Lesson 1 Blood Collection Tubes & Tests

ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS ● ● ● ● ● ● ● Used with both ETS and syringe method of obtaining blood specimens Contains pre-measured vacuum Tube stoppers: color-coded to identify a type of additive, absence of additive, or special tube property Made of glass or plastic ● ● Used to collect tiny amounts of blood obtained from capillary punctures Most have color-coded bodies or stoppers that correspond to color-coding of ETS blood collection tubes ADDITIVE: substances you add in the evacuated tubes ANTICOAGULANT: type of additive you add in tubes to prevent clotting CHELATES: consumes ● BINDS: attaches to VENIPUNCTURE STOPPER COLOR ADDITIVE MODE OF ACTION LABORATORY USAGE YELLOW SODIUM POLYANETHOL SULFONATE (SPS) Prevent coagulation by binding calcium RED 8 inversions BLOOD BANKING (Blood bank studies, HLA phenotyping, and DNA & paternity testing) ACID CITRATE DEXTROSE LIGHT BLUE MICROBIOLOGY (Blood Cultures) INVERSION 3.2% BUFFERED SODIUM CITRATE Blood to anticoagulant ratio (9:1) Prevent coagulation by chelating calcium HEMATOLOGY (Coagulation Studies) PT (prothrombin time) and aPTT (activated partial thromboplastin time): SENSITIVE TESTS 3-4 GENTLE inversions SILICONE-COATED (Glass) Promotes blood clotting CHEMISTRY (serum chemistry determination) 5 inversions if with clot activator CLOT ACTIVATION (SILICONE-COATED) – Plastic BLOOD BANK (routine blood donor screening) No inversion for glass tubes IMMUNOSEROLOGY (diagnostic testing for infectious disease) GOLD PLASTIC NO ADDITIVE GEL SEPARATOR (Thixotropic gel) TG has a heavier specific gravity than serum but is lighter than RBC Promotes blood clotting Blood clotting time: 30 minutes CHEMISTRY (serum chemistry determination) 5 inversions BLOOD BANK (routine blood donor screening) IMMUNOSEROLOGY (diagnostic testing for infectious disease) LIGHT GREEN GREEN LITHIUM SEPARATOR HEPARIN GEL Inhibits thrombin formation to prevent clotting CHEMISTRY (plasma determination in chemistry) 8-10 inversions 15-20 u/mL LITHIUM HEPARIN or SODIUM HEPARIN Inhibits thrombin formation to prevent clotting CHEMISTRY (blood gas analysis) 8-10 inversions HEMATOLOGY (osmotic fragility test) LAVENDER 1.5 mg/mL of blood of ETHYLENEDIAMINE TETRAACETIC ACID (EDTA) Must be tested within a 4-hour duration of being used for optimal results Inhibits blood coagulation chelating calcium ions by CHEMISTRY (HBA1C) HBA1C (glycosylated hemoglobin): most sensitive test for diabetic patients as it could trace back one’s average blood sugar up to 3 months prior to test HEMATOLOGY (routine CBC, ESR) BLOOD BANKING (routine immunohematology testing and donor screening) 8-10 inversions ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS GRAY POTASSIUM OXALATE Anticoagulant Oxalate prevents binding calcium clotting by SODIUM FLUORIDE Antiglycolytic agent (stops cells from producing sodium-glucose) Glycolysis: decreases glucose concentration by up to 10 mg/dL/hour SODIUM FLUORIDE: preserves glucose for up to and inhibits bacterial growth CHEMISTRY (glucose determination) IDEAL FOR FBS 8-10 inversions Inhibits bacterial growth Can be stored for 3 DAYS ORANGE ROYAL BLUE THROMBIN Clot activator Blood clotting time: 5 mins CHEMISTRY (STAT determination) NONE (red label) EDTA: prevents clotting by binding calcium forming insoluble salt CHEMISTRY (trace elements, toxicology) K2EDT (lavender label) HEPARIN (green label) TAN 8 inversions HEPARIN: prevents clotting by inhibiting thrombin SODIUM HEPARIN (Glass) CHEMISTRY (lead determination) K2EDTA (Plastic) PINK Spray-coated K2EDTA (Plastic) BLOOD BANK (routine immunohematology testing and blood donor screening) SPECIAL TUBE in BB ● ● ● ● Blood gas specimens EDTA specimens Other additive specimens Serum specimens 1. Immerse the pipet tip in the liquid to a level that will allow the tip to remain in the solution after the volume of the liquid has entered the pipet. 2. The pipet should be held UPRIGHT, not an angle. 3. Use a pipet (rubber) bulb to suction the liquid above the desired graduation line. 4. The suction is then stopped. Remove the rubber bulb and cover the top of the pipet using your INDEX FINGER simultaneously. 5. Raise the pipet tip slightly out of the solution before adjusting the volume. 6. Allow the liquid to drain until the bottom of the meniscus touches the desired calibration mark. 7. Wipe the tip with a tissue of any adhering liquid. NOTE: wipe the body of the pipet which was submerged in the solution, NOT THE TIP 8. Hold the pipette in a VERTICAL POSITION and the tip against the side of the receiving vessel when draining the pipet contents into the vessel. NOTE: more than half of the pipet should be submerged in the tube/container to avoid bubbles ➔ THUMB: used to press the rubber bulb ➔ INDEX: stops pipet 1. FIXED-VOLUME PIPETTE: Pipette that measures only one volume 2. VARIABLE PIPETTE: Pipette models with different volumes to select ● 0-1 mL is the widest volume range usually seen in a single pipette 3. MICROPIPETTE: pipetting capability of <1 mL 4. MACROPIPETTE: pipetting capability of >1mL ADVANCE CLASS - CLINICAL CHEMISTRY Lesson 1: BLOOD COLLECTION TUBES & TESTS 1. If using a variable pipette, rotate the adjustment knob to the desired volume to be used. NOTE: Use the friction ring of the automated pipette to adjust the volume (STANDARD IN LABORATORY) 2. Take a tip out of the tip box by loading it into the pipette. 3. While maintaining a vertical grip on the pipette, press the plunger to the FIRST STOP. 4. Place the tip inside the liquid component being sampled and while the pipette tip is still submerged, slowly release the plunger to draw up the liquid. 5. Transfer the liquid to a receiving vessel by depressing the plunger until it stops at the SECOND STOP point to deposit the liquid. 6. Press the ejector button to remove the used tip and place it in the proper garbage can.