Download Blood Collection Equipment

Chapter 6
Venipuncture Equipment Includes:
• Vacuum tubes and safety-engineered needle
collection devices
• Tourniquet
• Supplies to cleanse the puncture site
Labeling supplies
• Gloves
• Special trays to transport blood specimens
Vacuum (Evacuated) Tube System
• Requires an evacuated tube, a special
needle, and a special safety plastic holder
(adapter) that covers the needle after
blood collection
• One end of the double-pointed needle
enters the vein, the other end pierces the
top of the tube, and the vacuum aspirates
the blood
Two Criteria used to Describe Vacuum
Tube Size
• External tube diameter and length
• The maximum amount of specimen
to be drawn into the vacuum tube
Additives in Tubes
• Additives- substances (gels, clotting activators or
anti coagulants) that are added in small amounts
to tubes to alter the specimen to make it
appropriate for analysis
• EDTA- ethyleneadiamine tetra acetic acid- anti
coagulant**
• Oxalates, citrates and EDTA prevent coagulation by
removing calcium and forming insoluble salts**
Tubes and their
additives
• Tube tops are color-coded according to the additive
• Serum, plasma, or whole blood for various assays
• Many coagulation factors are involved in blood
clotting, and coagulation can be prevented by the
addition of different types of anticoagulants.
• These anticoagulants often contain preservatives that
can extend the metabolism and life span of the red
blood cells (RBCs) after blood collection
Green-Topped Tubes
• Contain the anticoagulants sodium heparin, ammonium heparin,
and lithium heparin.
• These tubes are used in various laboratory assays
requiring plasma or whole blood.
• Should not be used for collections for blood smears.
• Used for most chemistry tests (electrolytes)
• BUN- Blood Urea Nitrogen*** kidney function
• Creatinine- kidney function
• Glucose
• Calcium
• CK- Creatine kinase-** heart damage
Purple (Lavender)-Topped Tubes
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Contain EDTA
Typically used for CBC(complete blood count)**
Hematological procedures
Blood-banking procedures
Molecular diagnostic testing
Under filled purple topsinaccurate cell counts
inaccurate hematocrit
Light Blue–Topped Tubes
• Contain sodium citrate
• Many coagulation procedures, such as
PT and
APTT** are done on blood collected in light
blue– topped vacuum tubes.
• If a light blue–topped tube is under filled,
coagulation results will be inaccurate must be
filled to the line
Red-Topped, Royal Blue–Topped,
Brown-Topped Tubes and Tan-Topped
Tubes
• Red-topped tubes are tubes without
anticoagulant for the collection of serum.
• Royal blue –topped tubes are used to collect
samples for nutritional studies, therapeutic drug
monitoring, and toxicology. **
• Royal blue–topped tube is the trace element
tube.
• The brown-topped tube contains heparin or no
additive and is used for blood lead values.
• The tan-topped tube is used for lead testing and
contains EDTA**
• Grey topped tubes contain sodium flouride used for glucose and lactic acid
has glycolitic inhibitor- prevents glucose breakdown***
Yellow-Topped Tubes
• Contains sodium polyanethol sulfonate (SPS).
• Used for blood culture specimen collections in
microbiology.
• Tubes containing ACD additive are use for
specialty blood banking
Mottled-Topped, SpeckledTopped, and Gold-Topped Tubes
• AKA: Serum Separation Tubes
•These tubes contain a polymer barrier in
the bottom of the tube.
•During centrifugation, the polymer barrier
forms a barrier between the serum and
blood cells
Pink-Topped Tubes
• Contain EDTA and are used for blood
bank collections
• Type and Cross for blood transfusions
Black Topped tubes
• Contains sodium citrate additive
• Used for testing ESR (sed rate)**
• Used for patients whose veins are too fragile for blood
collection with vacuum tubes
• Hazardous and pose an increased risk of accidental
needle sticks
• Sometimes used for collecting blood from central venous
catheter (CVC) lines (RN performed)
• Consist of a needle, safety cover, hub, barrel, and
plunger
Safety Syringes
• The syringe needle should be shielded
after blood collection, removed, and
discarded in a sharps disposal container.
• The BD blood-transfer device is attached
to the syringe, and a vacuum tube is
inserted into the transfer device.
• The blood is transferred from the syringe
to the tube using the tube’s vacuum
Gauge and Length of a Needle
• The gauge number indicates the diameter of the
needle; the smaller the gauge number, the larger the needle diameter
**and higher the flow rate.
• Larger (16- to 18-gauge) needles are used for
collecting donor units of blood (450 mL or less)
• Smaller (21- and 22-gauge) needles are used for
collecting specimens for laboratory assays. (this is
typically what you will be using)
• Color coding of needles indicates gauge size**
• There are many manufacturers of
venipuncture equipment. The type of
equipment depends on the facility.
• Essentially, they are all the same
• Familiarize yourself with the equipment
that your facility uses
• Sterilized and packaged by vendors in
sealed shields that maintain sterility.
• Check the tip of each needle for damage.
• Multiple-sample needles are used with
vacuum collection tubes and the holder to
allow for multiple tube changes without
blood leakage within the plastic holder
The Butterfly Needle (Blood
Collection Set)
• Also called a blood collection set or winged
infusion set
• The most commonly used intravenous device
• The most common butterfly needle sizes are
21 and 23 gauge and the length of these
needles range from ½ to ¾ inches long.
• These safety needles each have a shield that
automatically covers the contaminated needle
point upon withdrawal from the patient’s vein
• Highest rate of needle stick injuries**.
Needle and Other Sharps Disposal
• Must be discarded in rigid, leak-proof, plastic
containers.
• Each unit is usually orange or red.
• Disposable as biohazardous waste
Tourniquets
Types
• The pliable strap
• The Velcro type
• The blood pressure cuff
• Non-latex disposable tourniquets are now
available.
• If the tourniquets used in the health care facility
are not disposable, they must be wiped frequently with 70
percent isopropyl alcohol and disinfected with a chlorine bleach
dilution of 1:10 if contaminated with blood or
other body fluids.
• Provide a barrier to slow down venous flow
Gloves for Blood Collection
• Use non-latex gloves
• Do not use gloves with talcum powder
• Change gloves after each patients’ blood
collection
• Do not wash, disinfect, or reuse gloves.
Other items needed for blood collection
• .Antiseptics, Sterile Gauze Pads and Bandages
• 70% isopropyl alcohol preparation
• iodine swab sticks or pads** (for blood cultures) are
essential for blood collection
Micro collection Equipment
• Usually, skin puncture blood-collecting
techniques are used on infants, because
venipuncture is excessively hazardous.
• For infants, the Clinical Laboratory
Standards Institute recommends a
penetration depth of less than 2.0 mm on
heelsticks to avoid penetrating bone.***
Lancets and Tubes
• Different facilities use different manufacturers
Examples
• BD Quikheel Lancet
• BD Genie Lancet
• Tenderlett Automated Skin Incision Device
• Monoject Monoletter Safety Lancet
• Greiner Bio-One Lancets
Microcontainers
• For dermal sticks two additional equipment is
required-Plastic micro hematocrit capillary tubes
-Disposable narrow-bore pipettes that are
used for packed red cell volume in
microcentrifugation
Micro collection tubes
• Have colored bands; a red band indicates a
heparin-coated tube, and a blue band
indicates no anticoagulant
• Usually color coded according to the
established protocol for blood collection
vacuum tube tops
Different manufacturers
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Samplette micro blood collector
BD Microtainer tube
Microvette capillary blood collection system
SAFE-T-FILL capillary blood collection system
Specimen Collection Trays
• Taken on blood-collecting rounds
• Made of plastic (preferably latex free) that
can be sterilized
• Includes all necessary collection
equipment
• Prior to rounds- ensure that your tray is
fully stocked
Specimen Collection Trays
For Home Health Care Providers
• Carry an enclosed container with the
biohazard symbol visible on the outside
• Lockable, to protect the contents from
tampering or accidental contamination
• With a tight seal to reduce the risk of infection
from bloodborne pathogens due to spills or
accidents