1. Drawing Blood And Collecting Diagnostic Samples

2. 1. Performing Blood Draws / Heel sticks 2. Labeling Specimens 3. Blood Bank Collections 4. Performing a Blood Culture Collection 5. Sample Issues 6. Collecting Diagnostic Specimens (Urine, stool, sputum,etc…)

3. 1. Wash hands 2. Identify the Patient 3. Prepare your equipment 4. Assess Patients Veins/don gloves 5. Perform Venipuncture 6. Collect all samples needed 7. Apply pressure bandage

4.  Use more than one alcohol prep pad to clean the draw site  Start in the middle of the site and move outward in a widening circular motion.  Allow to air dry ~ 30 sec.  DO NOT  Fan the site dry  Wipe/dab dry with a gauze pad Prepping the Puncture Site

6.  Identify the patient, wash hands and don gloves  Gather necessary equipment:  2.0mm lancet  Alcohol prep pad  Sterile gauze pads  Heel warmers

7.  Warm the site with a heating pack for ~ 5 min  Cleanse site with an alcohol prep pad  Remove safety clip from lancet and place the blade- slot flush against the incision site  Depress trigger  Lower heel below the baby, if possible  Wipe away first drop  Do not scrape or “milk” the site!  Bandage site with “Coflex”

8.  Complete all information  Do not contaminate filter paper circles by touching before or after blood collection  Once collected, lay flat to dry  Let dry at least 3hours

9.  Remember to label the specimen with:  time of collection  your initials  It may seem small, but the way a tube is labeled can slow the process of getting test results in a timely fashion.

10.  It is important to fill tubes to the proper fill line  This will allow a correct ratio of blood to additive, which will ensure sample stability and test accuracy.  Blood collection tubes have markings on the label or tube showing how much to fill

11.  MUST BE FILLED TO THE LINE!  Not under-filled or over-filled  We need the right ratio of anticoagulant to run the test  Using a butterfly needle? = PURGE THE LINE! Using the same tube type. Blue Top.  Air in the line will cause the tube to under-fill

13. The blood bank band is required for: -Type & Crossmatch -Emergency Release -RhoGAM Include the following information on the band: -Full Name -Date of birth -MRN -Your initials -Date & time of collection Remember to detach the label from the band and place on the sample tube!

14. NEW BAND = NEW SAMPLE! Never put a new label on an old sample! It does not matter what the situation is: If the original label has an error, a new sample is drawn and new band placed.

16. 1. Wash hands and don gloves 2. Gather the materials needed to draw the blood culture 3. Prep the culture bottle(s) with an alcohol pad, LET AIR DRY 4. First cleanse the site with an alcohol pad, LET AIR DRY 5. Second, use * Chlorhexidine * applicator to prepare puncture site – only for patients 1 year or older Use Povidone Iodine on infants 6. Scrub area for 2 minutes using a “ back-n-forth” motion 7. Mark the vials at the desired fill level for the correct amount of blood for each specimen. Use the following guidelines:

17.  Aerobic bottles only! We do not run anaerobic bottles at NSHC  Adult 8- 10mL  Pediatric 2.5 - 10 mL  Amount depends on size of child  Infant 0.5-1.0 mL maximum  Use a 3 mL syringe

18.  Mix the blood with the broth by gently rotating the bottle  Label the patient’s bottles with the barcode labels  Write collection site, time collected, and your initials on the bottle  If less than the recommended amount is collected, write the actual amount onto the bottle.  Put pressure bandage on collection site.

20.  Here are a few ways to prevent the sample from being hemolyzed:  Use the largest bore needle that’s appropriate  Never draw blood through a hematoma  Do not remove the needle while a collection tube is still attached  If using a syringe, avoid drawing the plunger back too forcibly or quickly, this can rupture blood cells  DO NOT PUSH THE PLUNGER WHEN FILLING THE TUBE! The vacuum will do it for you!  Gently invert tubes! Don’t shake!

21.  Rolling vein – Anchor it!  Puncture through vein – Bail!  When you pull back the needle, you’ll see a hematoma start to form.  Bevel on the wall of the vein – Pull back just a little  Collapsed vein – Use a syringe  The needle is partially inserted – Go further in

22.  Discussion on collection of urine, stool, and sputum.

23. Thank you for your time! ……… Anyone who would like some practice call the lab and ask for Dainard at ext. 3216