The first step in acquiring a quality lab test result for any patient is the specimen collection procedure. The venipuncture procedure is complex, requiring both knowledge and skill to perform. Several essential steps are required for every successful collection procedure: Show
Venipuncture Procedure:
Fingerstick Procedure:
Heelstick Procedure (infants):The recommended location for blood collection on a newborn baby or infant is the heel. The diagram below indicates the proper area to use for heel punctures for blood collection.
Order of Draw:Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. The recommended order of draw is:
Labeling The SampleAll specimens must be received by the laboratory with a legible label containing at least two (2) unique identifiers. The specimen must be labeled with the patient's full name (preferably last name first, then first name last) and one of the following:
Areas to Avoid When Choosing a Site for Blood Draw:Certain areas are to be avoided when choosing a site for blood draw:
Techniques to Prevent Hemolysis (which can interfere with many tests):
Blood Sample Handling and Processing:Pre-centrifugation Handling - The first critical step in the lab testing process, after obtaining the sample, is the preparation of the blood samples. Specimen integrity can be maintained by following some basic handling processes: How many minutes does it take for a specimen without additives to clot?(Minimum clotting time is 30 minutes for patients with an intact clotting process.) After allowing the clot to form, insert the tube in the centrifuge, stopper end up.
How many times should tubes with additives be inverted after collection?EDTA Tubes (Lavender Top)
Lavender top tubes must be adequately filled to ensure the correct blood to anticoagulant ratio. Gently invert the tube 8 to 10 times immediately after collection to ensure proper mixing with the anticoagulant.
Which is a possible occurrence for a coagulation specimen that was filled correctly but not mixed well enough?Which of the following is a possible occurrence if a blood specimen tube for hematology tests is filled correctly but not mixed long enough? Tiny clots will form in the specimen.
Which specimen should be chilled if there is a delay in specimen processing?Specimens for bacterial culture should be transported at room temperature. If transport is delayed the following specimens should be refrigerated: urines (within 30 min), stool (within 1 h), respiratory specimens. Specimens for viral culture must be transported to the laboratory immediately on ice.
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