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Specimen Collection

The document provides guidance on blood specimen collection through skin puncture and venipuncture. It discusses collecting microsamples from sites like the heel or fingers in infants and macrosamples using venipuncture in older children and adults. Common blood collection equipment is outlined including lancets, needles, and evacuated tube systems. Proper techniques like using a tourniquet, cleaning the site, inserting the needle at an angle, and avoiding arteries are described. Potential complications and ways to prepare different types of blood specimens with anticoagulants or separation gels are also summarized.

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Vera June Rañeses
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168 views

Specimen Collection

The document provides guidance on blood specimen collection through skin puncture and venipuncture. It discusses collecting microsamples from sites like the heel or fingers in infants and macrosamples using venipuncture in older children and adults. Common blood collection equipment is outlined including lancets, needles, and evacuated tube systems. Proper techniques like using a tourniquet, cleaning the site, inserting the needle at an angle, and avoiding arteries are described. Potential complications and ways to prepare different types of blood specimens with anticoagulants or separation gels are also summarized.

Uploaded by

Vera June Rañeses
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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B LO O D

S P E CI M E N
CO L L E CT I O N
SOURCES BLOOD
SPECIMEN

● Capillaries
● Arteries
● Veins
MICROSAMPLE

Skin Puncture
● Infants less than 6 months
● Young children if only a small
amount of blood is needed
● Adults - with difficult veins
- chemotherapy
Sites of Skin Puncture

● Infants: heel of the foot (medial or


lateral plantar surface)
● Older than 1 year: 3rd or 4th finger
● Margin of the earlobe
● Length of lancet: 1.75 mm
Skin Puncture Device

● Sterile blood lancet

● Needles (Clover’s, Hagedorn)

● Blades (Barb Parker, scalpel blade)

● Tenderfoot, Tenderlett
MICROSAMPLE
Sit e of P unct ure
MICROSAMPLE
Sit e of P unct ure
MICROSAMPLE

⮚ Capillary blood
⮚ Peripheral blood
⮚ Arteriolar blood

❖Mixture of VENOUS, ARTERIAL


and CAPILLARY blood
SITES TO BE AVOIDED

❑ Inflamed and pale areas


❑ Cold & Cyanotic areas
❑ Congested & edematous areas
❑ Scarred & heavily calloused areas
ERRORS IN SKIN PUNCTURE

❑ Sample error
❑ Excessive massage
❑ Excessive crying
MACROSAMPLE

❑ Open system
❑ Evacuated
Tube System
❑ Winged
Infusion Set
MACROSAMPLE
EQUIPMENT:
● Tourniquet
● Antiseptic solution
⮚ isopropyl 🡪🡪 iodine
⮚ chlorhexidine gluconate
⮚ benzalkonium Cl / Zephiran
● Syringe and needle
● Evacuated tube set
● Butterfly Infusion Set
Blood Collection
Ma cros a m ple Colle ct ion

Tourniquet: 3-4inches(7.5-10cm
above the venipuncture site)
Blood pressure cuff as
tourniquet: 40-60mmhg
Blood Collection
Ope n Sys t e m

Gauge: 21 – 23; 25
20G (steininger), 21G (rodak)
Length: 1 or 1.5 inches
( ½ to ¾ in. –butterfly needle)
Blood Collection
ETS
Arterial Puncture

● Mod. Allen’s Test


■ test for
collateral
circulation
● Radial (G23 - 25)
● Brachial (G18 - 20)
● Femoral
● 0.05 ml Heparin/mL
● Ice water
SITES OF COLLECTION:
Older than 3 y/o

⮲ Veins on the
antecubital fossa
⮲ Wrist vein
⮲ Veins of the dorsal
hand
⮲ Veins of the Foot
Blood Collection
Ma cros a m ple Colle ct ion
Blood Collection
Ma cros a m ple Colle ct ion
Blood Collection
Ma cros a m ple Colle ct ion

● SITES TO BE AVOIDED: Areas with


⮚ Edema
⮚ Hematoma
⮚ Scar
⮚ IV infusion
⮚ --Same side with mastectomy
Position Patient

Tourniquet
Application
Site Selection

Avoid arteries &


nerves
Needle
Insertion
Fill Tube
Complications of Venipucture

1. Immediate Local complication


● Hematoma
● Hemoconcentration
● Circulatory failure
● Syncope
Complications of Venipucture
2. Late Local Complications
● Thrombosis
● Thrombophlebitis

3. Delayed General Complications


● HIV
● Hepatitis
Specimen Preparation

● Whole blood
● Plasma
⮚ Anticoagulants
Principles _____

● Serum
⮚ DEFIBRINATION
Serum
P re pa ra t ion
Chemistry &
Red (glass) none
Serology

Red (plastic/ Chemistry &


Silica
hemogard) Serology

Yellow/gray &
Thrombin Chemistry
orange
Red/gray & gold
Clot activator
Chemistry
separation gel
Commonly Used Anticoagulants

● EDTA: (K2, K3, Na) – 1.5 mg/dL

Lavender Hematology

Pink spray-dried Blood Bank

Molecular
White EDTA & gel
Diagnostics

Tan (plastic) K2EDTA Pb Testing


Com m only Us e d Ant icoa g ula nt s
111
● EDTA
Concentration:
Anticoagulant of 1.5mg/mL of blood
choice for
Within 2 hours, it
hematologic cell
preserves the
counts and
cellular morphology
morphology
NOT for coagulation
tests
Chelation of calcium
forming insoluble
salts (same with
citrate and oxalate)
Commonly Used Anticoagulants

● Sodium Citrate:
⮚ 0.105 M / 0.109 M
⮚ 0.129M
⮚ Adv.

Coagulation
Light Blue Na Citrate
Ratio: 1:9

ESR
Black Na Citrate
Ratio: 1:4
Commonly Used Anticoagulants

● Heparin : 15 – 20 U/ml WB

Light Lithium heparin


Green/Black Chemistry
& gel
Green Na Heparin,
Chemistry
Li Heparin
Tan (glass) Na heparin Pb testing
Royal Blue Na heparin,
Chem; Trace
Na2EDTA
e. Toxicology
Commonly Used Anticoagulants

3 forms of EDTA: Platelet Satellitism


Na2EDTA: dipowder,
disodium salt( versene)

K2EDTA (spray dried):


recommended by CLSI
and ICSH

K3EDTA:liquid form Excessive EDTA =


(sequestrene)
membrane damage on
blood cells causing
shrinkage (dec Hct
and ESR results)
Ot he r Addit ive s
1
Other Tube Stoppers:
Gray Antiglycolytic agent
▪ NaF Glucose
▪ Li iodoacetate

Sodium Polyanethol
Yellow Culture
Sulfonate

BB; HLA
Yellow ACD
typing
TUBE STOPPER
ORDER OF DRAW RATIONALE FOR COLLECTION ORDER
COLOR
Yellow SPS
Minimizes chance of microbial
Blood cultures Sterile media
contamination
“stop,bottle
light red, stay put, green light, go”
all other additives affect coagulation
Coagulation tubes Light blue
tests
Glass nonadditive Prevents contamination by additives in
Red
tubes other tubes
Plastic clot Red; Red and gray
silica particles activate clotting and
activator tubes; rubber
affect coagulation tests
SSTs Gold plastic
Green and gray
Heparin affects coagulation tests and
rubber
Heparin tubes interferes in collection of serum
Light-green plastic
specimens
Green

Lavender *EDTA: more carry-over problems


EDTA tubes
Pink *NaF & potassium oxalate: affect Na+
and K+ levels.
Oxalate/fluoride
Pearl top *Oxalate: damages cell membranes and
tubes
Gray : abnormal RBC morphology.
✍End

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