1. Collecting, Processing, and Testing Blood Specimens48
Collecting, Processing, and Testing Blood Specimens

2. Learning Outcomes
48.1 Discuss the role of the medical assistant when collecting, processing, and testing blood samples.
48.2 Carry out the procedure for collecting a blood specimen.
48.3 Discuss ways to respond to patients’ needs when collecting blood.
48.4 Carry out the procedure for performing blood tests.

3. Introduction Medical assistant Collects blood specimens
Performs waived testing
Knowledge needed
Dealing with patients
How to obtain a blood sample
Appropriate supplies and equipment
How to perform and screen common blood tests
Learning Outcome: Discuss the role of the medical assistant when collecting, processing, and testing blood samples.

4. The Role of the Medical Assistant
Phlebotomy
Putting the patient at ease
Processing specimens and conduct testing
Completing necessary paperwork
Learning Outcome: Discuss the role of the medical assistant when collecting, processing, and testing blood samples.
The examination of blood can provide extensive information about a patient’s condition.
You will need
A basic understanding of the anatomy and physiology of the circulatory system.
A working knowledge of the functions of blood and the kinds of cells that make up blood tissue.
Refer to the chapters The Cardiovascular System and The Blood
Role includes
Phlebotomy – the insertion of a needle or cannula into a vein for the purpose of withdrawing blood.
Understanding how to process blood specimens and conduct various blood tests
Completing the necessary paperwork to ensure test results are handled efficiently and accurately.
Refer to OLC for the activity: Ordering Laboratory Tests

5. Apply Your Knowledge Very Good!
What is the role of the medical assistant related to collecting blood samples?
ANSWER: The medical assistant will put the patient at ease during the procedure, process specimens, conduct testing, complete necessary paperwork, and make sure specimens are handled properly.
Learning Outcome: Discuss the role of the medical assistant when collecting, processing, and testing blood samples.
Very Good!

6. Collecting Blood Specimens
Review the test order
Assemble equipment and supplies
Varies with test type
Collection devices ~ label correctly
Alcohol wipes; adhesive bandage
Tourniquet for venipuncture
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Reviewing the Test Order
Determine what tests will be run.
Office will have specific collection procedures.
Know the meaning of abbreviations used in blood testing.
Refer to Table 48-1 Common Abbreviations Routinely Used in Blood Tests.
Assembling the Equipment and Supplies
Equipment and collection devices vary with the type of test.
Label collection tubes, slides, and other containers as per policy.
Standard supplies
Alcohol, or povidone iodine or benzalkonium chloride, and cotton balls or alcohol wipes
Sterile gauze and adhesive bandage
Tourniquet – a flat, broad length of vinyl or rubber or a piece of fabric with a velcro closure used for venipuncture.

7. Collecting Blood Specimens
Preparing the patient
Greet and identify the patient
Confirm pretest preparation
Explain the procedure and safety precautions
Establish chain of custody
Handle an exposure incident
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Greeting and Identifying Patients
Introduce yourself, and explain that you will be drawing some blood.
Identify patients correctly before you begin.
Ask patients to state their full name and date of birth.
Verify that the name and DOB matches the order.
Confirming Pretest Preparation – determine if the patient has complied with pretest instructions.
Explaining the Procedure and Safety Precautions
Be clear and brief when you describe what you will do.
Follow Standard Precautions and assure the patient that these measures protect against exposure to infection.
Establishing a Chain of Custody – follow specific guidelines to establish a chain of custody for blood samples drawn for drug and alcohol analysis.
Handling an Exposure Incident – follow established procedure for handling exposure incidents.

8. Drawing Blood Know your scope of practice for your state Phlebotomy
Use Standard Precautions
Use appropriate PPE
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Some states permit medical assistants to obtain blood samples. If your duties include collecting blood samples, you will obtain them either through venipuncture or capillary puncture.
Refer to Procedure 48-1 Quality Control Procedures for Blood Specimen Collection
All phlebotomy procedures are a risk for exposure to contaminated blood or blood products.
Refer to Caution Handle with Care: Phlebotomy and Personal Protective Equipment
CONNECT to see a video about Quality Control Procedures for Blood Specimen Collection.

9. Drawing Blood (cont.) Venipuncture Evacuation systems
Double-pointed needle and collection tube holder
Decreased chance of accidental exposure
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Venipuncture – puncturing a vein with a needle and collecting blood in a tube or syringe.
The most common sites for venipuncture are the median cubital and cephalic veins of the forearm.
Practice using the venipuncture devices so your technique is smooth, steady, and competent.
Evacuation Systems
Several advantages over other methods of blood collection
Easy to collect several samples from one venipuncture site using the interchangeable vacuum collection tubes.
Tubes are calibrated to collect the exact amount of blood required.
Tubes are prepared with additives needed to correctly process the blood sample.
The potential for exposure to contaminated blood is reduced.
Refer to Procedure 48-2 Performing Venipuncture Using an Evacuation System

10. Drawing Blood (cont.) Needle and syringe systems Butterfly system
Winged infusion set
Less trauma to vein
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Needle and Syringe Systems
Collect blood using a sterile needle and syringe assembly when an evacuation system is not suitable such as for small or fragile veins.
Needle should be 23 gauge or larger.
The vacuum in the syringe is controlled by pulling the plunger back slowly.
The blood sample must immediately be transferred to a collection tube.
Butterfly Systems.
Use winged infusion sets for patients who have small or fragile veins.
A length of flexible tubing connects the needle to the collection device.
The inserted needle remains undisturbed while the collection device is manipulated causing less trauma to the vein and surrounding tissue than other venipuncture systems.
Generally uses a smaller needle (23 gauge).
Can be used with an evacuated collection tube or a syringe.

11. Drawing Blood (cont.) Collection tubes
Color-coded to identify appropriate additive such as EDTA
Be sure to select the correct tubes
Draw in correct order
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Blood samples must immediately be mixed with the appropriate additives in the correct collection tubes.
Tube stoppers are different colors identifying the type of additives, if any.
Since additives must be compatible with the laboratory process, the laboratory may choose which tubes to use for a particular test.
Additives include anticoagulants, like EDTA , and other materials that help preserve or process a sample for particular types of testing.
Be sure that you are using the appropriate collection tubes for the tests ordered.
Fill the tubes in a specific order to preserve the blood sample’s integrity by preventing carryover of tube additives from one tube to the next.
The National Committee for Clinical Laboratory Standards also publishes its recommended order of draw.
Refer to Table 48-2 Blood Collection Tubes.

12. Drawing Blood (cont.) Engineered safety devices
Reduce the possibility of needlestick injuries
Types
Retracting needles
Hinged or sliding shields
Self-blunting needles
Retractable lancets
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Engineered safety devices have been developed in response to the Needlestick Safety and Prevention Act.
According to the National Institute for Occupational Safety and Health (NIOSH), desired characteristics of engineered safety devices include:
Reliable performance
Easy to use, safe, and effective
Needleless when possible
Should not have to be activated by user or may be activated using only one hand
Once activated, cannot be deactivated

13. Drawing Blood (cont.) Capillary puncture Lancet
Superficial puncture of the skin
Sites ~ outer edge of finger or heel
Lancet
Automatic puncturing device
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
Capillary puncture
Blood may be collected in small, calibrated glass tubes, on glass microscope slides, or applied to reagent strips.
Sites:
Adults and children – the middle or the ring finger of non-dominant hand
Infants – one of the outer edges of the underside of the heel
Lancets – a small, disposable instrument with a sharp point used to puncture the skin and make a shallow incision.
Automatic puncturing devices loaded with a lancet.
Depth of puncture is mechanically controlled
More accurate and comfortable than the traditional lancet method.
Disposable platforms control desired depth of the puncture.
Advantages
Easy to use
The puncture depth can be easily adjusted
Automatic ejection button for lancet disposal

14. Drawing Blood (cont.) Micropipettes MICROTAINER tubes Reagent products
Smear slides
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
A micropipette
A small pipette that holds a small, precise volume of fluid.
Used to collect capillary blood for some tests.
Refer to Procedure 48-3 Performing Capillary Puncture
MICROTAINER Tubes
Small plastic tubes with a wide-mouthed collector which allows blood to flow quickly and freely into the tube.
Different colored tops indicate the additives.
Reagent Products – droplets of freshly collected blood to chemically treated paper or plastic reagent strips or small containers holding chemicals that react in the presence of specific substances or microorganisms.
Smear Slides – apply a drop of freshly collected blood to a prepared microscope slide

15. Apply Your Knowledge excellent!
What precautions should you take when collecting a blood specimen?
ANSWER: You should use Standard Precautions and appropriate personal protective equipment.
Learning Outcomes: Carry out the procedure for collecting a blood specimen.
excellent!

16. Responding to Patient Needs
Respond with sensitivity and competence
Provide information appropriate to patient’s needs
Answer questions that are within your scope of practice
Learning Outcome: 48.2 Carry out the procedure for collecting a blood specimen.
Be aware of possible sources of patient anxiety and understanding.
Patient Fears and Concerns
Decide how much information to give each patient and be prepared to answer questions.
Respond only to patient questions that are within your scope of practice.
Encourage patients to discuss other questions with the physician.

17. Patient Fears and Concerns
Pain
Bruises or scars – hematoma
Serious diagnosis
Contracting a disease from the procedure
Learning Outcome: Discuss ways to respond to patients’ needs when collecting blood.
Pain
Do not lie to the patient about the discomfort.
Ask the patient whether one arm is better to use than the other.
Consulting the patient helps the patient feel more in control and provides you with important information.
Bruises or Scars
Some bruising is possible; scars are unlikely
Hematomas can be prevented by releasing the tourniquet before withdrawing the needle and applying proper pressure over the puncture site after the needle has been withdrawn.
Serious Diagnosis
Explain that a blood test is one of the best ways to obtain an overall picture of health.
Explain why more than one tube of blood is needed.
Contracting a Disease from the Procedure
Explain the precautions you will take to prevent the spread of infection.
Allow the patient to see the precautions you take.
Use this opportunity to educate the patient about the transmission of AIDS.

18. Special Considerations (cont.)
Patients at risk for uncontrolled bleeding
Hemophilia or taking blood-thinning medication
Hold site for at least 5 minutes
Contact physician if bleeding does not stop
Learning Outcome: Discuss ways to respond to patients’ needs when collecting blood.
Some special needs and problematic situations are fairly common, and you must be prepared to deal with them.
Patients at Risk for Uncontrolled Bleeding
Patients who have hemophilia or are taking blood-thinning medications
Hemophilia – disorder in which blood does not coagulate at a wound or puncture site.
Follow the standard procedures for collecting a blood specimen.
In addition, hold several gauze squares over the puncture site for at least 5 minutes to make sure bleeding has stopped completely.
If uncontrolled bleeding does occur, call the physician immediately.

19. Special Considerations (cont.)
Difficult patients
Difficult venipuncture ~ do not stick more than twice
Fainting patients ~ position to avoid injury
Angry or violent patient ~ do not argue
Learning Outcome: Discuss ways to respond to patients’ needs when collecting blood.
The Difficult Venipuncture
If your first attempt at drawing blood fails, try again at another site.
If you cannot get a good sample on the second try, stop and ask for assistance.
Fainting Patients.
Patient who has a history of fainting or feels ill should lie down with feet elevated or knees drawn up while you complete the procedure.
If a patient does faint, notify the doctor
If there is a more severe reaction, notify the appropriate staff member and remain with the patient.
Refer to Caution Handle with Care: Venipuncture Complications
Angry or Violent Patients
Avoid arguing with the patient.
A patient has the right to refuse testing or treatment.
Do not attempt to physically force a patient to give a blood sample.
Report the problem to the appropriate staff, make a note on the order, and follow other established procedures.

20. Correct! Apply Your Knowledge
What is one precaution you can take when drawing blood from a patient who is taking anticoagulants?
ANSWER: After drawing blood on a patient taking anticoagulants, you should hold a cotton ball over the puncture site for at least 5 minutes, monitor the site carefully, and notify the physician if bleeding does not stop.
Learning Outcome: Discuss ways to respond to patients’ needs when collecting blood.
Correct!

21. Performing Common Blood Tests
Results aid in diagnosis
POLs – waived tests
Be familiar with other tests also
Learning Outcomes: Carry out the procedure for performing blood tests.
Refer to Table 48-3 Common Blood Tests and the Conditions They Help Identify.
Many POLs now perform only waived tests. Check with your employer about what tests your office performs regularly.
You should be familiar with a wide range of tests and the steps involved with each even if you do not anticipate performing them.

22. Performing Common Blood Tests (cont.)
Chemicals in lab
Anticoagulants
Serum separators
Stains
Range of normal test values
Learning Outcomes: Carry out the procedure for performing blood tests.
Chemicals you might encounter in laboratory work include
Anticoagulants – cause the blood to remain in a liquid, uncoagulated state.
Serum separators – form a gel-like barrier between serum and the clot in a coagulated blood sample.
Stains – color particular cells, making microscopic studies easier to complete.
Anticoagulants or serum separators are always present in blood-collection tubes and do not need to be added to the sample.
You must be absolutely clear about which chemicals are used for which tests and the precise amounts involved.
You must, in addition, know the range of normal test values so you can be aware of potential problems and note them for the doctor’s attention.
Refer to Table 48-4 Normal Ranges for Blood Tests.

23. Hematologic Tests Venous or capillary blood Whole blood
Formed elements
Plasma
Physician can order
Individual tests
Complete blood (cell) count
Learning Outcomes: Carry out the procedure for performing blood tests.
These tests can be performed on venous or capillary whole blood samples.
Whole blood contains the formed elements and the fluid portion (plasma).

24. Hematologic Tests Complete blood (cell) count RBC count
White blood cells
Differential WBC count
Learning Outcomes: Carry out the procedure for performing blood tests.
RBC count – the total number of RBCs in a sample;
WBC count – the total number of WBCs in a sample;
Differential WBC count – the percentage of each type of WBC in the first 100 leukocytes of a sample.

25. Hematologic Tests Complete blood (cell) count Platelet Hematocrit
Hemoglobin
Learning Outcomes: Carry out the procedure for performing blood tests.
Platelet count (automated) – the number of platelets in a sample, or a platelet estimate, which indicates whether the amount of platelets is adequate.
Hematocrit determination – how much of a sample’s volume is made up of RBCs after the sample has spun in a centrifuge.
Hemoglobin determination – the amount of hemoglobin by weight per volume in the sample.
Most POLs use automated equipment for performing blood counts.
Check your state regulations and office policy to find out if you are allowed to perform differential blood counts.
Know how to manually perform blood counts as a backup for the automated instrumentation. All manual counts are estimates.

26. Hematologic Tests Differential Cell count
Prepare a smear slide and stain the smear
Staining kits
Cell type / 100 leukocytes counted
Learning Outcomes: Carry out the procedure for performing blood tests.
Prepare a blood smear slide and stain the smear. Refer to Procedure 48-4 Preparing a Blood Smear Slide
A polychromatic (multicolored) stain simplifies a differential cell count.
Blood staining kits – follow the manufacturer’s instructions.
The dyes stain cell structures in ways that identify each of the five WBC types.
Neutrophils – dark purple nucleus and pale pink cytoplasm containing fine pink or lavender granules
Basophils – purple nucleus and light purple cytoplasm that contains large, blue-black granules
Eosinophils – purple nucleus and the bright orange granules in pink cytoplasm
Lymphocytes – large, dark purple nucleus surrounded by a small amount of blue cytoplasm
Monocytes – the largest WBC, has gray-blue cytoplasm
A total of 100 leukocytes are counted and recorded on a differential counter. Each cell type is expressed as a percentage of the 100 leukocytes counted.
Refer to CONNECT to see a video about Preparing a Blood Smear Slide .

27. Hematologic Tests (cont.)
Hematocrit
Centrifuge microhematocrit tube
Packed red blood cells
Buffy coat
Plasma
Compare column of packed RBCs to hematocrit gauge
Automated Hematocrit readers
Learning Outcomes: Carry out the procedure for performing blood tests.
Measure a patient’s hematocrit percentage by collecting a small sample of the patient’s blood in a microhematocrit tube. Then seal the tube and spin it in a centrifuge.
Heavier RBCs move to one end of the tube, and lighter plasma moves to the other end.
Between the RBCs, or packed red blood cells, and the plasma is the buffy coat containing the WBCs and platelets.
Using a hematocrit gauge, read the percentage of total blood volume represented by the RBCs.
Always run two samples of the patient’s blood specimen. Average the readings of the two patient samples. Repeat if samples are not within 2% of each other.
Procedure 48-5 Measuring Hematocrit Percentage After Centrifuge
Automated Hematocrit Readers – CLIA-waived testing devices for rapid and accurate measurement of hematocrit.
Refer to CONNECT to see a video about Measuring Hematocrit Percentage after Centrifuge .

28. Hematologic Tests (cont.)
Hemoglobin
Sample must undergo hemolysis
Color then evaluated
Automated hemoglobin analyzers
Measure amount of hemoglobin in whole blood
Follow manufacturer’s instructions
Learning Outcomes: Carry out the procedure for performing blood tests.
Hemoglobin resides within the RBCs.
The concentration of hemoglobin is determined in the blood by lysing the RBCs and evaluating the color of the sample.
The procedure may be done with a hemoglobinometer – a handheld device that makes color evaluation less subjective.
Several automated hemoglobin analyzers are now included on the CLIA ‘88 waived list.
They measure the amount of hemoglobin in a whole blood sample using a photometer.
Follow the manufacturer’s instructions.

29. Hematologic Tests (cont.)
Cell morphology – requires special training
Coagulation tests
PT and PTT
Automated devices ~ calculate International Normalized ratio (INR)
Learning Outcomes: Carry out the procedure for performing blood tests.
Morphology – the study of the shape or form of objects
Performed after the differential count and platelet estimate on the same slide.
Records the appearance and shape of cells for abnormal size, shape, or content and abnormal cell organization.
Not routinely done by medical assistants.
Coagulation Tests
Used to identify potential bleeding problems and monitor therapeutic drug levels for patient taking anticoagulant medication
Usually performed using automated devices.
Monitor the changing pattern of light transmission through the sample as coagulation occurs and calculate the INR (international normalized ratio)
Used to evaluate patients who are taking blood thinners like warfarin
Measures the amount of time it takes for the test sample to clot and compares it to a reference average.
Medical assistants sometimes perform these studies.

30. Hematologic Tests (cont.)
Erythrocyte sedimentation rate (ESR)
Measures rate of RBCs falling to the bottom of the blood sample
Tube must contain an anticoagulant
Read after one hour
Record as mm/hr.
Learning Outcomes: Carry out the procedure for performing blood tests.
Erythrocyte Sedimentation Rate
Diagnostic tool for inflammatory disease, cancer, and thyroid disease.
Transfer freshly collected, anticoagulated blood to a calibrated tube and place the tube in a sedimentation rack.
Examine the tube an hour later to determine how far the RBCs have fallen.
Test results are recorded as millimeters per hour (mm/hr).
Adhere closely to each manufacturer’s instructions when using these systems.
To ensure validity of ESR test
Use only fresh sample of blood.
Draw blood into a tube with anticoagulant additives.
Maintain lab temperature near 70 degrees Fahrenheit.
Position the sample tubes in the rack precisely.
Avoid vibrating or bumping the rack during the test.
Avoid introducing bubbles into the sample when transferring the blood into the tube.
Carefully watch the time and read the results in exactly one hour.

31. Chemical Tests Specialized equipment and techniques
Subject to CLIA ‘88 regulations
New automated equipment
More readily available
Simpler to operate
Development of new waived tests
Learning Outcomes: Carry out the procedure for performing blood tests.
Chemical tests are rarely performed in the POL because they require expensive, sophisticated equipment and techniques and are subject to strict CLIA ‘88 regulations.
Automated equipment for analyzing blood chemistry is becoming more available, less expensive, and simpler to operate than it was in the past.
New waived tests for an increasing array of chemicals in the blood are developed each year, making it more likely that you may use automated equipment to perform some blood chemistry tests.

32. Chemical Tests (cont.) Blood glucose monitoring
Routinely performed in POL
Glucometer
Patient education
Learning Outcomes: Carry out the procedure for performing blood tests.
Blood Glucose Monitoring
Routinely performed in the POL.
Measures blood glucose using a handheld glucometer.
Patient instructions
How to perform this test at home.
Stress the importance of following the manufacturer’s guidelines for correct operation.
How to manage diabetes.
Refer to Procedure 48-6 Measuring Blood Glucose Using a Handheld Glucometer and Educating the Patient: Managing Diabetes
Refer to CONNECT to see a video about Measuring Blood Glucose Using a Handheld Glucometer .

33. Chemical Tests (cont.) Hemoglobin A1c
Glucose molecules bind to hemoglobin
Provides overall picture of effectiveness of diabetes treatment
Options
Sent to outside laboratory
Perform in office
Home testing
Learning Outcomes: Carry out the procedure for performing blood tests.
Hemoglobin A1c
Used to monitor the health of diabetic patients
Measures the amount of glycosylated hemoglobin in the blood.
When blood glucose levels are elevated, the glucose molecules bind with hemoglobin to form hemoglobin A1c which remains for the RBC’s life (90 to 120 days).
HgBA1c test gives the physician a good overall picture of the patient’s compliance to and the effectiveness of diabetes treatment.
Options for performing this test include:
Sending it to an outside reference laboratory.
Performing it in the office laboratory if the necessary equipment is available.
Patient performing the test at home.
Always be done in conjunction with routine blood glucose monitoring.
Advantages of this testing include:
No pretesting preparation.
Better overall assessment of long-term blood glucose control
Checked two to four times per year with a target range of less than 7%.

34. Chemical Tests (cont.) Cholesterol tests Routinely performed in POL
Automated devices
POL
Home testing
Use a capillary sample
Learning Outcomes: Carry out the procedure for performing blood tests.
Cholesterol tests are performed on a routine basis in the POL.
Several automated devices are available for use in the POL and at home.
The analyzers test for a variety of blood chemicals, including glucose, total cholesterol, HDL cholesterol, and triglycerides.
The sample required is minimal and can be obtained with a capillary puncture.
There are several commercially available FDA-approved waived tests available.

35. Serologic Tests Detection a reaction to an antigen or antibody
Immunoassays
Western blot
Radioimmunoassay (RIA)
Enzyme-linked immunosorbent assay (ELISA)
Immunofluorescent antibody (IFA) test
Learning Outcomes: Carry out the procedure for performing blood tests.
Serologic test and immunoassay involve the introduction of an antigen or antibody into the specimen and the detection of a specific reaction to the antigen or antibody.
They can detect disease antibodies, drugs, hormones, and vitamins in the blood as well as determine blood types. They are also used to test urine and other body fluids.
Immunoassays
Medical assistants usually do not perform immunoassays but should be familiar with several immunoassay methods that have common applications.
Western blot – antigens are blotted onto special filter paper for examination; confirm HIV infection diagnosis.
Radioimmunoassay (RIA) – radioisotopes are used to “tag” antibodies.
Enzyme-linked immunosorbent assay (ELISA)
Enzyme-labeled antigens and substances that can absorb antigens generate reactions to specific antibodies.
These reactions are identified through visual or photoelectric color detection.
Detect HIV infection
Immunofluorescent antibody (IFA) test – dye colors specific antibodies; visible when the sample is examined under a fluorescent microscope.

36. Serologic Tests (cont.)
Rapid screening tests
Detect antibodies to certain infections
Infectious mononucleosis
HIV
Helicobacter pylori
Follow manufacturer’s instruction
Learning Outcomes: Carry out the procedure for performing blood tests.
Rapid Screening Tests.
Detect antibodies to certain infections
Infectious Mononucleosis
HIV
Helicobacter pylori
Explain their use to a patient.
The manufacturer’s guidelines must be carefully followed to ensure accurate results.
Refer to Procedure 48-7 Rapid Infectious Mononucleosis Test

37. Super! Apply Your Knowledge Matching: ___ Hemoglobin A1c A. ESR
___ Lysing RBCs/evaluating the color B. Serology test
___ Shape or form of objects C. Coagulation tests
___ Identify bleeding problems D. Chemical test
___ Rate at which RBCs fall E. Differential
___ Percentage of each type of WBC F. Morphology
___ ELISA G. Hemoglobin
ANSWER: D G F C
Learning Outcomes: Carry out the procedure for performing blood tests.
Refer to CONNECT to see activities about Sending a Patient’s Test
Report and Creating a Patient Order Form
Refer to OLC to practice ordering several laboratory tests in a live
EHR program. A E B
Super!

38. In Summary
48.1 As a medical assistant, you will collect and process blood specimens for examination, make sure the test results are handled efficiently and accurately, and complete the necessary paperwork before and after each test.

39. In Summary (cont.)
48.2 Blood is collected by venipuncture or capillary puncture.
When collecting blood specimens, it is essential that you:
confirm the patient’s identity
cleanse the skin prior to collection
follow standard precautions
collect the sample needed in the appropriate tube or container
ensure the patient’s safety.
48.2 Blood is collected by one of two means:
Venipuncture is the process of obtaining a blood sample from a vein.
Capillary puncture is the process of obtaining blood from a superficial skin puncture.
When collecting blood specimens, it is essential that you: confirm the patient’s identity before the sample is collected; cleanse the skin prior to collection; follow standard precautions; collect the sample needed in the appropriate tube or container; and ensure the patient’s safety at all times.

40. In Summary (cont.)
48.3 Patients may have concerns when having blood drawn. Good communication by the medical assistant is the key to easing these fears.
There are always patients who will have special needs. Each patient will present a special set of challenges and should be treated with the utmost care and concern.
48.3 Patients are often concerned about pain, bruising, and scarring when having blood drawn. They are sometimes afraid they may have a serious disease, especially if large amounts of blood are drawn.
Good communication by the medical assistant is the key to easing these fears.
There are always patients who will have special needs, including children, the elderly, patients who have bleeding disorders, and difficult patients.
Each patient will present a special set of challenges and should be treated with the utmost care and concern.

41. In Summary (cont.)
48.4 Hematologic, chemical, and serologic tests require special care when performing them.
The medical assistant should review the manufacturer’s instructions carefully for important information about correctly performing each test.

42. End of Chapter 48 Blood will tell, but often it tells too much.
~ Don Marquis