears

caused by a bloodborne parasite of the genus Plasmodium

dx made by blood smears collected just before the onset of fever and chills when the parasite is multiplying

testing requires 2-3 regular blood smears plus a thick smear which must dry for at least 2 hrs and is stained to look for parasites