It is used in the identification of metabolic, respiratory, and mixed acid-base disorders, where CO2 levels require understanding or monitoring. If the patient is <6 years old, one (1) mL of blood should be drawn and discarded before the second blue top tube is filled, whether a syringe or a vacutainer is used. Do not leave the specimens in warm water for more than a few minutes after death. While the minimum volume necessary for testing is stated in the test menu, when clinically possible it is advisable to collect the preferred volume, as this will allow for repeat testing when necessary. Note: CSF samples for Beta Amyloid 42/Tau Protein Analysis must be collected in a special polypropylene tube to prevent adherence of the protein to the sides of the tube. Note that if a winged blood collection set ("butterfly") is used and the coagulation tube is the first tube drawn, a discard blue top tube should be used to clear the dead-space volume of the line or the line should be allowed to 'fill' prior to attaching the vacutainer adapter.
When drawing ONLY a (light) blue top tube for coagulation studies: If the venipuncture is promptly successful with a good flow of blood directly into the vacutainer, that single, filled tube may be submitted for coagulation studies. collecting a blood sample: 3 methods examined. **NOTE: Our testing is validated for BD vacutainers.
Venous Sample Collection Method. Please follow this link for some useful phlebotomy/specimen collection policies and procedures. Order in which multiple samples should be drawn: Blood samples should be collected directly into vacutainer(s) in the following order to prevent cross contamination of one tube with the additive of another tube that could result in spurious lab results. Please see the Specimen Collection section of our Microbiology Guide for collection information, including our Microbiology Specimen Collection Guide for … Patient welfare at the point of collection is not the only reason why this method should be considered the best way to collect a blood sample.
Complete filling of vacutainers (especially for coagulation testing): 4. Learn about insights, research, case studies, and tutorials on integrating remote specimen collection, microsampling, and more! All rights reserved. Transferring sample between tubes results in adulteration of the sample and will produce spurious test results. Check the expiration date of all tubes prior to collecting samples and discard any expired tubes. The laboratory offering the test should be contacted to determine the specifics of sample collection and handling; required samples range from hair to skin or blood. The long-term benefits to the patient include the loss of less blood and the ability to carry out testing at home, as a phlebotomist is not required for the procedure. Sputum Collection At least three consecutive sputum specimens are needed. * In general, because of the risk of bacterial contamination, if blood cultures are needed they should always be drawn first. �9���ndPe`l� Q�X` ѭ.7 Please note that specimens for Cytology should be submitted directly to the Department of Anatomic Pathology (not the UCSF Clinical Labs) with a paper copy of the APeX requisition. 3 Quality results begin with proper specimen collection! The tubes are stocked in the Memory & Aging clinic and are available from laboratory processing areas at each hospital.
endstream endobj startxref Citrate; Blue tops & ACD; Yellow tops) should always be filled to their full draw volume for chemical analysis; this is. %%EOF This method allows a specimen, which is not contaminated from external sources to be obtained without catheterization . Use of the Mitra Microsampler in Laboratory Developed Tests (LDTs) requires further processing including the establishment of performance characteristics and successful validation by the laboratory in a manner consistent with CLIA and/or other regulatory requirements.The Mitra Microsampling Device is a FDA listed Class 1 exempt device, CE-IVD self-certified in the UK and EU, a Class I IVD in Australia, and registered with Health Canada. The band/tourniquet retains blood within the arm and makes the veins more visible; Select the vein from where the sample is to be taken. The Mitra Device is a single-use, non-sterile device used as a specimen collector and for the storage and transport of blood or other biological fluids. PLAY. Unless otherwise specified, requested tests will be done on selected tubes as follows: Cell counts are preferably performed on Tube #3 to reduce the impact of blood contamination secondary to the procedure itself. An elastic band/ tourniquet is tied around the arm/ site. There are also risks related to the storage, transportation, and potential loss or contamination of the blood samples once they are collected. Midstream “clean-catch” urine collection is the most common method of obtaining urine specimens from adults, particularly men. heparin or saline). Venipuncture is the most common way to collect blood from adult patients. Each respiratory pathogen requires a unique set of specimen types, collection methods and handling conditions to optimize diagnostic yield. what veins are an acceptable alternative for venipuncture. Position the patient in a chair, or sitting or lying on a bed. Many blood-based analyses require collection into yellow-topped acid-citrate-dextrose tubes and … This will ensure that an adequate blood volume is collected. We recognize that this is not always possible, and will make every effort to provide a result on the sample submitted. Collection Method The method of collection should be checked when the specimen is received in the laboratory to ensure the type of specimen submitted meets the needs of the test ordered. Part 2 will cover sources of preanalytical artifact arising during urine collection, handling and transportation. Because these guidelines are There are also several potential contradictions that can affect the site of the collection, such as an abnormal modified Allen test or local infection. Laboratory phlebotomists have been instructed not to collect samples proximal to an IV, and will ask nursing personnel to stop the IV prior to phlebotomy and restart it after the samples have been collected. In all settings in which specimens are collected and prepared for testing, laboratory and health care personnel should follow current recommended sterile techniques, including precautions regarding the use of needles and other sterile equipment as well as guidelines for the responsible disposal of all biological material that is potentially hazardous as well as contaminated specimen collection supplies. min read. Specimens must be obtained in the proper tubes or containers, correctly labeled, and then promptly transported to the laboratory. Please see the Urine Preservative Table for important requirements relevant to chemical analyses of urine specimens. endstream endobj 814 0 obj <>/Metadata 35 0 R/OCProperties<>/OCGs[826 0 R]>>/Outlines 50 0 R/PageLabels 809 0 R/PageLayout/OneColumn/Pages 811 0 R/PieceInfo<>>>/StructTreeRoot 56 0 R/Type/Catalog>> endobj 815 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 816 0 obj <>stream This reduces pain and discomfort for the patient. the 3 methods of specimen collections. �W�k�ְ'�&���U�2��e���V��!��yQ�QN=�jV��%�aN��Oi[ n�qh�_��rYL����H����}@%ɘmM��d8�L�d+�`�祁�Vl4/��� venipuncture, capillary puncture, & arterial puncture, what veins are an acceptable alternative for venipuncture, 4 areas to avoid during the venipuncture procedure, hematomas, scar tissue, sides of previous mastectomy, side of paralysis, patient's first & last name; DOB & gender; name of physician; date & time collected; indication of testes requested; source of specimen, mixture of arterial, venous, capillary blood as well as interstitial fluid & intracellular fluids, when is it appropriate/acceptable to use the winged infusion needle, for most difficult draws- small veins, older patients, children; fragile veins in geriatric or cancer patients; difficult hand veins, difficult patient position, 3 reasons you would do a capillary puncture, infant blood needed; infant screening for PKU; & home or facilities testing of glucose for blood sugar monitoring, the hollow opening inside of the needle, that allows blood to flow through (expressed in gauges), the length of the needle (expressed in inches), the threaded part at the base that is used to connect the needle to the holding apparatus, rubber piece covering the second needle which can bounce back to cover the tip, stopping the flow of blood, allowing multiple tubes to be drawn from a single stick, plastic sleeve that the needle hilt screws into, which also serves as a tube holder, designed to be engaged immediately after withdrawing the needle from the patient to prevent accidental needlesticks and possible exposure to bloodborne pathogens, bevel, lumen, shaft/cannula, sheath/sleeve, hub/tube holder, safety device, what degree is an arterial puncture performed, Acknowledge, Introduce, Duration, Explain, Thank, 2 things that every specimen that is submitted to the lab must have, correct puncture depth, on infants, using the capillary collection method, at what angle should a blood smear be performed at, what is the safety mechanism on a lancet called, the correct angle for needle insertion when performing a venipuncture, the most common specimen collection system used in venipuncture, 3 main veins that run through the antecubital fossa, cephalic vein, basilic vein, median cubital vein, 4 arteries that run through the antecubital fossa, brachial, ulmar, radial, & deep palmar arch, glucose & cholesterol (fasting tests)- how many hours to abstain from food or liquids, specimens collected at specific intervals for monitoring certain medical conditions, will draw the specimen 30 minutes prior to the next scheduled dose of medication, when the medication is at the absolute lowest in the patient's blood stream, when the medication is at the absolute highest in the blood stream, used if the veins are prone to collapse or if the phlebotomist needs more control over the blood collection flow rate- uses collection needle, syringe, transfer device, used when smaller amounts of blood are needed from adults or infant- uses lancet, capillary tube or small collection tube, usually first choice in vein; has structural support, is large, least likely to develop a hematoma, 2nd best choice in vein; lies on the outside edge of the antecubital fossa, but makes positioning patient & needle slightly more difficult, last choice in vein; often on top of bone, tendon, artery & a major nerve; high risk of damage to underlying structures; difficult to enter, not supported well; more uncomfortable for patient, blood that has pooled & clotted in the tissue above the vein, dense collagenous fibers in the connective tissue, from previous injuries, that are very hard to penetrate with a needle, due to the removal of lymph nodes in the breasts, fluid called lymph, can collect in these areas & become infected & inflamed causing lymphedema &/or cellulitis, avoid this side of patient due to the their inability to feel; patient would not know if phlebotomist punctured an artery or hits a nerve, tendon or muscle, usually found in patients that are undergoing dialysis treatment, try to avoid drawing from the same side as in IN placement; if patient has IV in both arms, always draw BELOW the site of the IV, how to label a tube in venipuncture procedure, Patients last, first name & DOB; date & time; your initials, aka dermal puncture, skin puncture, and/or finger stick, palmar or lateral surface of the ring or middle finger of nondominant hand, earlobe, big toes & and in an infant, heel, another method of blood collection & is usually performed for analysis of blood gases; should be performed with no exposure of the blood drawn to air which prevents the escape of gases from the blood.