BALIUAG UNIVERSITY

HISTOPATHOLOGY AND CYTOPATHOLOGY TECHNIQUE

SY: 2ND TRIMESTER 2020 – 2021

Name: Dela Cruz, Albert Bryan R. Year Level: BSMT - 1

Date: February 11, 2022 Exercise #: 8

Evacuated Tube System

Title

Objective: The activity aims to help the students understand the concept about ETS and how it is done
based on its procedure. The activity also helps the students

Principle: The evacuated tube system or ETS is the most frequently used venipuncture method. Blood is
collected directly into the evacuated tube, eliminating needs of specimen transfer and minimizing
biohazard risks. ETS is consists of a double-pointed needle, a holder or adaptor, and color-coded
evacuated tubes.

Sample: none
Equipment and materials: pencil, paper, pen
Reagent used: none

Procedure:
1. Prepare the materials to be used for collection: ETS needle and adaptor, evacuated tubes,
tourniquet, antiseptic, cotton, and band-aid/gauze.
2. You can also use a blood pressure cuff as a tourniquet to eye a vein in antecubital fossa. It is
important to tie the tourniquet properly.
3. Carefully cleanse the puncture site with antiseptic (e.g. alcohol) since it is a universal precaution.
4. Carefully remove the cap of the needle and insert it to the adaptor. Make sure to secure it to its
place.
5. Lift the needle guard and remove the other cap of the needle. See that the hole in the bevel edge of
the needle is facing up and is aligned with the needle guard.
6. Take a shallow approach to the vein and the blood flashing back to the evacuated tube confirms
that you are in.
7. Gently oscillate the tube to mix the blood with the stabilizing agent (e.g. heparin) in the tube.
8. If you are drawing multiple samples and if you want to switch tubes while not causing discomfort to
the patient, make sure to steady your hand against the arm then pop the next tube in without
pushing the needle end deeper.
9. As you finished, one pull of the tourniquet and then place a cotton ball above the puncture site and
not on the needle.
10. Withdraw the needle straight back and place the cotton gently over the puncture site, applying
steady pressure.
 BALIUAG UNIVERSITY
HISTOPATHOLOGY AND CYTOPATHOLOGY TECHNIQUE
SY: 2ND TRIMESTER 2020 – 2021

11. Lift the needle guard back to the place, protect the puncture, and then dispose the sharp needle
immediately to its appropriate disposal container.

Illustrated procedure:

Reading, interpretation, recording and reporting: The activity helped in memorizing the procedure on
how you can extract blood through the use of ETS. The video helped the students to have an idea on
how ETS worked and why ETS is a safer method of venipuncture as it directly collects the blood sample
to the tubes, which is helpful to prevent specimen contamination.
 BALIUAG UNIVERSITY
HISTOPATHOLOGY AND CYTOPATHOLOGY TECHNIQUE
SY: 2ND TRIMESTER 2020 – 2021

Waste management and other safety precautions

Questions:
 List the things you will do in case of emergencies during collection like fainting, seizures, etc.
 Fainting or syncope: The phlebotomist should ask the patient if they have had problems with
blood collection or a tendency to faint. If the patient begins to faint during the procedure,
immediately remove the tourniquet and needle, and apply pressure to the venipuncture site.
 Seizures: Like in fainting, the tourniquet and needle should be removed, pressure applied to
the site, and help summoned. Also, restrain the patient only to the extent that injury is
prevented and do not attempt to place anything in the patient’s mouth.
 Vomiting or nausea: If the patient is nauseated, instruct the patient to breathe deeply and
slowly and apply cold compresses to the patient’s forehead. If the patient vomits, stop the
blood collection and provide the patient with an empty basin or waste basket and tissues.
 Additional Patient Observations: Phlebotomists must be alert for changes in a patient’s
condition (e.g. infiltrated or removed IV fluid lines or extreme breathing difficulty) and notify
the nursing station.

 What are the possible faults or problems you encounter during practicing collecting sample?
 The list below lists all the possible problems we might encounter during sample collection.
Sample Collection Complications
A. Failure to Obtain Blood
 Needle Position
 Bevel Against the Wall of the Vein
 Needle Too Deep or Shallow
 BALIUAG UNIVERSITY
HISTOPATHOLOGY AND CYTOPATHOLOGY TECHNIQUE
SY: 2ND TRIMESTER 2020 – 2021

 Collapsed Vein
 Needle Beside the Vein
 Faulty Evacuated Tube
B. Collection Attempts
 should select another site and repeat the
procedure using a new needle
C. Nerve Injury
D. Iatrogenic Anemia
E. Hemolyzed Samples
F. Reflux of Anticoagulant
G. Hematoma Formation
H. Syncope
I. Hemoconcentration
J. Circulatory failure
K. Thrombosis and thrombophlebitis
L. Allergic reactions and infections
M. Neurological and cardiovascular complications
N. Accidental Arterial Puncture