Clinical Chemistry Lecture (SEM 1 2022) PDF

CLINICAL CHEMISTRY Lecture (Course) (Block) | PROF. (Name) | SEM 1 2022 slide that is used for specimens to be looked at under a microscope M1...

CLINICAL CHEMISTRY Lecture (Course) (Block) | PROF. (Name) | SEM 1 2022 slide that is used for specimens to be looked at under a microscope M1 ○ A Cover Slip is used to place over the specimen on the Microscope Slide. This FAMILIARIZATION OF LABORATORY holds it in place APPARATUS AND SAFETY Dropper - a slender graduated PRECAUTIONARY MEASURES tube used in a laboratory for measuring and transferring quantities of liquids from one INTRODUCTION container to another. Lab Equipment - one of the basic Pipette (Serological/Micropipette) - tools for Scientists to explore and Pipettes are a common laboratory discover. tool used to transport measured Beaker - a flat-bottomed cylindrical volumes of liquid and come in a container, usually with a pouring multitude of channels, lip, to measure, mix, and prepare displacements and construction liquids. materials. Test tube - a hollow cylinder of Bunsen Burner - a type of gas thin glass with one end closed, burner, commonly used in used for experiments in labs. chemical laboratories, with which a Test Tube Holder - This test tube very hot, practically nonluminous holder, or clamp, is 6.25 inches flame is obtained by allowing air to long with finger grips. Holds any enter at the base and mix with the size test tube. gas ○ The test tube holder is used Glass Stirring Rod - A glass, to hold test tubes when cylindrical-like stick that is used to they are hot and mix solutions in a beaker. Also untouchable. referred to as a “Swizzle Stick” Test Tube Rack - A plastic holder Triple Beam Balance - A triple used to hold test tubes or dry them beam balance is used to read the Erlenmeyer Flask - a bottle, mass of items. A triple beam usually of glass, having a rounded balance has three beams: one with body and a narrow neck, used 100 gram increments, 10 gram especially in laboratory increments, and 1 gram experimentation. increments Graduated Cylinder - a narrow, ○ First make sure to calibrate cylindrical container marked with the scale so that it reads horizontal lines to represent units zero when nothing is of measurement and used to placed on the pan, with all precisely measure the volume of weight to the left. liquids. Spectrophotometer - A Microscope - an optical spectrophotometer is an instrument having a magnifying instrument that measures the lens or a combination of lenses for amount of photons (the intensity of inspecting objects too small to be light) absorbed after it passes seen or too small to be seen through sample solution. With the distinctly and in detail by the spectrophotometer, the amount of unaided eye a known chemical substance Magnifying Glass - lens that (concentrations) can also be produces an enlarged image of an determined by measuring the object. intensity of light detected. Microscope Slide and Cover Slip Centrifuge - Centrifuge, any - A glass or plastic rectangular device that applies a sustained  centrifugal force—that is, a force prevents the return of venous due to rotation blood to the heart. The prevention ○ It separates the liquid and of blood flow to the heart causes solid portion of a solution the vein beneath the tourniquet to Hot Plate - An hot plate is flat become enlarged with blood. This surfaced device used for controlled technique allows the vein of the heating directly or using the hot interest to become easily palpable plate to create a heat bath. In the and visible to the phlebotomist. lab, a hot plate can be more useful Antiseptics - Antiseptic materials than a Bunsen burner because the such as alcohol pads are hot plate has the option of heating commonly used to disinfect the the substance slow as opposed to area to be punctured for the a rapid open flame heat source. collection of blood. Gauze pad or Cotton ball - At the completion of a venipuncture M2 procedure and prior to withdrawing the needle, a 2-by-2 inch gauze pad is used. These pads are used 2.1 - BLOOD SPECIMEN COLLECTION by phlebotomists to apply pressure to the venipuncture site and maintain sterilization. Syringe/Evacuated Tube System RATIONALE - These tools are used to puncture The first consideration in the a vein with the intention of measurement of blood analyte is obtaining venous blood for specimen collection. Specimens diagnostic testing. may include whole blood, serum or Evacuated Collection Tubes - plasma. Venous blood is a These are necessary for commonly used sample in most phlebotomists to complete Clinical Chemistry Analyses. In venipuncture procedures. These some cases, however, capillary tubes may be plastic or glass with and arterial blood may be used. a colored, rubber top. The color of This module focuses on each top will vary in accordance phlebotomy which is the act of with its additive to indicate the collecting blood samples from the specific diagnostic test to be patient using venipuncture. performed Venipuncture may be done either Requisition Form - These forms using the conventional needle and are also used during the syringe or through the use of identification process of each Evacuated Tube System (ETS), patient. Prior to the venipuncture composed of two-way needle, procedure, proper identification of adapter and color-coded each patient is required in order to evacuated tube. ensure proper healthcare is given to the appropriate individual. Sharps Container - The use of MATERIALS these containers are necessary for Personal Protective Equipment - the proper and safe disposal of Goggles, mask, gloves and lab used needles, syringes, lancets coat are the most commonly used and any tool that can cause an PPE to protect the laboratory incision. These containers are red personnel from exposure to in color with a biohazard sign and possible infectious agents. simply require the deposit of such Tourniquet - It is used as a vein used equipment. compressor. Consequently, it 2  VENIPUNCTURE PROCEDURE 12. Remove the needle from the 1. A phlebotomist must have a patient's arm using a swift professional, courteous, and backward motion. understanding manner in all 13. Place gauze immediately on the contact with all patients. puncture site. Apply and hold 2. The first step to the collection is to adequate pressure to avoid positively identify the patient by formation of a hematoma. After two forms of identification; ask the holding pressure for 1-2 minutes, patient to state and spell his/her tape a fresh piece of gauze or name and give you his/her birth Band-Aid to the puncture site. date. Check these against the 14. Dispose of contaminated requisition (paper or electronic). materials/supplies in designated 3. Check the requisition form for containers. requested tests, other patient information and any special draw requirements. Gather the tubes 2.2 - PREPARATION OF SERUM AND and supplies that you will need for PLASMA the draw. 4. Position the patient in a chair, or sitting or lying on a bed. 5. Wash your hands. RATIONALE 6. Select a suitable site for Serum and plasma represent the venipuncture, by placing the straw (yellow) liquid portions of tourniquet 3 to 4 inches above the clotted and unclotted blood, selected puncture site on the respectively. Anticoagulants may patient. be added to blood collected 7. Do not put the tourniquet on too through the capillary, venous, or tightly or leave it on the patient arterial puncture to prevent clot longer than 1 minute. formation. In most clinical 8. Next, put on non-latex gloves, and chemistry determinations, the palpate for a vein. serum is more preferred than 9. When a vein is selected, cleanse plasma. Whether serum or plasma the area in a circular motion, is used, it is important that the beginning at the site and working specimen should be free from outward. Allow the area to air dry. hemolysis, lipemia, and icteric, as After the area is cleansed, it should these sample variations greatly not be touched or palpated again. affect results of the analysis, which If you find it necessary to consequently may lead to incorrect reevaluate the site by palpation, patient's diagnosis. the area needs to be re-cleansed before the venipuncture is performed. 10. Ask the patient to make a fist; avoid “pumping the fist.” Grasp the patient’s arm firmly using your thumb to draw the skin taut and anchor the vein. Swiftly insert the needle through the skin into the lumen of the vein. The needle should form a 15-30 degree angle with the arm surface. Avoid excess probing. 11. When the last tube is filling, TYPES OF SAMPLES remove the tourniquet. Hemolyzed - rupture of RBCs so, HC released from RBCs 3  Icteric - Serum appears yellow due to high bilirubin Lipemic - serum appears milky or turbid due to high lipid MATERIALS Red-top and lavender-top Applicator stick Centrifuge Clean test tube Venipuncture materials PROCEDURE 1. Collect 5.0 mL blood from the patient's vein. 2. Transfer half of the bood into a plain (red-top) tube and the other half into a tube with anticoagulant (preferably EDTA or violet-top evacuated tube). 3. Let the blood samples stand for 15 minutes at room temperature to allow the blood to clot. 4. Using clean applicator stick, gently swirl the side of the tube for the clotted blood. 5. To the EDTA tube, invert the tube gently for eight times to ensure adequate mixing of blood with the anticoagulant. 6. Centrifuge blood at 2,000-2,500 rpm for 10 minutes. Keep container stopper to prevent evaporation. 7. Separate the yellow juice both tubes and transfer to a clean dry test tube. 8. Compare the appearance of serum and plasma in terms of clarity of the specimen. 4