AC3 - CLINCHEM (LAB).pdf

ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS Used with both ETS and syringe method of obtaining Used to collect tiny amounts of blood obtained from blood specimens...

ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS Used with both ETS and syringe method of obtaining Used to collect tiny amounts of blood obtained from blood specimens capillary punctures Contains pre-measured vacuum Most have color-coded bodies or stoppers that Tube stoppers: color-coded to identify a type of correspond to color-coding of ETS blood collection additive, absence of additive, or special tube tubes property Made of glass or plastic ADDITIVE: substances you add in the evacuated BINDS: attaches to tubes ANTICOAGULANT: type of additive you add in tubes to prevent clotting CHELATES: consumes VENIPUNCTURE STOPPER COLOR ADDITIVE MODE OF ACTION LABORATORY USAGE INVERSION YELLOW SODIUM POLYANETHOL Prevent coagulation by binding MICROBIOLOGY (Blood Cultures) 8 inversions SULFONATE (SPS) calcium BLOOD BANKING ACID CITRATE DEXTROSE (Blood bank studies, HLA phenotyping, and DNA & paternity testing) LIGHT BLUE 3.2% BUFFERED SODIUM Prevent coagulation by chelating HEMATOLOGY 3-4 GENTLE CITRATE calcium (Coagulation Studies) inversions - Blood to anticoagulant - PT (prothrombin time) and ratio (9:1) aPTT (activated partial thromboplastin time): SENSITIVE TESTS RED SILICONE-COATED (Glass) Promotes blood clotting CHEMISTRY 5 inversions if (serum chemistry determination) with clot CLOT ACTIVATION activator (SILICONE-COATED) – Plastic BLOOD BANK (routine blood donor screening) No inversion for glass tubes IMMUNOSEROLOGY (diagnostic testing for infectious disease) GOLD PLASTIC NO ADDITIVE GEL SEPARATOR Promotes blood clotting CHEMISTRY 5 inversions (Thixotropic gel) - Blood clotting time: 30 (serum chemistry determination) - TG has a heavier specific minutes gravity than serum but is BLOOD BANK lighter than RBC (routine blood donor screening) IMMUNOSEROLOGY (diagnostic testing for infectious disease) LIGHT GREEN LITHIUM HEPARIN GEL Inhibits thrombin formation to CHEMISTRY 8-10 SEPARATOR prevent clotting (plasma determination in chemistry) inversions GREEN 15-20 u/mL LITHIUM HEPARIN or Inhibits thrombin formation to CHEMISTRY 8-10 SODIUM HEPARIN prevent clotting (blood gas analysis) inversions HEMATOLOGY (osmotic fragility test) LAVENDER 1.5 mg/mL of blood of Inhibits blood coagulation by CHEMISTRY 8-10 ETHYLENEDIAMINE chelating calcium ions (HBA1C) inversions TETRAACETIC ACID (EDTA) - HBA1C (glycosylated - Must be tested within a hemoglobin): most sensitive 4-hour duration of being test for diabetic patients as it used for optimal results could trace back one’s average blood sugar up to 3 months prior to test HEMATOLOGY (routine CBC, ESR) BLOOD BANKING (routine immunohematology testing and donor screening) ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS GRAY POTASSIUM OXALATE Oxalate prevents clotting by CHEMISTRY 8-10 - Anticoagulant binding calcium (glucose determination) inversions - IDEAL FOR FBS SODIUM FLUORIDE SODIUM FLUORIDE: preserves - Antiglycolytic agent glucose for up to and inhibits (stops cells from producing bacterial growth sodium-glucose) - Glycolysis: decreases glucose concentration by up to 10 mg/dL/hour Inhibits bacterial growth Can be stored for 3 DAYS ORANGE THROMBIN Clot activator CHEMISTRY - Blood clotting time: 5 (STAT determination) mins ROYAL BLUE NONE (red label) EDTA: prevents clotting by CHEMISTRY binding calcium forming (trace elements, toxicology) 8 inversions K2EDT (lavender label) insoluble salt HEPARIN (green label) HEPARIN: prevents clotting by inhibiting thrombin TAN SODIUM HEPARIN (Glass) CHEMISTRY (lead determination) K2EDTA (Plastic) PINK Spray-coated K2EDTA (Plastic) BLOOD BANK (routine immunohematology testing and blood donor screening) SPECIAL TUBE in BB Blood gas specimens EDTA specimens Other additive specimens Serum specimens 1. Immerse the pipet tip in the liquid to a level that will allow the tip to remain in the solution after the 1. FIXED-VOLUME PIPETTE: Pipette that measures volume of the liquid has entered the pipet. only one volume 2. The pipet should be held UPRIGHT, not an angle. 2. VARIABLE PIPETTE: Pipette models with different 3. Use a pipet (rubber) bulb to suction the liquid volumes to select above the desired graduation line. 4. The suction is then stopped. Remove the rubber bulb 0-1 mL is the widest volume range usually seen in a and cover the top of the pipet using your INDEX single pipette FINGER simultaneously. 5. Raise the pipet tip slightly out of the solution 3. MICROPIPETTE: pipetting capability of 1mL 6. Allow the liquid to drain until the bottom of the meniscus touches the desired calibration mark. 7. Wipe the tip with a tissue of any adhering liquid. NOTE: wipe the body of the pipet which was submerged in the solution, NOT THE TIP 8. Hold the pipette in a VERTICAL POSITION and the tip against the side of the receiving vessel when draining the pipet contents into the vessel. NOTE: more than half of the pipet should be submerged in the tube/container to avoid bubbles ➔ THUMB: used to press the rubber bulb ➔ INDEX: stops pipet ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS 1. If using a variable pipette, rotate the adjustment knob to the desired volume to be used. NOTE: Use the friction ring of the automated pipette to adjust the volume (STANDARD IN LABORATORY) 2. Take a tip out of the tip box by loading it into the pipette. 3. While maintaining a vertical grip on the pipette, press the plunger to the FIRST STOP. 4. Place the tip inside the liquid component being sampled and while the pipette tip is still submerged, slowly release the plunger to draw up the liquid. 5. Transfer the liquid to a receiving vessel by depressing the plunger until it stops at the SECOND STOP point to deposit the liquid. 6. Press the ejector button to remove the used tip and place it in the proper garbage can.