| Discussion Hemolysis can easily be caused by improper phlebotomy techniques. Hemolysis occurs when RBCs are broken up and hemoglobin is released into the plasma, causing it to become pink rather than its natural straw color. Hemolysis can occur by using too small a needle, pulling a syringe plunger too rapidly, expelling blood vigorously into a tube, or shaking a tube of blood too hard. Hemolysis can cause falsely increased potassium, magnesium, iron, and ammonia levels, and other aberrant lab results.In this case, Marcie did not properly wipe the site with gauze after cleaning it with alcohol, and alcohol contacting the blood could have caused RBCs to break up or hemolyze. Marcie also squeezed the baby’s foot too hard, causing hemolysis.Relevant topics:Site selection and preparation, Heelstick: Puncture, Hemolysis, Causes of hemolysis | View Page |
| Discussion Clotting of blood specimens may be caused by several factors. Clotting usually occurs due to improper phlebotomy technique,and clotted specimens will generally be rejected for those tests that require the blood to be mixed with an anticoagulant. When a clot forms in a tube containing anticoagulant, it usually indicates that the blood and anticoagulant aren’t in proper balance. That is why it is crucial to invert tubes with anticoagulant almost immediately after collection to ensure proper mixing of blood and anticoagulant. Relevant topics: Lavender top tubes, Light blue top tubes, Unsatisfactory specimens: Clots, Causes of clotting | View Page |
| Case A phlebotomist at an outpatient drawing station prepares to collect blood from a patient who is scheduled for surgery the next day. The patient tells the phlebotomist that she is afraid of needles. The phlebotomist assures the patient that everything will be fine. He seats the patient in a phlebotomy chair. He talks the patient through the beginning of the venipuncture and she seemed to be doing fine. As the second of four tubes is being drawn, the patient suddenly blurts out that she fells very dizzy and is going to faint. | View Page |
| Sterilization materials for phlebotomy Sterilization materials generally contain either:
Isopropyl alcohol (rubbing alcohol), usually in the form of prep pads, or
Iodine as povidone-iodine solution ( Betadine™, Purdue Frederick) in the form of solutions , swabs, or swab sticks.
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| Sharps disposal containers All sharps must be disposed in appropriate sharps disposal containers.
These are usually available in patient rooms, but may also be available on the phlebotomy tray depending on your institution’s policies and procedures.
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| Introduction to phlebotomy equipment The following section will familiarize you with the supplies & equipment you will need to collect a blood specimen.
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| Phlebotomy trays A Phlebotomy tray is used to carry blood drawing equipment to the bedside.Trays should be sanitized daily, & kept well-stocked and organized.
Phlebotomy trays may be sanitized using 10% bleach solution, or other appropriate disinfectant.
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| Insufficient volume Insufficient blood volume (short draws) within a collection tube containing anticoagulant will result in an incorrect ratio of blood to anticoagulant, and yield incorrect test results.Short draws can be caused by: A vein collapsing during phlebotomy.The needle coming out of the vein before the collection tube is full.Loss of collection tube vacuum before the tube is full. (Always keep extra tubes on hand.) | View Page |
| What is phlebotomy? Phlebotomy, also known as venipuncture, means collecting blood from veins.Phlebotomists, by definition, collect venous blood, but perform a variety of other important medical tasks as well. | View Page |
| Anatomy & physiology: essential to phlebotomy Since phlebotomy involves puncture of the skin (integumentary system) and veins,
(A component of the cardiovascular system), a basic knowledge of the anatomy and physiology of these systems is essential.
Knowledge of blood and its components is also important.
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