Procedure of Specimen Collection Blood

Procedure of Specimen Collection Blood

General Guidelines
■ Verify if Pt has allergies to latex, iodine, adhesives.
■ A tourniquet should not be left in place longer than 1 minute.
■ Previous puncture site areas should be avoided for 24–48 hours.
■ Specimens should never be collected above an IV site.
■ Order of draw: If multiple tubes are required, they are collected in the following order: blood cultures, red or red marble top with gel, light blue, green, lavender, and then gray.

Procedure
■ Prepare the patient: Explain the procedure to the Pt and offer reassurance.
■ Supplies:Tourniquet, skin cleanser, sterile 2x2 gauze, evacuated collection tubes or syringes, needle and needle holder, and tape.
■ Position patient: Sitting or lying with arm extended and supported.
■ Tourniquet: 3–4 inches above the intended venipuncture site.
■ Choose vein: Most common and easily accessed are the median cubital, cephalic, and basilic veins located in the antecubital (AC) fossa anterior to the elbow. Veins of the forearm, wrist, and hand may also be used, but are smaller and often more painful.
■ Cleanse the site: Briefly remove tourniquet. With an alcohol swab, cleanse the site from the center out using a circular motion. Allow the site to air dry for 30–60 seconds. For blood alcohol level and blood culture specimens, use iodine in place of alcohol.
■ Perform venipuncture: Reapply tourniquet. If necessary, cleanse end of gloved finger for additional vein palpation. Insert needle, bevel up, at 15–30 degrees using dominant hand. With nondominant hand, push the evacuated collection tube completely into the needle holder or pull back on the syringe plunger with slow, consistent tension.
■ Remove tourniquet: If the procedure will last longer than 1 minute, remove the tourniquet after blood begins to flow.
■ Remove needle: Remove tourniquet if still in place. Place sterile gauze over puncture site, remove needle, and apply pressure.
■ Equipment disposal: Per facility policy/standard precautions.
■ Prepare specimen: If using syringes, transfer specimen into proper tubes. Mix additives with a gentle rolling motion. Label specimen tubes with Pt’s name, ID number, date, time, and your initials.
■ Document: Record specimen collection in medical record.

Common Blood Collection Tubes

1 Red (None)

2 Red Marble Top or Gold (Clot activator and gel for serum separation)

3 Light Blue (Sodium Citrate)

4 Green (Sodium Heparin or Lithium Heparin)

5 Lavender (EDTA ethylenediamine tetraacetic acid)

6 Gray (Potassium Oxalate/Sodium Fluoride or Sodium Fluoride)

7 Yellow (SPS Sodium Polyanetholsulfonate)

8 Yellow Marble Top or Orange (Thrombin)

9 Light Green (Lithium Heparin and gel for plasma separation)

10 Pink (EDTA)

11 Tan (Sodium Heparin [glass tubes] EDTA [plastic])

12 Royal Blue (Sodium Heparin EDTA None)

Red: (blood bank, type and cross, discard tube)
Red marble top or gold: (chemistry, Ca, BUN, creatinine)
Light blue: (coagulation studies, PT, PTT, INR, fibrinogen)
Lavender: (Hematology, CBC, ABC, H&H, platelet counts)
Gray: (chemistry, glucose determinations)
Green: (chemistry, ionized Ca, plasma determinations)