How to collect blood samples ?Collection procedure,Order of draw,tubes and tests,Personal safety -Pathinfotech

➡️ How to collect the blood Samples?

Blood collection is a part of the Medical diagnosis and analysis Procedure under a pathological laboratory. It's completely done by a phlebotomist.  Blood collection is not a single process, it's divided by many parts like Requisition Form, Site selection, Equipment, Collection, Order of Draw, Labeling the sample, etc. Commonly veins blood are required for laboratory analysis but some times are required arterial blood for special tests. Veins' blood is collected from the Antecubital area in a normal patient.

⏩ What is Requisition Form?

The requisition form is an essential part of the collection. This requisition form must contain the proper information to process the specimen.
The elements of the requisition form are:

• Patient's Name and address.
• Patient's ID number.
• Patient's age and sex.
• Date and time of collection.
• Reference Dr. Name.
• Source of specimens.
• Name of tests.

⏩ Blood Collection Equipment :

When patient identification was completed then we entered the collection process.
Some equipment is needed for collection. The elements are -

• Proper Collection Tube's (Vacuum/Non-Vacuum).
• Syringe (for a single draw)
• Vacuum needle with Holder (for multiple draws).
• Tourniquet.
• Alcohol Wipes / Cotton.( If we use Cotton then require 70% isopropyl alcohol for sterilization)
• Povidone-iodine - used for sterilization if blood culture specimen is drawn.
• Bandages / tape - for venipuncture site protection.
• Needle disposal container - for safety.
• Gloves, Mask, Apron - For personal safety.

⏩ Venipuncture Site Selection:

Antecubital fossa area is most commonly used for collection. The first choice is Median cubital, second choice Cephalic veins then choose others. These two types of veins are used more frequently. Wrist and hand veins are also acceptable for collection.

⏩ The proper method for Tourniquet application :

 

Wrap the tourniquet around the arm 3 to 4 inches above the venipuncture site.

keptcross-shapedwith tourniquet maintaining tight.

Holding the tight and tuck one portion of the tourniquet under the arm.

Check that the tourniquet will not come loose.

 ⏩ Blood collection Procedure :

• Identify the patients correctly.
• Patients condition - like Fasting, Medications, timing, treatment, etc.
• Apply the tourniquet 3-4 inches above the selected puncture site.
• Select the vein ( if vein does not look well then pump the hand.
• Sterilize the selected area by using the alcohol wipes otherwise use cotton with 70% alcohol. (Rules is - From the center to the outside)
• Then sterilized by Povidone-iodine and again use Alcohol wipes.
• After sterilization, insert the needle into the vein at a 15-30 degree angle and collect the blood.
• When enough blood has been taken, first remove the tourniquet then the needle.
• Press down a cotton boll to stop bleeding on the puncture site.
• Dispose of the needle immediately and draw the sample in appropriate tubes.
• Then labels all the appropriate tubes and Deliver specimens to the laboratory.

⏩ Blood collection Order Of Draw:

Blood collection tubes must be drawn in a specific order. The standard order is - 

• First - draw blood culture tube
• Second - draw a non-additive tube ( and mixed thoroughly ).
• Third - draw coagulation tube.

⏩ Labeling The Blood Sample:
After the draw, proper labeling is an essential part of the results of the test match the patient. The elements of labeling are...

• Patients name
• Patients id no.
• Date and time
• And test name

⏩ Blood collection tubes and tests :

Purple top

• Using Anticoagulant EDTA
• Mainly used for all types of Hematological work.

Red top

• Serum separated by centrifugation.
• Mainly used for Biochemical tests, Immunological and serological tests.

Light Gray top

• Using anticoagulants Sodium fluoride and potassium oxalate. Its stop glycolysis process and preserve glucose at 4 to 5 days.
• Mainly used for lithium level and Glucose determination.

Light blue

• Using anticoagulant sodium citrate.
• Mainly used for Coagulation tests (Prothrombin time and APTT).

Red Gray top

• Serum separation tube (SST). Quickly separated clot and serum.
• Mainly used for Biochemical tests.

Light Green top

• Plasma separating tube (PST).
• Using anticoagulant lithium heparin.
• Mainly used for Biochemical tests.

Gold top

• Serum separator tube (SST). Quickly separate clot and serum.
• Mainly used for Biochemical tests, immunological and serological tests.

Black top

• Using anticoagulant sodium citrate (buffered).
• Mainly used for ESR determination.

Yellow top

• Using anticoagulant ACD (acid citrate dextrose).
• Mainly used for HLA tissue typing, paternity testing, DNA studies.

Yellow Black top

• Broth mixture
• Mainly used for Microbiology.

Brown Top

• Using anticoagulant Sodium heparin.
• Mainly used for serum lead determination.

⏩ Fingerstick collection technique :

The fingerstick collection technique is used to collect a small amount of blood. The best locations for finger sticks are the 3rd and 4th fingers of the hand. Do not use the tip of the finger or the center of the finger. Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface.

Procedure 

• Select the finger and clean it with alcohol wipes.
• Make a skin puncture just off the center of the finger by using a lancet.
• Collect drops of blood into the collection device or glass tubes.
• Hold a cotton ball over the puncture site for 5 to 10 mins.
• Labeled the tubes and deliver specimens properly to the laboratory.

⏩ Infants blood collection :

The infant's blood collection is more sensitive than other collections. Proper vein dose not mature in infants. The recommended location in a newborn baby is the heel.

Collection Procedure

• Warm the infant's heel at 42 C for 3 to 5 minutes. It increases the blood flow and helps to fast collection. Do not use high temperatures because the baby's skin is thin and maybe created a thermal injury.
• Sterilized puncture site by using cotton with 70% alcohol.
• Take a lancet and Run through a small bit just center of the heel. Create pressure and collect the blood drop by drop in collection tubes.
• Do not run through a deep bit, because the bone is close to the skin surface and susceptible to bone injury.

• When the collection is completed, take a cotton ball and hold the puncture site to stop bleeding.

⏩ Personal and patients safety control :

Safety is an important thing in every profession. Without safety create a big problem and going through your life the other root. So, all the time follow some rules which are helping to protect you and other peoples. The essential elements of personal and patients safety are...

• Use universal protect items, such as gloves, lab coat, mask, hat, Gogol, etc in the collection period.
• Clean the hand two times, before collection and after collection.
• Change gloves after each patient or when contaminated.
• Daily change lab coat.
• Change syringe to each patient after collection because its to spread many diseases.
• Knowledge with appropriate containers and dispose of items properly.
• Taken extra protection when you collect blood samples like HIV, HbsAg, HCV, etc patients and avoid any type of contamination.
• Clean up any blood spills on the floor by using hypochlorite.