DEITat Bloed collection, anticoagulants Honatology teats and prosed 2.1. Routine 2:2. Antomation ae aoe 8, 23: Special = 58 Hematopoiesis, discases/disozders, veference valve % ‘3,1. Hemavopoiesis (in general) : ree (TUT E-2-Beythropoiesia and Rats 7 = ie 3:3. Leukopoiesis anc WECs See Fe Tze Sid. Thrombopotesis afid platelets Tos @Wagaiation (principles, procedures, discusea/ Wonders aad caference valsee) 25 Gai, Hemostasis ~ thesvies/concepts, mechani: ea i 4121 Geaguletion procedures/teste = 3% 4:3. Coagulasion factors, di! gorders Toe Guality assurance : 3 [eeeeeeeeercreeeeeeee = Toe “GoMPOSTTION OF BLOOD f Totel blood volume in ay adule DTT SS 1 PHEBOVOREMTA | dee in bleed vole LEMAR, gy ree | S Lng ef whole bleed Less of 2 shy er . rf _ plasm t 7 Vo | sees cee Se Formed SIaGeRts’ HCE, Wees and plavelers \S8erinsaporticn s SERUM [Senos water | EEBEE pewtten of clotted hiced +408 Proteins (albumin, globulin, fibrinogen) Cazhenydrate, vitamins, hormones, | pnasMa Se eer __Higia Portion of anticoagulated blood ANTICOAGUL. AR Fluide Weds seme . = a = Versane is used i conaenirations of L8G 0.25) mame + Sequestrens is used tn-the liquic farm | | = “Most cormmoniy used anticoaguiant for nematoiogy 2b | © Breparation of blood films up to 2 te $ hours following blood collection 0-7 2 Ge ie Befinheral borders ot neussaphie, oa am factor vihien reacts In the pisssneasoh: ime Inthe presence of EDTA oer & b 2s an_anicoagulant should correst this-prabiar vine Because a Sain nS oltate Tubes, it ie neoseeary To rpuliph, ia i eptalnes pleelct gou wiaiiae %, Ven ¥SE 0 irs," eee caescaa e Yon VE Cee rca A iorcosguiation | _ -MGHG and a falsely lo ESR) a - Prbick se ton. “Bogeneraive sHangessm Wace ond the platelets will swell and. bree aie esause EDTA neti cnacing s fasely increased platelet count (ago ty tho broken fragments ee a a texans iereet 7 Bagensraive cplotarchanges St som veuperataze |. WSCsmay show vacuniminn otthe ovtonlasm and | netcigeration of blood a4 ater 3 hours rere omogenaut nuns, reqs’ or pany defies | wi low down he degenara aaean Gylanlasmiebamers, anc developmen sfitegulary | provess, and there wil be ttle -_shapss.aveiet evidence of change In the __| BEB Se wit ncroase in size ten sisineegeate | Ramatger WO sount of RBC | FERee Te Biwes £-ReGe wil begin to-swoll, causing an iqerease INMICV "count afer 24 hours. Si'ieom teaperstuze | 5. Decreased ESR (wollen RBCS don rouloaune ee artes hours | iefeased OFT AMC PORT VPS 0-104 H 2 =o Light blue-top {ub65 are used Tor ia concentration of | * Prevents sanmuation by tading | Bart Q.208 8 (3-241 ‘sodium. Citfate (trisodium chrate dehydrate) to eae ot oboe parts whole Biood:upiantiosadi : a we Soldéle complex ang also helps the |» Buffered 9.109 ™ cirate may Increase the stabil (Sacer v 20g a | Soe Pltolots retain” their functional | « “Whenever ne pallont hematocrit = S894 the amiountof socTum cate ‘capabilities - “tie collection tube should be decreased; the following formula may be su: | - “ae four eins), qe determine tne proper amount of sodiim cttrato: ou Ahew ve Amount of sodium citrate = 100—hemateerit x mL of whole blood used Sjeapt hens ceeds 596 — hematocrit ee. luni eaamecasee | RARE => conan ‘trate and are used for the! si . oo the ratio of amtfcdanatenttos 7Rag Wt a GE oF STH URES | = i eR Ceagulstian ic provorned ay te |g t a q A ts eat ate. i interscton wit anttvombo | « Eee Wibcsten | id Subsequent ighiblion “of | plates. Thoin for only 2 ‘hrombin |. Limited use in nematology and is the anticoagulant of choice for only 2 fer ores + PISSEFIT HT most body tissues | hematology procedures (¢.g.. cametic. test) * Used as an in vitee and in| - When blood smear is prepared from hey ‘SPevimen and Wrigh saive_anticoaguiant Suh + “Least interference wifhanelyses | « Never us&d Tor coagulation studiés because of heparin's inhibitory efféct 0 + Eight inversiong-(@—20x) thrombin = +_May also cause error in = (Potassium oxalate ig the mos! widely usec 1 SERSSSRATMY aUtied 1 Tubes ContInTng Tlucose preservatives to provide 1 Acts by formation of Insaluble : F | an sae WO, SS maMCOreted usually | | | + “| employed + _Elghtto ten inversions je) shrinks cells (2 parts) Yosh Mec y ur ‘swells calls (2. parts) Serves glucose for 24 hours (otherwise, approx.. 7% glucose destroyed/nr) Combined with potassium oxalate anticoagulation needed a (8= 10%) Infibits yeas, ot an ‘anticoagulant aa seer » @ okvete ere wer dyels fen Defilwivebed bled — SET, FE SPECIAL-USE ANT AGULANTS ~ ad . oe Arvtohernds 7 eeause, in addiion To being an anilcoagulant, W reduces the acto nate” | of complement. whieh destroys hacteria. lt also slows down ahagacytosis (Ingestion of bacteria b EDTA pale, purpe| jo Sreae - EDF Soran AR, ORDER OF DRAW EMA ‘Blood culture tubes (yellow) Your. Coagulation sodium citrate tube qwiue stopper) gusuifai |Z. Slides, unless made from EDTA microcollection tube ‘Serum tubes with or without clot activator or gel separator{oie's | EDTA microcollection tubs: Heparin tubes witn or without gel (green stopper) Grow ¢ I 5 * Other microcollection tubes with anticoagulants (L.e., green ) EDTA tubes (lavender stopper) Eeuey 6. Glyoolytic inhibitor tubes stopper) Fhavice, Gray | 5. Seru de te 2 cup GoLOR AND ANTICOAGULANT/ADDITIVE ” Non ‘SeruTvchemistty and serology Red ‘Clot activator im/chemistry and Serology | Silica clot activator (plasticHemogard) | _ _ Lavender (glass) | GEDTA in iquid fom Pasinamamatoion | ehetates nas aaa ‘Lavender (plastic) | KoEDTA/spray-drieo | Piasmamnematology T Ghelates (binds) calcium Pink Se Spray-dried K2EDTA _ ‘Biasma/blood bank ‘Chelates (binds) calcium wie EDTA oe Prasma/p lagnost ‘Chelatos (binds) caloum [ight 6iue Scat Plasma/coagulation {[Chelates (binds) caleium — Light Blue | Thrombin and soybean trypsin Plasma/coaguiation | Good for fibrin degradation inhibtor ee | products ‘Black ‘Sodium arate ~— BiasmavESA—hematoren ["Chelates (binds) caleium Light green/biack Lithium heparin and gel Plasma/chemistry Inhibits thrombin Formation ‘Green ‘Sodium heparin, ithium heparin Plasma‘chemisiry inhibits thrombin formation Royal bie Sodium heparin, NaxEDTA Piasine/onemistryoweoIoay Heparin inhibis thrombin \ | | formation NazEDTA binds I I 7 cH || calcu Gay Sodium fords aed Thiam jasrnalglusase (esting Tinnioits alvesivers | fadoacetate = | Yellow | Sterile containing sodium | Serum/microbiology culture | Aids in bacterial recovery b { | polyanetholesulfonate (SPS) inhibiting complement, i ' phagocytes and certain is eee __| antibiotios Yoiiow | Reid Giate dextrose (ACBy | Sarurnotood bank, HLA | RBC pressivaive z _| phenotyping ana paternity testing | i Fan gies) ‘Sodium heparin Plasnafead testing —— ‘inhiis thrombin formation Tan (plastic) [EDTA ——TBiasmiviead testing ‘Chelates (binds) calcium | Yellowigray and | Thrombin: [ ‘Serumvchemistry, | ‘Clot activator ‘orange zi eae ( Redigray and gots | Giot aaiivator Separation gel | Seninvehersiry Silica clot acivatorbeMax Review auB ANNA LEAH NAVARRO 4639479560660 Page 13 BLOOD COLLECTION i lose than 6 months of age generally do not have a large: tlocd supply and Its dangerou 2. Infant blood in venipuncture. b. Inyoung children, if only @ small amount of blood is needed, 2 skin puncture is performed on the finger. e Wiben en eduit has poor veins, when the veins cannot be Used because of IV Infusions, or in the case of a severely bumed patient, the finger may be used as a phlebotomy site. 7 Capiliary blood, peripheral blood 1 = mixture of capillazy, venous and arterial bl i#ferent from those obtarneti on venous specimens LOWER RBC count, HIGHER_Wi Br, in-older ehiren ang adults, the pelmac-surface of the distal portion of the third (micia).or fownh_(Ang? finger on 2 nondominant hand may be used. anes Gor et b. “Tnnfants is the-lateral-{outsida) dr medial (Insicie) surface of the olantar side (bottom) of the hes! 7 [Binctures should not be made more than 2 mm decp because of the sisk of bone injury anc possible infection [osteomyeliti Mwac |, Pecet, Wb, Pe [Waiming Gan increase the blood flow sevenfold. The site can be warmed with = warm washcloth © a commercial heel warmer. The site should be warmei to a temperature no greater than 42° ¢ fo no longer than 2 utes, unless the collection is for capillary blood gas _anezyen their collection a Ta bee A= ere = Eegistane inere Te Phiebptoniste should cazrx Aug. pune, 2. VENIPUNCTURE — CleY contco! bub ~ Z. Evacuated tube system 2 t 93 ==. 2 sysinge Is; LLtin Chenett nedies LEMAR, ge e_ Butterfly infusion set > I Fhe higher the gauge nunber, th 21 or 22 4 smaller recommended. {he standard needle for blood coll ie a 2i-gauge needle. The two most widely used needle Leng’ he syringe oF evacuated bicod collection tube |. the nesdieanoaid be in tke bevel up position, and should make an approximate 15° angle wit the arms (S-APEL-4 ) ARBOR Be ate. + the courndQuee aXould not be Left on For Tongex chan 1 minute.— Jeno covetrv ro how © When a blood pressure cuff is used as a tourniquet, iz is usually inflated to approximatel Tene as eens ep ae V vein Soho ‘ege_ Sv aste Leen shempy is arumes tort aid of @ etastes) Ot |__aizrerent vein from the i hack SECT Geiss MeaVeine at ine antecubital region median cubital vein (preterred vein), cephalic veln (Second choice) and basitie vein (init choice), b. Altemate sites: Ifa vein cannot be located in eltuer arm, it may be necessary to examine the veins on the dorsal sid dF the wrist and hand. The veins in the feet should not be used without physician permission. Tere FAILURE TO DRAW BLOOD = Ome reason for failure to draw blood is that the vein Is missad, often because of inpraper unede-postoaing 5) Occasionally, an evacuated tube hes insufficient vacuum, and insertion of anotffer Tube yields blood. Keeping extra tubes suithin reach during blood collection can avoid a recollection when the probiem is a technical issue associated with the tube: 2. PATIENT INTERACTION = cieanse ace WERNER + identity the patient : + Nota pationt isoiation restctions + Inspect needle + Note pationt dietary restrictions + Perform venipuncture + Reassure patient oe + Release tourniquet * Verity paperwork fae * Position gauze over puncture site + Position patient TPLY Awbye + Remove needio and apply pressure 2. ASSEMBLE SUPPLIES AND HOUZPMENT 4. SPECIMEN PREPARATION # if syringe used, fil tubes Discard needle = Label specimens = Transport specimens promptly and properly 3. VENIPUNCTURE + Select general venipuncture lovsiion * Apply the tourniquet = Select exact venipuncture site