Lesson 4 — Blood Collection Equipment, Additives, and Order of Draw Flashcards

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Blood Drawing Station

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A dedicated area primarily used for outpatient blood collection where phlebotomy supplies and seating are organized. It provides a controlled environment for safe and efficient specimen collection and patient processing.

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Phlebotomy Chair

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A specialized chair designed for patient comfort during blood collection, typically with an arm rest to support the limb during venipuncture. It helps stabilize the patient and provides proper positioning for the phlebotomist.

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Equipment Carrier

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A portable kit or cart used to hold phlebotomy supplies during collection. Hand-held carriers are used for STAT or mobile draws, while carts are used for routine sample collection in clinical areas.

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Gloves

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Personal protective equipment worn for every patient to reduce infection risk; a new pair must be used for each draw and must fit properly. Types include sterile and non-sterile varieties such as $Nitrile$, $Vinyl$, $Neoprene$, and disposable options.

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Antiseptics

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Chemical agents applied to skin to prevent harmful bacteria from entering the puncture site during venipuncture. They are used on the patient’s skin prior to needle insertion to reduce infection risk.

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Disinfectants

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Substances used to kill microorganisms on surfaces and instruments in the phlebotomy area. They are applied to work surfaces, equipment, and non-living items to maintain a clean environment.

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Hand Sanitizers

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Alcohol-based antiseptic solutions, often wall-mounted, used for hand antisepsis when handwashing is not immediately available. They complement handwashing and reduce microbial load on hands between patient contacts.

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Gauze Pads

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2x2 inch folded gauze pads used to apply pressure after venipuncture to help stop bleeding and protect the site. They are sterile and commonly used in post-draw care until hemostasis is achieved.

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Bandages

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Adhesive dressings applied over the puncture site to protect it after bleeding has stopped. They help keep the site clean and reduce the risk of contamination or re-bleeding.

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Glass Slides

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1x3 inch glass slides used in hematology for blood smear preparation and microscopic examination. They provide a flat surface for spreading and staining blood for cell morphology studies.

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Pen/Sharpie

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Permanent markers used for labeling patient specimens and documentation. Accurate labeling is critical to ensure specimen identification and avoid processing errors.

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Watch with Timer

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A watch or timing device used to monitor procedures that require timed steps, such as tourniquet application time or clotting assays. It ensures adherence to protocol timing for accurate test results.

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Biohazard & Sharps Container

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Specialized containers for the safe disposal of biohazardous waste and used sharp objects like needles. They prevent needlestick injuries and environmental contamination.

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Vein Locating Device

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A transillumination device used to help visualize and locate veins, particularly useful in patients with difficult venous access. It improves success rates and reduces patient discomfort when identifying suitable veins.

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Tourniquet

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A constricting device applied to an arm to temporarily impede venous blood flow and distend veins for easier palpation and puncture. It should be applied for the minimal time necessary to prevent hemoconcentration.

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Needles

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Single-use devices used to withdraw blood; they come in multiple types such as multi-sample needles, hypodermic needles, and winged infusion sets. Proper selection and disposal of needles are essential for patient safety and infection control.

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Needle Gauge

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A numeric system that denotes the diameter of a needle’s lumen where a higher gauge number corresponds to a smaller lumen. Correct gauge selection balances blood flow rate with patient vein size to minimize trauma.

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Evacuated Tube System

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A closed collection system composed of a double-pointed needle, tube holder, and evacuated tubes that draws blood by vacuum. It is efficient and reduces contamination and needle exposure during routine phlebotomy.

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Isopropyl Alcohol

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An antiseptic commonly used to cleanse the skin prior to venipuncture that is more effective than ethyl alcohol in many cases. It has been noted to have carcinogenic potential only with heavy, prolonged exposure, which is not a risk in routine topical use.

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Multi-sample Needle

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A needle designed for use with the evacuated tube system that allows multiple tubes to be filled during a single venipuncture. It has a double-ended design to pierce both the patient vein and the evacuated tube stopper.

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Hypodermic Needle

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A single-ended needle used with syringes for direct aspiration or injection; available in various gauges and lengths. It is often used for syringe draws or injections rather than multi-tube collection.

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Winged Infusion

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Also called a "butterfly" needle, this winged set is used for small or difficult veins and pediatric or geriatric patients. It includes short tubing and a luer attachment for compatibility with tubes or syringes and typically uses $23$–$25$ gauge needles.

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Syringe System

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An alternative blood collection method using a syringe and hypodermic needle to draw blood from patients with difficult veins. After collection, blood is transferred from the syringe into tubes via appropriate adapters to avoid contamination.

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Drawback Technique

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A method where the syringe plunger is pulled back to create vacuum pressure so blood fills the syringe barrel. This technique gives control during difficult draws but requires careful transfer to collection tubes afterward.

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Additives

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Chemical agents contained in collection tubes that serve specific functions such as anticoagulation, preservation, or culture enhancement. Additives may be sprayed-dried, liquid, or powdered and tubes should be inverted $3$ to $10$ times to mix the additive with the sample properly.

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Anticoagulants

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Substances in collection tubes that prevent blood clotting by either chelating calcium or inhibiting thrombin formation. Common examples include $EDTA$, $Citrate$, $Heparin$, and $Oxalates$, each used for specific laboratory tests.

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Special Use Anticoagulants

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Anticoagulant formulations designed for specialized testing and storage such as $Acid\text{-}Citrate\text{-}Dextrose$ and $Citrate\text{-}Phosphate\text{-}Dextrose$. They preserve cellular components for procedures like transfusion testing and certain cellular assays.

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Thixotropic Gel Separator

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A gel in certain tubes that moves between cells and serum or plasma during centrifugation to create a physical barrier. This separator inhibits cells from metabolizing analytes in the serum or plasma, preserving sample integrity.

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Trace-Element-Free Tubes

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Tubes specially manufactured to be free of trace element contamination and are typically used for toxicology or trace metal testing. They are often identified by a royal blue top to prevent contamination from tube additives or glass.

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Order of Draw

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A standardized sequence for collecting blood into tubes with different additives to prevent cross-contamination between additives and ensure accurate test results. Following the correct order avoids carryover of anticoagulants or preservatives that could alter downstream assays.

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SPS Yellow Top

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Tubes containing $Sodium\,Polyanethol\,Sulfate$ ($SPS$) used primarily for blood culture collections because they inhibit complement and phagocytosis. They preserve microorganisms during transport and improve culture recovery.

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Sodium Citrate Blue Top

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Tubes containing $Sodium\,Citrate$ at concentrations such as $3.2\%$ or at a ratio of $1:9$, used mainly for coagulation studies. The citrate chelates calcium temporarily to prevent clotting while preserving clotting factors for analysis.

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Non-additive Red Top

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Plain tubes without additives used for serum collection when clotting is permitted and no separator or anticoagulant is needed. They are commonly used for chemistry tests where serum free of additives is required.

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Heparin Green Top

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Tubes containing $Sodium$ or $Lithium\,Heparin$ used as anticoagulants for plasma chemistry analyses. Heparin inactivates thrombin to prevent clotting and allows rapid processing for many assays.

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EDTA Lavender Top

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Tubes containing $EDTA$ (ethylenediaminetetraacetic acid) that chelates calcium to prevent clotting, preserving cellular morphology for hematology tests. They are the preferred tubes for complete blood counts and blood smears.

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Gray Top Tubes

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Tubes containing glycolysis inhibitors such as $Sodium\,Fluoride$ coupled with $Potassium\,Oxalate$, used for glucose testing and to inhibit glycolysis. They stabilize blood glucose levels during transport and processing.

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Black Top Tubes

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Tubes containing $Sodium\,Citrate$ at a higher concentration such as $3.5\%$ or a ratio of $1:4$, typically used for sedimentation rate testing. The different citrate concentration is optimized for specific analytical requirements.

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Tube Inversions

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The recommended number of gentle tube inversions mixes additives with the blood without causing hemolysis; typical inversion counts range from $3$ to $10$ depending on the tube type. Proper inversion ensures additives function correctly and yields reliable test results.