1. Blood Collection Equipment
Chapter 6

2. 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

3. 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

4. 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

5. 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**

6. Tubes and their additives

7. Tubes 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

8. 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

9. Purple (Lavender)-Topped Tubes
Contain EDTA
Typically used for CBC(complete blood count)**
Hematological procedures
Blood-banking procedures
Molecular diagnostic testing
Under filled purple tops-
inaccurate cell counts
inaccurate hematocrit

10. 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

11. 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.

12. 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***

13. 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

14. Mottled-Topped, Speckled-Topped, 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

15. Pink-Topped Tubes Contain EDTA and are used for blood bank collections
Type and Cross for blood transfusions

16. Black Topped tubes Contains sodium citrate additive
Used for testing ESR (sed rate)**

17. Safety Syringes
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

18. 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

20. 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**

21. There are many manufacturers of venipuncture equipment
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

22. Needles
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

23. 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**.

24. 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

25. Tourniquets Types The pliable strap The Velcro type
The blood pressure cuff

26. 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

27. 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.

28. 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

29. 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.***

30. 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

31. 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

32. 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

33. Different manufacturers
Samplette micro blood collector
BD Microtainer tube
Microvette capillary blood collection system
SAFE-T-FILL capillary blood collection system

34. 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

35. 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