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Questions and Answers
What is Capillary Puncture?
3rd or 4th finger for adults, heel stick for infants; lancet cut across ridges; hold the tube horizontal when filling. Don't squeeze finger too tightly or milk the finger. Wipe off 1st drop.
What can happen if the vein collapses during a blood draw?
If you pull on the plunger of the syringe too hard or too quickly during a draw, or use too strong of a vacuum for the vein.
What is an anticoagulant?
An agent used to prevent blood clotting and to keep the specimen whole blood.
What is the purpose of a red top tube?
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What is a tiger top tube also known as?
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What is the additive in a lavender top tube?
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What substance is found in a grey top tube?
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What should you do with the first drop of blood during a capillary draw?
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What veins are in the antecubital area?
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What is hemoconcentration?
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What is the purpose of a tourniquet in phlebotomy?
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What should a medical assistant do if a patient feels dizzy during a blood draw?
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What should be done after successfully drawing blood?
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What tests are included in a Complete Blood Count?
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What are Prothrombin time (PT) and Partial thromboplastin time (PTT) tests used for?
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What is measured in lipid studies?
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What does a chemistry panel measure?
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What hormones are included in a thyroid panel?
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What tests are included in MI studies?
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What is contained in spun uncoagulated blood?
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What is the difference between spun clotted blood and spun uncoagulated blood?
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Study Notes
Phlebotomy Techniques
- Capillary puncture is performed on the 3rd or 4th finger for adults and heel sticks for infants; wipe away the first drop to avoid contamination.
- Tourniquet should be placed 3-4 inches above the puncture site for no longer than 1 minute to prevent hemoconcentration.
Vein Anatomy
- Three main veins in the antecubital area: basilic, cephalic, and median.
Blood Components
- Erythrocytes, leukocytes, and thrombocytes represent the solid elements in blood, while plasma is the liquid portion containing clotting factors.
- Serum is the liquid portion of clotted blood, devoid of clotting factors.
Blood Collection Tubes
- Red top: No additive; used for serum studies including chemistries and hormones.
- Tiger top (Red/Gray): Contains clot activator; used for serum studies.
- Lavender top: Contains EDTA; for whole blood tests such as CBC and blood banking.
- Gold top: Clot activator; used for serum studies.
- Grey top: Contains sodium fluoride/potassium oxalate for glucose and alcohol testing.
- Light blue top: Contains sodium citrate; used for coagulation studies (PT, PTT) and must be filled to the proper level.
Common Procedures and Precautions
- Avoid squeezing the finger tightly during a draw to prevent vein collapse.
- Hemoconcentration can occur from prolonged tourniquet application or fist pumping.
- Properly label tubes and document the draw after collection.
Patient Care
- If the patient feels dizzy during a blood draw, immediately remove the tourniquet and needle, support the patient, and apply a cold compress to the neck.
Blood Tests
- Complete Blood Count (CBC) includes WBC, RBC, Hct, Hemoglobin, and platelet count.
- Coagulation studies include Prothrombin time (PT) and Partial thromboplastin time (PTT).
- Lipid studies measure cholesterol and triglycerides levels.
- Chemistry panels assess various electrolytes and metabolic functions.
Types of Blood Samples
- Spun uncoagulated blood has plasma on top, buffy coat in the middle, and red blood cells at the bottom.
- Spun clotted blood has serum on top and a clot at the bottom.
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