First, a blood specimen is drawn from a fasting patient. Our comprehensive laboratory services support clinical trials in countries around the world and are tailored to your product and requirements. Latex hypersensitivity: Use latex-free gloves and tourniquet. Place the tube upright in a rack as quickly as possible after collection. The specimen must not be refrigerated but kept as close to body temperature as possible by placing the container in a pocket and delivering it to the laboratory within 60 minutes. Collect blood in room temperature containers unless the specimen requirement specifies otherwise. Let the specimen stand for 30 to 60 minutes and (preferably) not longer than 60 minutes prior to centrifugation. Collect whole blood according to instructions provided for the individual test. The downloadable PDF also contains a linked Table of Contents, so you can easily find the information you are looking for. If blood is being obtained for blood cultures, vigorously cleanse the site with alcohol for 30 seconds, allow the alcohol to dry, and then swab in outwardly expanding, overlapping circles using chlorhexidine or povidone-iodine. Accessed October 2008. The purpose of the blood collection, e.g. See the articles on test/procedure preparation for infants, toddlers, preschoolers, and adolescents. Quest is the brand name used for services offered by Quest Diagnostics Incorporated and its affiliated companies. The specimen is collected by running a swab over the area of interest and processed for testing, such ascultures. Collect in an appropriate collection tube. If chain of custody documentation is necessary for the procedure, follow the appropriate protocol. The blood collection area should have the following supplies: Lab coats and gloves Phlebotomy chair Plastic cart with wheels (or plastic tray with compartments) for supplies Ice bucket with crushed ice, filled 10 minutes before blood draw Blood tube racks Blood tube rocker Basin (just in case) Smelling salts Washcloths and towels CDC. Support the supinated forearm (or other chosen site) on a comfortable surface. Phlebotomists are trained to collect blood samples through: Venipuncture (a puncture in your vein). Order supplies, access Lab Utilization Reports, and more! Single-Visit Sample Collection Recommended for Hep C Testing However, the impact of the blood collection tube matrix of samples collected needs to be carefully . This minimizes the effects of ingested substances on the test results. Throat, nasal, vaginal, and superficial wound cultures, for example, are obtained in this way. Divide specimen into separate containers for tests with such requirements. Even though the patients skin has been numbed, the patient may feel brief but uncomfortable pressure (pulling and/or pushing) sensations during these procedures. Well-fitting gloves make palpation of the vein easier. If you are physically uncomfortable, discuss this with your healthcare provider. specimens from humans, including blood, stool, urine, sputum, skin snips, and other tissue biopsies, and swabs or smears collected from skin or mucosal surfaces entomological specimens for studies of vectors, and animal or malacological specimens for studies of intermediate hosts food, water, and environmental samples. Blood Sample Collection Methods - healthcare nt sickcare Heel pricks, which are specifically for infants. Medical Director of North Arundel Senior Care, Severna Park, Maryland. There read more ). Grossly or moderately hemolyzed specimens may be rejected and even slight hemolysis may alter certain test results. Only one test request form accompanies the serial samples, and it is completed with all patient information, including any medications administered and the number of samples sent. If multiple samples are being drawn, invert each specimen as soon as it is drawn. Drive efficiency and better patient outcomes. In general, specimens for determining the concentration of body constituents should be collected when the patient is in a basal state (ie, in the early morning after awakening and about 12 to 14 hours after the last ingestion of food). To allow for adequate mixing of blood with the anticoagulant or preservative, use a slow rolling wrist motion to invert the tube gently four to eight times. What Is a Phlebotomist? What They Do & Training - Cleveland Clinic Rebecca Elon, MD, MPH. For some samples, they can be obtained as the body naturally eliminates them. Use our convenient insurance lookup tool to find out. PDF BLOOD SAMPLING GUIDELINES - Partners HealthCare A vacutainer blood collection tube is a sterile glass or plastic test tube with a colored rubber stopper creating a vacuum seal inside of the tube, facilitating the drawing of a predetermined volume of liquid. Random, 24-hour. The additive in each tube is specified on the label and tube stoppers are color coded according to the additive present. The patient is then instructed to lie quietly until their blood pressure, heart rate, and temperature are normal, and then to keep the collection site dry and covered for about 48 hours. Random, 24-hour. Pagana K, Pagana T. Mosbys Manual of Diagnostic and Laboratory Tests. Swab, urine, sputum . When more than one blood specimen is required, multiple sample needles and vacuum tubes make blood collection simpler and more efficient. Hemolysis occurs when the membrane surrounding red blood cells is disrupted and hemoglobin and other intracellular components escape into the serum or plasma. Please confirm that you are a health care professional. One of the most common problems in specimen collection is the submission of an insufficient volume of specimen for testing. For plasma and whole blood, completely fill the Vacutainer whenever possible to eliminate dilution from the anticoagulant or preservative and immediately mix the blood by gently and thoroughly inverting the tube five to ten times. Phlebotomy is the procedure in which a phlebotomist or a healthcare worker draws out blood from a vein, with the help of a needle, for laboratory testing. For a bone marrow biopsy, a special needle is used to collect a core (a cylindrical sample) of bone and marrow. Introduction to Specimen Collection | Labcorp Butterfly needles. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. All third-party marks and are the property of their respective owners. Tap the tube gently at a point just below the top to release any additive adhering to the tube or top. A. location such as a hospital room number is not an appropriate patient identifier. Collect in an appropriate collection tube. Fasting here is defined as no caloric intake for at least eight hours. Sample Collection Process - Blood | U.S. Anti-Doping Agency (USADA) Safety Needles, 22g or less 2. Some of the common considerations affecting all types of specimens: Serum Preparation. All specimens should be labeled in the presence of the patient. Thebone marrow aspiration and/or biopsyprocedure is performed by a trained healthcare specialist. Transfer the serum with a pipette to a plastic vial for transport to the laboratory. To help distend and locate veins, tap a potential site with your fingertips. If applying povidone-iodine, wipe it off with alcohol and allow the alcohol to dry. These veins extend through and branch within the antecubital fossa, creating the large antecubital and proximal forearm veins. About Site on Mental Health Resources. biochemical analysis, DNA extraction etc. Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. When there is difficulty accessing a vein or when a vacuum tube fills too slowly due to a difficult venipuncture, damage to the red blood cells may result. This results in increase in both total serum thyroxine and unsaturated thyroxine-binding globulin, but with no significant change in unbound (free) thyroxine. Serum, plasma, or whole blood collection | Quest Diagnostics Postprandial glucose may be performed two hours after a meal for a timed test that is helpful in diabetes detection. KidsHealth. Urinalysis - Mayo Clinic Most often, all that is required is a blood sample. Plasma contains fibrinogen and other clotting factors when separated from the red blood cells. The supplies and equipment vary slightly between the types of collections. A urinalysis is a test of your urine. A blood culture specimen is a 20 to 30-ml blood sample drawn at one time from one location.2Blood culture specimens should be drawn when the patient is experiencing signs and symptoms of bloodstream infection, including fever or chills, and before the administration of antibiotics to increase the likelihood of obtaining a true-positive result. The gel-barrier tube is an additive tube and should be inverted five to six times after collection. It is a special but relatively routine procedure. The pharmacologic or toxic effect is hyperuricemia and hyperglycemia. Fasting or diet restrictions, such as low-fat diets, should be explained in detail, particularly to aged or overanxious patients or their caregivers. Patients are instructed to cough upsputumfrom as far down in the lungs as possible. Many tumor markers (tests used to follow the patient's response to treatment for cancer) may be monitored over the course of several years. The typical open blood collection system is a syringe combined with a needle . Venous sampling - RadiologyInfo.org If povidone-iodine is used to cleanse the skin, allow it to dry and then remove it with isopropyl alcohol, to avoid erroneous blood test results (eg, hyperkalemia, hyperphosphatemia Hyperphosphatemia Hyperphosphatemia is a serum phosphate concentration > 4.5 mg/dL (> 1.46 mmol/L). Karen Szafran, CPNP. Use to remove results with certain terms If the patient cannot be taken off the medication in question, its presence should be noted on the test request form. Never freeze whole blood unless specifically instructed in the specimen requirements. It is essential to promptly identify and confirm the type of gout stone to alleviate pain and inflammation in patients and prevent complications associated with gout stones. Do not collect a specimen from or through a hematoma. 3rd Edition, St. Louis: Mosby Elsevier; 2006. Maintain the specimen at room temperature or on cool packs before submitting to our laboratory unless instructed otherwise by the specimen requirements. Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. Specific instructions for serial monitoring are found in the test description for the applicable test being monitored. Introduction to Maternity and Pediatric Nursing. What Is an Arterial Blood Sample? - MedicineNet o [ abdominal pain pediatric ] Caution must be taken to avoid arterial puncture. 17.2: Sample collection - Medicine LibreTexts Palpate with your gloved finger to locate the middle of the target vein. Available online at https://www.nlm.nih.gov/medlineplus/ency/article/003416.htm. Prior to each collection, review the appropriate test description, including the specimen type indicated, the volume, the procedure, the collection materials, patient preparation, and storage and handling instructions. Background information on arterial blood sampling. Blood Sample Collection PRocess Athletes who compete in events sanctioned by, are members of, or license holders of a National Governing Body or International Federation, or who fall under the USADA testing jurisdiction as defined in the USADA Protocol for Olympic and Paralympic Movement Testing, are subject to blood testing. Here are some instances in which timed multiple specimen tests may be ordered. Specimen Collection & Procedures: A Nurse's Guide A special needle is inserted through the skin, between two vertebrae, and into the spinal canal. Vacutainer tubes may contain additives designed to stabilize and preserve the specimen prior to analytical testing. Blood Collection Process: Venipuncture - University of Florida It is performed while the person is lying on their side in a curled up, fetal position or sometimes in a sitting position. The components of the blood may be examined along with the levels of red blood cells, white blood cells, and platelets. Random Urine Sample 4.2. Timed Urine Specimens (2-Hour, 4-Hour, 24-Hour) Traction may not be necessary for larger veins of the forearm or antecubital fossa. After the needle has been withdrawn, a sterile bandage is placed over the site and pressure is applied. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team. A Comparison of Serum and Plasma Blood Collection Tubes for the Use OR to account for alternate terms To avoid dietary-induced high lipid levels prior to testing, many physicians require patients to exclude the high-fat foods from their diets or to fast for 12 to 14 hours prior to specimen collection. Others are quick and easy to acquire because they reside in the bodys orifices. However, in these cases, it is essential to freeze the specimen as soon as it is separated from the cells. Phlebotomy Supervisor, Department of Laboratory Medicine and Pathology, Mayo Foundation, Rochester, Minnesota. Whole blood and blood fractions comprise a major portion of biospecimen collections for population-based studies. Preparing the Patient. Mix by inverting specimen with additive immediately after collection. Indicate that the specimen is plasma on the plastic screw-cap vial for transport and test requisition. If a wound or infection is deep, however, a needle and syringe may be used toaspiratea sample of fluid or pus from the site. Causes and prevention are discussed under the section on hemolysis. Available on the Internet at https://www.drkoop.com. For all those who are involved in specimen collection and preparation, the responsibility to adhere to current recommendations designed to maintain the safety of both patients and health care workers does not end when the patient is dismissed. Todays technologies allow testing on an impressively wide variety of samples collected from the human body. The accuracy of test results is dependent on the integrity of specimens. The color-coded Vacutainer tubes on the inside cover are recommended unless otherwise indicated in the alphabetical test listing. Mine data to find the right patients and doctors and support the unique journey of both. (See appendices or individual tests for specific information.). In the clinical information/comments section of the test request form, indicate the time the patient ate. Quest Diagnostics does not If you are using your own collection equipment instead of the vacuum tube technique, use only clean, dry, sterile needles, syringes, and tubes. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. Instruct patients to look away from the equipment and the procedure to help prevent a vasovagal episode. See Blood Specimens: Chemistry and Hematology Consideration for Single and Multiple Sample Collection. Sometimes there are options for the type of sample, such as withHIV antibody testing(blood, urine, and oral fluid screening tests are available), and in other situations, one particular type of sample is required. If blind percutaneous placement read more . Most urine specimens are collected by having the patient urinate into a container or receptacle. To minimize the risk of hemolysis, do not place whole blood specimens in direct contact with cool packs. Separate plasma by centrifugation. 2. Please visit our appointment scheduling page to make your appointment. These procedures are conducted by healthcare providers who have had specialized training. Usually, men need to refrain from ejaculating for at least 2 days prior but less than 7 days before collecting the specimen. Illustrated Guide to Diagnostic Tests, Student Version. Blood sample definition and meaning | Collins English Dictionary Abnormal levels of certain substances in the blood such as hormones may indicate the presence of disease in the organ or tissue that produces them. Collection of Blood: How and why is this done? - All Medical Tests Add the preservative (as specified in the test requirements) to the urine collection container prior to collection of the specimen if the preservative is not already in the container. Centrifuge for at least 15 minutes at 2200-2500 RPM. Abstract. Blood sample definition: an amount of a person's blood taken from their body for use in medical tests | Meaning, pronunciation, translations and examples The most common serum preparation considerations: Plasma Preparation. To keep the sample from becoming contaminated by materials outside the urinary tract, patients are given instructions on how to clean the genital area and void a bit of urine before collecting the specimen into the container. It contains detailed instructions on requisitions, irreplaceable sample handling, collection procedures, infectious substances, and more. Oral contraceptives cause a decrease in serum vitamin B12 levels that is often indistinguishable from vitamin B12 deficiency of any cause. Dr Koop.com. Do not freeze plastic Serum Separator Tubes. Screw cap on firmly to prevent leakage. Since information related to any of these areas may change as clinical laboratory technology changes, please refer to the latest edition of the Labcorp Directory of Services and Interpretive Guide for current instructions. Before you collect. Microbiology Specimen. Transfer Device 6. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. When blood collection is complete, gently hold a folded gauze square at the venipuncture site with your nondominant hand, and in one motion remove the needle and immediately apply pressure to the site with the gauze. Saunders Company, 1995: 577. Samples are regularly sent to help analyze conditions, for example, uneven electrolyte components, to choose for risk variables like elevated cholesterol levels, and to eliminate the results of medicines and drugs. Urine . A successful launch starts with an informed strategy. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. However, samples of urine, saliva, sputum, feces, semen, and other bodily fluids and tissues also can be tested. General Specimen Collection. (See Quantity Not Sufficient.). Ultrasound guidance , when equipment and trained personnel are available, can facilitate blood sampling from deep, nonpalpable veins. Pipette the serum or plasma into a clean plastic screw-cap vial and attach the label. Philadelphia, Pa: W.B. Samples of vaginal secretions are obtained by running a cotton swab over the walls of the vagina; cervical cells for aPap testare obtained using a cotton swab and spatula or a tiny brush. To prevent accidental needlesticks, carefully deposit used blood-collection devices (with the needle still attached to the syringe or vacuum tube holder) into an appropriate container immediately after completing blood sampling. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. (biometric screening), we need to redirect you to the Health & Wellness website. Learn more about the MSD Manuals and our commitment to. Lipemic serum or plasma may not be a true indicator of the patient's physiologic state. Careful attention to routine procedures can eliminate most of the potential problems related to specimen collection. Use clear tape to secure label to specimen transport tube. Verify the patient's identification. Executive Vice-President, American Association for Clinical Chemistry, Washington, District of Columbia. Fill multiple collection tubes in the proper sequence. * When multiple blood tests are to be done, blood should be allocated to the collection tubes in a proper sequence; first cultures, then tubes with anticoagulant, and then others. The most common urine collection considerations: Collection of Vacuum Tubes Containing Additives (eg, anticoagulants, preservatives, clot activators, gel-barrier). Springhouse, PA: Springhouse Corp., 1994. If it is not possible to avoid placing the specimen lockbox in direct sunlight, add 20F to the temperatures listed above to determine how many frozen gel packs to use. Blood is typically drawn and collected to play out a variety of research center tests. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. The most common timed procedure is a glucose tolerance test. Diagnosis of many endocrine diseases requires sequential sampling of blood and/or urine. To test the effect of a certain medication, a physician may order the same test to be obtained on consecutive days, before, during, and after the patient has received a medication. Patients who consume these foods within the 24-hour period immediately preceding collection of a blood specimen may have temporarily elevated lipid levels, which may be manifested by cloudy or lipemic serum. What is the Phlebotomy Order of Draw? | Phlebotomy Info All rights reserved. Terminate the procedure: Remove the tourniquet and the needle and apply pressure to the puncture site with a gauze pad (a minute or 2 is usually adequate unless the patient has a coagulopathy). Note: If more than one test is requested on a frozen specimen, split the sample prior to freezing. Hemolysis: Hemolysis: What is it and How to Prevent it. Place the sharps container within reach. Blood Sample Collection: Take The Following Precautions Inform patients that fasting does not include abstaining from water. New York: Random House, Inc., 1994: 767. Labcorp also offers a different lockbox for use at locations that experience extreme temperatures. Other affiliates operated under the Quest brand, such as Quest Consumer Inc., do not provide HIPAA covered services. When using a serum separator tube, follow these instructions: Note: Do not use serum separator tubes for therapeutic drug monitoring or toxicological analysis.
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