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RAJESH MOHESS,CLT.
ORDER OF DRAW
Tube order:
1. Sterile tube (blood cultures)
2.Blue top (coagulation)
3.Serum tube (with or without clot
activator/gel)
activator/gel
4.Heparin tubes (with or without plasma
separator)
separator e.g.. Green, royal blue
5.EDTA tubes
6.Glycolytic inhibitor tube
Rationale for Order of Draw
Coagulation tubes
Light blue
Collected first because all other additives affect
coagulation testing
Rationale for Order of Draw
Sterile - Stop
Light blue - Light
Red - Red
SST - Stay
PST - Put
Green - Green
Lavender - Light
Gray - Go
ORDER OF DRAW
Microbial contamination
Blood cultures detect organisms in blood
Special cleaning is necessary iodine
It is collected first to avoid contamination
from the non sterile tubes
Most of the time drawn separately
Carryover/cross contamination
Note:
To minimize carryover, make sure that you fill tubes from
bottom up and the contents does not come in contact
with the needle
EDTA tends to have the most carryover problems than
any other additive
Heparin causes the least carryover because it occurs in
the body naturally
If drawing specimen for trace elements (royal blue), it is
recommended to be drawn separately to avoid any
contamination.
If using a syringe system and collecting trace elements
afterwards, the transfer device should be changed
VENIPUNCTURE SITES
VENIPUNCTURE SITE SELECTION
PEDIATRICS
Increased anxiety both parents and child
Be compassionate and gentle
Take your time and gain the childs trust and confidence
Get help with restraining
ADOLESCENTS
Relax and anticipate anxiety from the patient
Maintain eye contact
May engage in conversation
DIFFERENT TYPES OF PATIENTS
ADULTS
Be honest and pleasant
Follow HIPAA rules
GERIATRICS
Be patient and pleasant and Treat with dignity and respect
Engage in conversation
May have to speak loud and slow for some patients
COMBATIVE PATIENTS
Some patients may be combative if you think you are in danger and
may get yourself hurt, do not attempt to draw notify your supervisor
ARTERIAL BLOOD DRAW
4. Sanitize hands
Hands can be washed or used sanitizer follow
facility protocol
VENIPUNCTURE PROCEDURE
9. Reapply tourniquet
Uncap and inspect needle (although rare needle may have
deformities)
Never leave the tourniquet for more than 2 minutes as it can elevate
certain tests, such as: alb, AST, Ca2+, Chol, iron, T. protein, T. bili
THE END