San Pedro College

School of Medical Laboratory Science

IMMUNOLOGY & SEROLOGY (MLS 412)

Learning Activity No. 1

The Proper Way to Perform Blood Extraction Using
Evacuated Tube System

Specific Learning Objectives:

At the end of this laboratory exercise, the student is expected to:

1. discuss the importance of performing Evacuated Tube System;
2. explain the advantages and disadvantages of Evacuated Tube System;
3. demonstrate the proper technique for blood extraction using Evacuated Tube
System;
4. analyze the step-by-step procedure of Evacuated Tube System method;
5. obtain a blood specimen from antecubital vein using the evacuated tube system.

Learning Content:

INTRODUCTION

Performing blood extraction using the evacuated system method is a common procedure
in medical and laboratory settings. This activity should only be conducted by trained
professionals or under the guidance of experienced instructors.

The procedure for Evacuated Tube System is recommended for extracting multiple
blood tubes in patients that have numerous laboratory tests. Multiple blood draw means that a
phlebotomist can collect blood samples using different tubes in one needle insertion. This
system is preferred because it is direct, efficient, relatively safe for the patient and the blood
drawer, and allows multiple tubes to be easily collected.

It is essential to follow proper hygiene and safety protocols when dealing with blood
samples.

Principle of the Test

MATERIALS AND EQUIPMENT

Evacuated blood collection tubes Sharps container

(various types depending on the required
tests)
Tourniquet Permanent pen
Sterile gauze pad Biohazard container
Antiseptic prep pad Disposable gloves
ETS needle (2-way needle) PPE
ETS adapter

TEST PROCEDURE

1. Preparation:
a. Wash hands thoroughly and put on disposable gloves and other personal protective
equipment.
b. Ensure the patient is seated comfortably or lying down.
c. Assemble all the necessary equipment and place them within reach.
d. Label the blood collection tubes with the appropriate patient and test information.

1
 2. Patient Identification:
Confirm the patient's identity by asking for their full name and date of birth.

3. Site Preparation:
a. Identify a suitable vein for blood collection, typically in the antecubital area of the arm.
b. Apply a tourniquet to the upper arm to help locate and stabilize the vein.
If not using a tourniquet, ask the patient to make a fist to increase blood flow to the
veins.

4.Vein Disinfection:
a. Clean the intended venipuncture site with a sterile alcohol swab.
b. Allow the area to air-dry before proceeding.

5. Blood Collection:
a. Take the blood collection needle and attach it to the evacuated tube adapter holder.
b. Confirm that the needle safety cap is intact and remove it just before use.
c. Using the non-dominant hand, anchor the patient's skin near the venipuncture site.
d. With the dominant hand, hold the needle at a shallow angle (about 15-30 degrees) to
the skin.
e. Insert the needle smoothly into the vein and look for a flashback of blood into the
needle's hub, indicating successful venipuncture.
f. Engage the vacuum in the evacuated tube by inserting the tube into the holder,
allowing the blood to fill the tube automatically.
g. Release the tourniquet or ask the patient to unclench their fist while maintaining
pressure on the venipuncture site with a sterile gauze pad.
h. Collect the required number of blood tubes in the specified order.

6. Tube Removal and Bandaging:

a. Remove the filled tubes one by one, gently mixing the blood in each tube as required
for specific tests.
b. After the last tube, withdraw the needle from the vein and immediately apply pressure
to the site with a sterile gauze pad.
c. Discard the used needle into the biohazard container.

7. Post-Collection Steps:
a. Label each blood collection tube accurately with the patient's details and test
information.
b. Thank the patient for their cooperation.
c. Dispose of any waste, such as gloves and used materials, in appropriate biohazard
containers.
d. Properly store the blood collection tubes for transportation to the laboratory.

Note: This activity should be performed in a controlled laboratory or healthcare

environment. Proper disposal of biohazardous waste and adherence to all safety
protocols are essential. In a real medical setting, additional steps, such as verifying the
patient's medical history and explaining the procedure to the patient, would be
performed. This outline serves as a general guide and should be adapted according to
the specific requirements and regulations of the laboratory or healthcare facility.

2
Phlebotomy procedure. After the site is prepared with an alcohol sterile wipe and gauze square,
(A) anchor the skin from below by pulling the skin tight with the thumb of your free hand. B: The needle
is gently inserted into the patient’s vein. C: Apply the first tube. D: Release tourniquet. E: Remove and
exchange tubes. F: After the appropriate evacuated tubes are filled, the procedure is terminated by
covering the venipuncture site with a square of sterile gauze and applying pressure. A sterile adhesive
bandage is then placed on the site. (Reprinted with permission from Ernst DJ. Applied Phlebotomy,
Baltimore, MD: Lippincott Williams & Wilkins, 2005.)

Reference:

1. Turgeon, M. L. (2012), Clinical Hematology: Theory and Procedures, Lippincott Williams

& Wilkins, 5th edition.

3
 San Pedro College
School of Medical Laboratory Science
IMMUNOLOGY & SEROLOGY (MLS 412)

Name__________________________________ Points Earned _______________________

Yr/Section ______________________________ Date _______________________________

Learning Activity No. 1

The Proper Way to Perform Blood Extraction Using
Evacuated Tube System

STUDENT LEARNING OUTCOME EVALUATION

Rating:
3 = Able to perform all the indicators
2 = Able to perform most of the indicators
1 = Most of the indicators are not performed
PRE-COLLECTION:
1. Wearing of Personal Protective Equipment
2. Introductory
3. Identification of patient
4. Explains the purpose/procedure of
the method
COLLECTION:
1. Properly position the patient
1. Cleansing of the puncture site
2. Application of tourniquet
INDICATORS 3 2 1
a. Wears complete PPE
b. Gloves are worn in front of the patient
c. Gloves are worn prior to performance of any
procedure
a. Greets the patient before interacting
b. States his/her name
c. Asks for the patient request form in a polite and
friendly manner
a. Allows the patient to state his/her name
b. Name asked is complete (first and last name)
c. Asks for the age of the patient
d. Verifies patient information with information in
the request form
e. Verifies if patient do not have any allergies to
latex
a. Purpose/Procedure to perform is explained
comprehensively
b. Assures the patient that the procedure is painful
but tolerable
c. Done in an understandable manner
a. Make sure that the patient is seated comfortably
b. Instructs the patient to extend arm
c. Properly position the arm of the patient
a. Proper disinfection is done
b. Disinfection is done with appropriate equipment
c. Allows the antiseptic to air dry
d. Cleansed puncture site was not touched once
again before the needle insertion
a. Applied in proper place and tightened properly
b. Application does not exceed 1 minute
c. Removes the tourniquet before disinfecting the
site

4

3. Palpation/Selection of the puncture site
4. Preparation of ETS needle and adapter
5. Insertion of needle
6. Filling of tubes
POST COLLECTION:
1. Labelling of specimen
2. Demonstrating patient care technique:
a. Stopping of bleeding
b. Courtesy to the patient
3. Cleanliness of the working area
TOTAL SCORE
d. Removes the tourniquet before removal of needle
e. Makes sure that tourniquet is not left on the
patient’s arm every time it is removed
a. Locates the vein using appropriate finger
b. Checks both arms for the median vein prior to
choosing other sites
c. Chooses the most prominent vein
d. Makes sure not to palpate the vein again once
disinfection is done
a. Chooses the appropriate 2-way needle
b. Securely attaches the 2-way needle to adapter
a. Bevel facing up and done in smooth, quick
insertion
b. Needle angle and depth are correct
c. Needle adjustments are made
appropriately but not excessively
redirecting
d. Needle is inserted below the fold
e. Vein is anchored by stretching the skin
before inserting the needle
a. Chooses appropriate tube to use
b. Fills the needed tube to appropriate level
a. Ensures that the tube is fully and appropriately
mixed when necessary
a. Label is complete (Name, Age and Sex of the
patient, Date and time of collection, initials of
phlebotomist)
b. Penmanship is legible
c. Done in front of the patient
a. Place a cotton (with or without plaster) at the site
of puncture
b. Instructs the patient to apply pressure
c. Done in an understandable manner
a. Thank the patient
b. Shows politeness and respect to the patient
c. Done in a non-hostile manner
c. Give instructions to the patient on what to do
after (e.g., time results will be available)
a. Infectious, non-infectious, and sharp
materials are placed inseparate containers
b. Completely cleaned the area with no evidence of
mess
c. Done in a careful manner
5
 San Pedro College
School of Medical Laboratory Science
IMMUNOLOGY & SEROLOGY (MLS 412)

Name__________________________________ Points Earned _______________________

Yr/Section ______________________________ Date _______________________________

Learning Activity No. 1

The Proper Way to Perform Blood Extraction Using
Evacuated Tube System

GUIDE QUESTIONS:

General Instructions:
1. All answers MUST be in capital letters except for units of expressions.
2. Avoid erasures and alterations.

3 points 2 points 1 point

Neatness The work is exceptionally neat The work is very neat The work is not neat.

The answer is appropriate to The answer is appropriate to

Content unrelated to the
Content the question. The content is the question. Content may
question.
factually correct. have one or two factual errors.

1. What is the purpose of using an evacuated tube system for blood collection? How does it
differ from other blood collection methods?? (6 points).
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

2. In what order should blood collection tubes be filled when multiple tubes are required for
different tests? (6 points).
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

3. Discuss the role of the vacuum in the evacuated tube system and how it aids in blood
collection. (6 points).
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________