MLS REVIWER FOR MIDTERM

Activity #5

blood specimen collection by venipuncture - The testing of laboratory specimens are

essential to the correct diagnosis, treatment and monitoring of the condition of a patient. -
70% of gathered data from the laboratory results are used by health physicians to
determine the disease or illness of a patient. - Inaccurate results and poor findings can lead
to the wrong treatment of a patient that will result to under-medication, over-medication
and even death as the worst-case scenario. - Finding a test 56% of misreading in
laboratories occur during the pre-analytical phase or before samples are subjected to tests.
Blood borne-pathogens are: Human immunodeficiency virus (HIV), Hepatitis B virus (HBV),
Hepatitis C virus (HCV). There are different safety precautions for a phlebotomist in handling
samples:

1. Abiding by isolation practices

2. Wearing proper personnel protective equipment (PPE)

3. Observing proper hygiene - Alcohol solutions may only be used as an alternative for
hand washing if the hands are not evidently contaminated or a phlebotomist did not enter
or stay in an isolation room with a patient infected with highly motile bacteria such as
Clostridium difficile.

4. Properly using safety device

5. Placing collection tray closely

6. Correctly packaging specimens

7. Labeling and cushioning specimens for transport

8. Reporting all accidental exposure to needle sticks and starting post-exposure prophylaxis
(PEP) when needed

9. Disposing entire assemblies including tube holders and needles after use

10. Disposing contaminated materials in designated containers

11. Decontaminating surfaces- surfaces exposed to potentially hazardous and infectious

matters should be decontaminated with disinfectants such as SODIUM HYPOCHLORITE.
Personnel who work in off-site facilities or physician’s office may be required to perform
initial work on specimens such as CINTRIFUGATION and SERUM or PLASMA SEPARATION.
Lessons in activities: Venipuncture is defined as the process of collecting or drawing blood
from a vein. There are two ways by which blood can be collected by venipuncture. The first
is using the needle and syringe which is also referred to as the open system. And the second
is through evacuated tube system referred to as the closed system. - Obtain and accession
the test request: manual requisitions, computer generated requisitions, barcode labels -
Explain the procedure to enlighten them, before dealing with patients wash your hands first
to avoid contamination of diseases or viruses. - Then, in doing venipuncture to the patients.
Ask them first their personal data like name, age and birthdate. Patients arm should be
supported firmly and arm should not be bent at the elbow. Supine patients should be arm
extended and not bent at elbow. The patient’s hands should be fist. Do not allow the patient
to pump (open and close) fist as this causes Hemoconcentration - In selecting venipuncture
site it should be bouncy and resilience. Use the tip of the index finger to palpitate the veins.
Do not draw from above an IV if necessary, have IV turned off for a minimum of 2 minutes.
Avoid burned, scarred or tattooed areas because it was already contaminated. - Avoid
drawing in the area of Hematoma, draw from below the site if there is no other alternative.
Mastectomy patients, draw from the side opposite of mastectomy whenever possible. If
patient has double mastectomy, the physician should be consulted usually to avoid the side
of the most recent mastectomy. - Use with antiseptic (70% isopropyl alcohol). Use circular
motion cleaning the anticubital fossa area. Do not touch an area that already clean to avoid
contamination. Applying tourniquet should be less than or exact 1 minute then remove it. -
In anchoring vein it should be 1 to 2 inches in placing your thumb. Have the patient make
fist and line up the needle bevel up in the direction of the vein. Insert the needle at 15
degrees to 30 degrees. After doing venipuncture, apply pressure using gauze on the site.
Put the details that are needed in order to easily distinguish a patient. In verifying the test
results, there will a signature from a phlebotomist or medical technologist, validator and
physician. Special test that requires procedure to follow: -putting on crushed ice (ammonia,
lactic acid, blood gases) - keeping it in warm (cold agglutinin, cryoglobulin) - protecting
from light (bilirubin)