• COLLECTION OF BLOOD

AND
URINE
ses

CHARUMATHI .S
DIVYA DHARSHINI .V
IDA NANCY.S
FEDORA CHRISTY DORCAS
J
 What is blood collection
• The process of withdrawing blood from a
persons body for testing ,diagnosis,
donation,or treatment purposes

WHY
• Diagnostic testing
• Blood donation
• Therapeutic Reasons
• Monitoring treatment
 TYPES OF BLOOD SAMPLES
1.WHOLE BLOOD
whole blood is anticoagulated blood sampling
containing all formed elements as well as plasma
Uses:
• For complete haemogram or complete blood count
• Foetal haemoglobin determination
• Osmotic fragility
• Hb electrophoresis
• Coombs test
• Biochemical estimation of glucose and urea
 2.SERUM
When freshly collected blood ( without
anticoagulant) is
Allowed to stand in a tube for at least one hour
serum separates on the top while clotted blood
retractsat bottom Of tube . The yield of serum
can be increased by centrifugation at 3000 tpm
for 15 minutes
Uses:
• For quantitative biochemical determination
of most components of metabolism,
enzymes, hormones, marker
• Electrophoresis of proteins and
immunoglobulins
• Serum antibody tests

•
3. PLASMA
Plasma is obtained by centrifugation of
anticoagulantedblood (in comparison with serum
which is centrifugation of clotted blood) After
centrifugation plasma lies in supernatant the
tube ,bottom of tube contains RBC while junction
of plasma with sedimented RBC contains
leucocytes, platelets

Uses:
Coagulation studies
Factor assay
Test product of coagulation
TYPES OF BLOOD
COLLECTION
1.Venipuncture
• Site : mediancubital vein
purpose:blood test for diagnosis
eg: CBC, glucose, electrolytes
2.Capillary Blood collection
• Site: finger prick inadults and
heel prick in neonates
• Purpose: testing glucose,
hemoglobin
3. Arterial Blood collection
Site: Radial artery
Purpose: Arterial Blood gas analysis

4. Central line collection

Site: central veins ( subclavian ,internal
jugular)
Purpose: ICU / critical care patients with
central Venous catheters
 ANTICOAGULANTS

⚬ They are used to prevent clotting of blood

⚬ In such a way that the anticoagulants does not
cause any alteration in the blood plasma or
formed elements.
Some commonly used anticoagulants :

• Ethylene-diamine-tetra-acetate
(EDTA)
• Sodium citrate
• Double oxalate
• Heparin
• Sodium fluoride
 RED COLOUR
• VACCUTAINER
It facilitates the separation of serum from
blood
• Coated with clot activator like silica particles
• uses:
serology tests, electrolyte panels,
hormon assays, antibody detection.

Red colour vaccutainer

 EDTA
• Mechanism of action of k2EDTA as
anticoagulants is by removal of free
calcium from blood by chelation.
• Uses • Smear can be prepared
• CBC, TLC, DLC,RBC count,
platelet count, eosinophile count
 Sodium
citrate
• Trisodium citrate pentahydrate salt is used
• Prevents coagulation by loosely binding free
calcium ions of the blood in soluble complex,
calcium citrate complex
•
• Uses: It is the choice for anticoagulation studies
• Citrate blood is used in Westergren
method of ESR
 DOUBLE
OXALATE
• Oxalate combines with calcium in blood to form
insoluble calcium oxalate.
• Uses:
coagulation studies ,
used for CBC and ESR by wintrobe methods
 HEPARIN
• More expensive
• It does not cause any cell distortion
• Uses: coagulation studies,
red cell enzyme studies eg. G6PD and PK
deficiency.
osmotic fragility test
 SODIUM
FLUORIDE
• Used for estimation of blood
glucose and is not used for
hematologic tests.
• Acts by inhibiting red call
glycolytic enzyme pathway.
BLOOD COLLECTION
 PROCEDURE
1.Patient preparation
2.Gather equipments
3.Hand hygiene
4.Apply tourniquet
5.Select a vein
6.Clean the site
7.Insert the needle
8.Fill the tube
9.Remove the tourniquet
10.Dispose the needle
11.Label the tube
12.Check for any bleeding and post
URINE SAMPLE
COLLECTION
Urine reflects the physiological and Pathological states
of kidneys,urinary tract,and metabolic processes
INDICATIONS:
Urinary Tract Infections
Kidney diseases
Diabetes Mellitus
Pregnancy
Other Systemic diseases
TYPES OF URINE SAMPLES

1.By timing of Collection

2.By Collection Method
 • Random Urine Sample
TIMING OF • First morning urine sample
• Second morning sample
COLLECTION • Post Prandial urine sample
• Timed urine sample
Random • Collected at
samples unspecified times

• For General urinalysis

and routine screenings
First morning urine sample
• 8 hour sample
• Collected immediately after waking up
• Most concentrated
• Ideal for detecting pregnancy(hcg),proteinuria,
casts and cells

Second morning urine sample

Collected after the first urination ,typically two to four

hours later
 Post prandial urine sample
• a urine sample collected two hours after a meal.
• It's primarily used to assess glucose levels in the
urine
24 hours urine sample

• Collected over a full 24 hour

period to measure total
excretion of substances by the
kidneys
• Nephrotic syndrome,assessing
kidney functions,metabolic
disease
 • Midstream clean catch
BY COLLECTION METHODS
• Catheterised sample
• Suprapubic Aspiration
• Paediatric Urine Bag
 MIDSTREAM CLEAN CATCH
Most Common

• aims to minimize
contamination from bacteria
and other microorganisms on
the skin surrounding the
urethra
• In a sterile container
• For urine culture and
sensitivity,
UTI
 STEPS
Wash hands thoroughly with soap and
water,rinse and dry
Open the container but DO NOT TOUCH
INSIDE OF CUP OR RIM
For male
Retract Foreskin if present -cleanse the
urinary opening of penis
For Female
Spread labia -cleanse the area around the
opening
• Remove the Cap carefully,DO NOT TOUCH the inside of
the container,cap or rim
• Void urine,discard the first few drops pass into toilet
• Fill 2/3rd the container
• Replace cap and tighten it
• Bring to lab within 1 hour of collection or store
refrigerated for upto 24 hours
CATHETERISED SAMPLE

• Avoids contamination form urethra or external

genitalia
• To get a sterile urine sample in a person who cannot
urinate on their own
• urinary tract infection
• urinary retention
 SUPRAPUBIC ASPIRATION

• in infants and young children

• When sterile urine sample is needed
• When urethral catheterization is not possible
Paediatric urine collection bag
In neonates or children who cannot follow instructions
Risk of contamination
INDICATIONS:
 TYPES OF CONTAINERS

Clean catch or Non sterile 24 hr urine

sterile container container collection
⚬Non sterile plastic ⚬Opaque rigid plastic (HDPE)
⚬For general urine tests ⚬For tests requiring total
⚬sterile plastic
not involving culture urine output over 24 hrs (Eg:
container
(Eg: pregnancy test, creatinine clearance, protein
⚬For routine urine
dipstick) estimation)
analysts,culture and
⚬May or may not have ⚬holds 2-5 litres
sensitivity tests ⚬Contains preservatives (Eg:
⚬Screw top lid to lid
⚬disposable acid or boric acid)
prevent leaks ⚬Should be refrigerated or
⚬not suitable for
⚬holds 30-60ml kept cool during collection
microbiological
 TYPES OF CONTAINERS

Pediatric urine Urine Culture

Tube/ Special Containers
collection bag
⚬Soft plastic with adhesive ⚬Vacutainer
Vaccum sealed plastic ⚬For specific biochemical
strip tube tests
⚬For infants and small ⚬For transport to labs, (Eg:Catecholamines,
especially in automated
children Cortisol)
systems
⚬adheres around genital ⚬May contain HCl, thymol
⚬Contains a preservative
area or other stabilizers
(Eg: Boric acid)
⚬Comes in male and female
⚬Pre measured vacuum
designs for specific collection
⚬Must be transferred to a ⚬Reduces contamination
sterile container if culture is
 HANDLING AND
TRANSPORT
Purpose of test Storage Temperature Time limit

Routine urine analysis 2-8°C (refrigerated) Upto 24 hrs

Ideally processed
Urine culture and
2-8°C (refrigerated) within 2hrs; max 24
sensitivity
hrs
24 Hour urine Entire duration of 24
Refrigerated (2-8°C)
collection hr collection
Room temp (15-25°C)
Drug testing Refrigerate if delayed
if
Process ASAP;
Pregnancy testing Room temp (15-30°C)
refrigerate if required
As per test specific
Hormones/metabolites 2-8°C or frozen (-20°C)
instructions
precautions should be taken to avoid contamination and
less than 2
hrs
 URINE
PRESERVATION

Chemical (e.g.
Refrigeration Boric Acid) Freezing

⚬Up to 24 hrs ⚬24–72 hrs ⚬Days to weeks

⚬Urinalysis, culture, ⚬Culture, special ⚬Hormonal/
24-hour collections tests metabolite analysis
⚬Prevents bacterial ⚬Not for routine
overgrowth urine microscopy
 SPECIAL
CONSIDERATIONS

⚬Pediatric patient - use urine collection bag; transfer immediately

⚬Menstruation - Avoid unless necessary

⚬Vaginal discharge - May contaminate the sample(Instruct proper

cleaning before collection)

⚬Pregnancy testing - First morning urine is preferred (high hCG

concentration)

⚬Hormone/metabolite testing - freeze or use specific preservatives