Do Medical Lab Technicians Draw Blood

(Run into specific Microbiology Specimen sections for additional instructions.)

Blood Components

In the average developed male person there are approximately 5 quarts (four.75 liters) of blood, composed of about 3 quarts (ii.85 liters) of plasma and ii quarts (1.9 liters) of cells.

Claret cells are suspended in the plasma, which is made up of h2o and dissolved materials, including hormones, antibodies, and enzymes that are being carried to the tissues, and cellular waste product products that are being carried to the lungs and kidneys.

The major blood cells are classified as cherry cells (erythrocytes), white cells (leukocytes), and platelets (thrombocytes).

The red cells are delicate, circular, concave bodies that contain hemoglobin, the circuitous chemic that transports oxygen and carbon dioxide.

Hemolysis occurs when the thin protective membrane that encases the frail red cells is ruptured, assuasive hemoglobin to escape into the plasma. Hemolysis can be acquired by rough handling of a blood specimen, leaving the tourniquet on too long (causing claret stasis) or squeezing the tip of the finger too difficult during capillary collection, dilution, exposure to contaminants, extremes in temperature, or pathologic conditions.

The main purpose of the white cells is to fight infection. In a good for you person, the white cells respond to modest infections by increasing in number and eliminating pathogens. Platelets are small fragments of special cells that aid in blood clotting.

Either plasma or serum may be separated from the blood cells by centrifugation. The essential difference betwixt plasma and serum is that plasma retains fibrinogen (the clotting component), which is removed from serum.

Serum is obtained from clotted blood that has not been mixed with an anticoagulant (a chemical that prevents the clotting of blood). This clotted blood is and then centrifuged, yielding serum, which contains two types of protein: albumin and globulin. Serum is usually collected in mottled cherry/grayness, gold, or cherry ruby-red-acme tubes, and red-elevation tubes are occasionally used.

Plasma is obtained from blood that has been mixed with an anticoagulant in the collection tube and has, therefore, not clotted. This mixed blood may then be centrifuged, yielding plasma, which contains albumin, globulin, and fibrinogen.

There are numerous coagulation factors (factor Viii, cistron IX, etc) involved in the clotting of blood. Several different types of anticoagulants interfere with the activity of these factors to forbid clotting. Both anticoagulants and preservatives may exist required for plasma specimens. The specified anticoagulant or preservative must be used for the test ordered. The chemical has been called to preserve some feature of the specimen and to work with the method used to perform the test. Blood collected with i anticoagulant suitable for the test described may not exist considered suitable for other tests. Because additives are not interchangeable, it is necessary to consult the specimen requirement field of private exam descriptions to determine the appropriate collection requirements for the examination ordered.

Blood Collection / Transport Containers

Following the collection, preparation, and transport instructions suggested by LabCorp supports the best possible test results. Materials for proper specimen collection and ship are supplied by LabCorp. Note: Specimens to exist tested by LabCorp should exist collected in specimen containers provided by LabCorp.

Anticoagulants and Preservatives. To ensure accurate test results, all tubes containing an anticoagulant or preservative must exist allowed to fill completely. Attempts to forcefulness more claret into the tube by exerting pressure, as in collection with a syringe, will result in damage to the red cells (hemolysis). If the vacuum tube is not filling properly, and you are certain that you take entered the vein properly, substitute some other tube. Occasionally, vacuum tubes lose their vacuum. If the specimen cannot be properly collected, select another site and using new, sterile drove equipment, collect the specimen. (Special note for light blue [sodium citrate] tubes used for coagulation studies: Always fully seat and concord the tube deeply on the Vacutainer® hub while filling.)

Note: Use plastic ship tubes for all frozen specimens.

Specimen Containers

Note: Please examine specimen collection and transportation supplies to be sure they practice not include expired containers.

Red-acme tube: Contains no anticoagulant or preservative.

Use: Serum or clotted whole blood. Serum must be separated from cells inside 45 minutes to two hours depending on the test(south). Please refer to the specimen requirements for the test(south) of involvement available in the Directory of Services. Send serum in a plastic ship tube.

Mottled red/gray-top, gold-summit, or red reddish-top (gel-bulwark) tube: Contains jell activator and gel for separating serum from cells, but not anticoagulant. Exercise non apply gel-barrier tubes to submit specimens for therapeutic drug monitoring. Ever check the examination clarification to determine whether a gel-bulwark tube is acceptable.

Use: Serum, may be used for assays requiring serum unless otherwise stated. Separate serum from cells within within 45 minutes to ii hours depending on the test(s). Delight refer to the specimen requirements for the examination(s) of interest available in the Directory of Services. Serum may exist sent in the centrifuge tube with an intact bulwark (correct separation upon centrifugation) between cells and serum or in a plastic ship tube. If specimen is centrifuged before clotting is complete, a fibrin clot will form on top of the cell. This finding is frequent in hemolyzed specimens. As well, the gel bulwark may not exist intact and could cause improper separation of serum and cells, perhaps affecting test results.

Lavender-top tube: Contains Grand₂ EDTA.

Use: EDTA whole claret or plasma. Send plasma in a plastic send tube labeled "Plasma, EDTA." Transport whole claret in a lavender-elevation tube.

Grey-acme tube: Contains sodium fluoride (a preservative) and potassium oxalate (an anticoagulant).

Apply: Sodium fluoride whole claret or plasma. Send plasma in a plastic send tube labeled "Plasma, Sodium Fluoride." Ship whole blood in a gray-pinnacle tube.

Blue-top tube (too light bluish-pinnacle tube): Contains sodium citrate. Be certain to utilize only tubes with a iii.two% sodium citrate concentration. These are easily identified by the yellow diagonal stripes on the characterization.

Utilise: Sodium citrate plasma. Send plasma in a plastic transport tube labeled "Plasma, Sodium Citrate." Send whole blood in a blueish-acme tube.

Green-tiptop tube: Contains sodium heparin or lithium heparin.

Use: Heparinized whole blood or plasma. Transport plasma in a plastic ship tube labeled "Plasma, Sodium Heparin" or "Plasma, Lithium Heparin." Send whole claret in a green-top tube.

Yellow-top tube: Contains acid citrate dextrose (ACD) solution.

Apply: ACD whole blood. Transport whole blood in a yellow-summit tube.

Royal blue-meridian tube: Contains sodium EDTA for trace metallic studies. Some royal bluish-pinnacle tubes practice non contain EDTA.

Use: EDTA whole blood or plasma. Ship whole claret in a majestic blue-top tube. Send plasma in a plastic transport tube labeled "Plasma, EDTA from majestic blue."

Tan-pinnacle tube: Contains sodium EDTA for blood lead analysis.

Use: EDTA whole blood. Send whole claret in a tan-meridian tube.

Plasma Preparation Tube (PPT™): Contains EDTA.

Use: EDTA plasma for molecular diagnostic tests (eg, polymerase concatenation reaction (PCR) and/or branched Dna amplification (bDNA) techniques). Upon centrifugation, a gel barrier is formed betwixt the plasma and the cellular components of the blood. The tube tin can exist sent direct to the lab without transferring to a secondary tube. Plastic tubes can exist frozen at -80°C without risk of breakage.

This department is presented as a guide for trained venipuncture technicians, or phlebotomists, and is non intended to train individuals in venipuncture technique. When drawing blood, please follow all venipuncture procedures recommended for use by recognized organizations and/or in accordance with applicable state regulations involving phlebotomy practices. The Clinical Laboratory Standards Constitute (CLSI) is an excellent resource for additional information.

Assembling Supplies. Assemble the following supplies: lab coat, gloves, labels, safety needle, needle holder, tourniquet, appropriate tubes, gauze, alcohol sponge, adhesive strip, and sharps container. (See Effigy ii.) Put on the lab glaze and gloves. The aseptic method of collecting and transporting a blood specimen works on the principle of a vacuum tube for drawing blood. A double-pointed needle or multiple sample needle (both disposable) may be used for venipuncture. Usually, a 21- or 22-gauge needle is used. A small bore, sharp needle causes minimum patient discomfort; 22- or 23-gauge is the smallest bore (or lumen) size recommended to avoid hemolysis. A needle length of i to 1½ inches permits an bending of entry that will not pierce both vein walls and enter tissue.

Figure 2

When more than one claret specimen is required, multiple sample needles and vacuum tubes make blood collection simpler and more efficient. A tiny rubber sleeve automatically closes when the vacuum tube is removed from the holder, preventing leakage and loss of claret when the tubes are beingness changed.

Place the sharps container within accomplish. Open the single or multiple sample needle bundle in front of the patient; practise not tear the paper seal for the needle'south cap, and exercise not remove the needle'southward cap (sterile shield) at this point. (See Figure three.)

Figure iii

Figure four

Prepare the needle holder in order to adhere the safety needle in the appropriate fashion. Pull the condom shield on the needle back over the holder before removing the needle shield. Thread the needle into the holder and tighten information technology firmly. (See Figure 4.) Follow the manufacturer'southward recommendations on properly setting the needle. With some needle assemblies, you may slide the collection tube into the holder, carefully pushing the tubes forward until the needle touches the stopper. Gently tap tubes containing additives to dislodge any cloth that may be adhering to the stopper. Carefully button the tube forrard until the top edge of the stopper meets the guideline on the holder. Let get. The tube will retract beneath the guideline. Leave it in that position. This footstep embeds the full point of the needle in the stopper without puncturing it, preventing blood leakage on venipuncture and the premature loss of vacuum.

During venipuncture, practice non have the patient clench and unclench the fist repeatedly ("pumping"). This will crusade a shift in fluid betwixt the vein and the surrounding tissue. This can pb to changes in concentration of sure analytes. To facilitate making the vein more prominent, the patient may exist asked to hold firmly to a rubber ball, a thick wad of gauze, etc. Also, never get out a tourniquet on the arm for more than one minute without releasing it. This can cause discomfort to the patient and may also cause hemolysis.

Preparing the Puncture Site. Later securing the tourniquet and reaffirming your selection of the best vein, both by sight and palpation, proceed as follows. Note: If a patient has intravenous (IV) solutions going into ane or both arms, it is adequate to puncture the vein 3 to iv inches below the site of the Iv.

1. Except when a claret alcohol is ordered, swab the site with a sterile alcohol sponge (70% alcohol) in a circular move, inside to outside, to button contaminants away from the puncture site. Exercise non routinely use an iodine preparation. Iodine may contaminate specimens for sure chemistry tests.
2. Permit the puncture site to air dry after swabbing, or dry out the site with gauze. If booze is not immune to dry out, it may cause specimen hemolysis. If the arm is dry, you will avert stinging the patient at venipuncture.
3. Break the newspaper seal on the needle cap in the presence of that patient, and remove the needle cap. Visually inspect the signal of the needle for burrs and possible discoloration forth the shaft of the needle before using the needle. If it has burrs or discoloration, do non use that needle; use another sterile needle.
4. Anchor the vein. Enter the vein with the needle at an bending of approximately 15 to 30 degrees.

Considerations for Unmarried and Multiple Sample Collection. If just a unmarried collection tube is required, when the vacuum is exhausted and the tube completely filled, release the tourniquet, and remove the tube from the needle assembly. Place a piece of dry gauze over the needle and withdraw the needle carefully.

Figure 5

When multiple specimens are required, remove the starting time collection tube from the holder as shortly every bit blood flow ceases, invert the get-go tube to prevent clotting, and gently insert the second tube into the holder. Puncture the diaphragm of the stopper by pushing the tube forward and initiating vacuum suction. (See Effigy v.) Remove and invert each successive tube later on it is filled. When all samples have been drawn, remove the entire assembly from the arm. Firmly lock the safety shield on the needle; confirm that it has locked both visually and audibly. Dispose of the used needle and holder in a sharps container co-ordinate to the provisions in your exposure control plan. Practice non epitomize, cut, or bend any needles; dispose of them in a sharps container. Do non reuse needles.

1. Utilise direct force per unit area to the puncture site. Afterwards drawing blood, observe proper venipuncture techniques to forbid continued bleeding and/or hematoma. Excessive bleeding (longer than v minutes) should exist brought to the attention of the physician. Besides, a jell tube (eg, carmine-pinnacle tube or gel-barrier) that does not clot should exist brought to the attending of the physician.

Note: When multiple specimens are drawn from a single venipuncture, the following order is recommended: (1) sterile claret culture tubes, (ii) nonadditive clotting tubes (crimson), (3) coagulation tubes and tubes containing citrate (blue), (4) gel-barrier tubes and tubes with additives (ruby-red), (5) tubes containing heparin (green), (6) tubes containing EDTA (lavander, royal blueish), (7) tubes containing acid citrate dextrose (yellow), and (8) tubes containing sodium fluoride and potassium oxalate (gray).

Note: If the claret has to be mixed with an condiment (gently invert the tube iv to 10 times depending on the specimen tube being used), this must exist done immediately afterward collection. You can exercise this quickly while the patient's arm is elevated. Mix blood with anticoagulant thoroughly, using a rolling wrist motion and past inverting the tube gently 4 or ten times. (Meet Figure 6.) As soon as possible after collection, set the claret upright in a exam tube rack.

Figure 6

Figure 7

1. Label tubes in front end of the patient immediately afterward collection, confirming all necessary data with the patient. (See Figure 7.)
2. If blood is fatigued for routine hematology, prepare the blood films (blood smears) immediately after collection.
3. Complete the examination request course to betoken time and engagement of drove along with collector's identification.

Annotation: LabCorp works with health care providers to minimize the total volume collected from pediatric and geriatric patients.

Syringe Transfer Technique in Venipuncture

A syringe is unremarkably used with patients who are difficult to collect past routine venipuncture procedure, including techniques using a safety-winged blood collection prepare (butterfly). With the syringe technique, venipuncture is accomplished without directly connection to the collection tube. Follow these steps:

1. Utilize disposable plastic syringes and condom straight needles or a safety-winged claret collection set. For most laboratory specimens, using 20 mL plastic syringes will allow the withdrawal of adequate specimen. Generally, the needle should not be smaller than 21-gauge.
2. If glass syringes are used, information technology is essential that the barrel and plunger be absolutely dry. Small amounts of moisture can cause hemolysis. If the glass syringe has been autoclaved, information technology should be oven dried before use. Air drying techniques are ordinarily not satisfactory.
3. After the claret is collected by syringe, actuate the prophylactic characteristic of the safety direct needle or rubber winged blood collection set. Dispose of the used needle in a sharps container co-ordinate to the provisions of your exposure control plan, and fill the vacuum tubes co-ordinate to the provisions of your exposure control plan. Use blood transfer device to fill tubes from syringe.
4. Do not force blood into the tube past pushing the plunger; this tin can cause hemolysis and may disrupt the ratio of specimen to anticoagulant.

Blood Specimen Training Procedures

There are two important guidelines to follow when submitting blood specimens. For some tests, such as chemical science procedures, fasting samples are oftentimes the specimen of option. Also, because hemolysis interferes with many procedures, please submit samples that are every bit gratis from hemolysis as possible.

Preparing Serum

Serum Preparation From Cerise-peak Tube. Follow the steps below when preparing a serum specimen for submission. Be certain to use the centrifuge that LabCorp has provided for your use in these separations. For additional information regarding preparation of serum samples, view the post-obit video:

1. Draw whole blood in an corporeality 2½ times the required volume of serum so that a sufficient corporeality of serum can exist obtained. The eight.5 mL cherry-red-top tube will yield approximately iii.5 mL serum after clotting and centrifuging. Label the specimen appropriately (see Specimen Containers).

2. Identify the collection tube in the upright position in the rack, and let the blood to jell at room temperature for xxx to threescore minutes.  If clotting fails to occur within 60 minutes, notify the doctor. Do not remove the tube stopper.

Effigy 8

three. Afterwards allowing clot to form, insert the tube in the centrifuge, stopper end up. (See Figure viii.) Operate the centrifuge for no more than than 10 minutes at the speed recommended by the manufacturer. Prolonged centrifugation may cause hemolysis. When using a demote-elevation centrifuge, use a residual tube of the aforementioned type containing an equivalent volume of water.

four. Turn the centrifuge off, if non automated turn off, and let it to come to a complete cease. Exercise not attempt to open the lid and stop by hand or restriction. Remove the tube carefully without disturbing the contents. Do not spin more x minutes unless otherwise specified.

5. Remove the stopper and carefully aspirate all serum from cells, using a separate disposable pipette for each tube.

Identify the tip of the pipette against the side of the tube, approximately ¼ inch above the cell layer. (See Effigy 9.)

Do not disturb the cell layer or bear any cells over into the pipette. If cells do enter the pipette, recentrifuge the unabridged specimen.

Figure 9

Figure ten

viii. Transfer the serum from the pipette into the transport tube. (See Figure x.) Inspect the serum for signs of hemolysis and turbidity by holding it up to the low-cal. Be sure to provide the laboratory with the amount of serum specified.

9. Characterization the tube carefully and conspicuously with all pertinent information or bar code. Unless otherwise indicated, serum samples may be sent at room temperature. When multiple tests requiring frozen serum are ordered, a plastic transport tube should be prepared for each test.

Claret Collection / Transport Containers​

Frozen Serum. When frozen serum is required, identify the plastic transport tube(s) (prepared above) immediately in the freezer compartment of the fridge. At the time of specimen pickup, inform your professional person service representative that yous accept a frozen specimen to exist picked upwards. A carve up frozen sample must be submitted for each test requiring a frozen specimen. A frozen specimen should be held in a freezer at 0°C to -20°C unless a specific exam requires the specimen to be frozen at -70°C (dry ice).

1. If y'all take after-hours pickup for frozen specimens, label the tube with a permanent marker. (Water-soluble markers may wash off with freezing and ship.) Place the tube(s) in a designated freezer. Set the silverish gel packs that fit into the Frozen Specimen Keeper by making sure that they also are frozen. Equally late as possible before the lockbox is to be put out, place the frozen transport tube in the Frozen Specimen Keeper between the silver frozen gel packs. These containers can keep frozen specimens frozen, but they will not be able to freeze specimens at room temperature or refrigerated specimens.  Refer to the Frozen Specimen Keeper instructions for use for further details.
2. Put the Frozen Specimen Keeper containing the specimens in your lockbox co-ordinate to the pictorial instructions provided (see link higher up). Your professional person services representative will transfer the send tube from the Frozen Specimen Keeper to dry water ice for transport. The Frozen Specimen Keeper will be left in your lockbox for reuse. Specimens for multiple tests should be frozen into different transport tubes.

Notation: Some lock boxes may be too small to concord the Frozen Specimen Keeper.  The original Transpak containers can be used for these lock boxes.

Frozen Gel Packs. To ensure specimen integrity during warm conditions, follow these Instructions for Useof frozen gel packs and specimen lockboxes.

Gel-barrier Tubes. Gel-barrier (mottled red/gray, gilt, or cerise red-height) tubes incorporate jell activator and gel for separating serum from cells but include no anticoagulant. Attach to the post-obit steps when using a gel-barrier tube. Do non use gel-bulwark tubes to submit specimens for therapeutic drug monitoring, direct Coombs', blood group, and claret types. In that location are other times when gel-barrier tubes should not be used. Always consult the test description and AccuDraw® prior to drove.

1. Draw whole blood in an amount 2½ times the required book of serum so that a sufficient amount of serum can be obtained. The 8.five mL red-peak tube will yield approximately 3.5 mL serum after clotting and centrifuging. Label the specimen appropriately.
2. Gently invert the gel-barrier tube v times to mix the clot activator and blood.
3. Place the collection tube in the upright position in the rack, and let the blood to clot at room temperature for 30 to 60 minutes. (Minimum clotting time is xxx minutes for patients with an intact clotting process.)
4. Subsequently assuasive the jell to grade, insert the tube in the centrifuge, stopper stop upward. Operate the centrifuge for 10 minutes at the speed recommended by the manufacturer. Prolonged centrifugation may cause hemolysis. When using a bench-top centrifuge, employ a balance tube of the same blazon containing an equivalent volume of water. Do not exceed 10 minutes of spin time unless otherwise specified.
5. Turn the centrifuge off, if not an automated plough off, and permit it to come to a complete cease. Do not stop it past paw or brake. Remove the tube carefully without disturbing the contents. Inspect the bulwark gel to ensure that it has formed a solid seal between the serum and packed cells. Also, examine the serum for signs of hemolysis and turbidity by belongings information technology upwards to the light. Be certain to provide the laboratory with the amount of serum specified.
6. Make sure the tube is clearly labeled with all pertinent data or bar code.
7. If a frozen specimen is not required, it is not necessary to transfer serum to a plastic transport tube. Unless otherwise indicated, serum specimens may exist sent at room temperature.
8. When frozen serum is required, transfer the serum using a pipette into a plastic transport tube. Follow the steps in Frozen Serum.

Plasma Grooming. When plasma is required, follow these steps.

one. Always use the proper vacuum tube for tests requiring a special anticoagulant (eg, EDTA, heparin, sodium citrate, etc) or preservative.

2. Tap the tube gently to release additive adhering to the tube or stopper diaphragm. (See Figure 11.)

Figure 11

3. Permit the vacuum tube to make full completely. Failure to fill the tube volition cause an improper blood-to-anticoagulant ratio and yield questionable and/or QNS test results.

4. To avoid clotting, mix the blood with the anticoagulant or preservative immediately afterwards drawing each sample.

5. To permit acceptable mixing, slowly capsize the tube eight to ten times (iv times for citrate tubes) using a gentle wrist rotation motion.

vi. Immediately centrifuge the specimen for as long as 10 minutes or equally specified by the tube manufacturer. Exercise not remove the stopper.

7. Turn the centrifuge off, if not an automatic turn off, and allow it to come to a complete end. Do not stop it past mitt or brake. Remove the tube advisedly without agonizing the contents.

viii. Remove the stopper and carefully aspirate plasma, using a dissever disposable Pasteur pipette for each tube.

ix. Place the tip of the pipette against the side of the tube, approximately ¼ inch above the cell layer. Do not disturb the cell layer or acquit whatever cells over into the pipette. Practise not pour off; use transfer pipette.

ten. Transfer the plasma from the pipette into the transport tube. Be sure to provide the laboratory with the amount of plasma specified.

11. Label all tubes clearly and carefully with all pertinent data or bar lawmaking. All tubes should be labeled with the patient'south full name or identification number as it appears on the test request form or affix bar lawmaking. Also, impress on the characterization the type of plasma submitted (eg, "Plasma, Sodium Citrate," "Plasma, EDTA," etc).

12. When frozen plasma is required, place plastic ship tube(due south) immediately in the freezer compartment of the fridge, and notify your professional person service representative that you have a frozen specimen to exist picked upwardly.

13. Never freeze glass tubes. For afterward-hours pickup, follow the steps under Frozen Serum to a higher place.

Plasma Preparation Using a Plasma Grooming Tube (PPT™)

1. The BD Vacutainer® Plasma Preparation Tube (PPT™) is a plastic evacuated tube used for the drove of venous claret in order to prepare undiluted plasma for utilise in molecular diagnostic testing.
2. The BD PPT™ should be at room temperature and properly labeled for patient identification.
3. Collect blood into the BD PPT™ following standard procedure for venipuncture and sample drove. Permit the vacuum tube to fill completely. Failure to fill the tube will crusade an improper blood-to-anticoagulant ratio and may yield questionable and/or QNS test results.
4. To avoid clotting, gently mix the blood with the anticoagulant immediately afterward cartoon each sample.
5. To ensure adequate mixing, gently invert the BD PPT™ eight to ten times using a gentle wrist rotation motion.
6. Later mixing, store the BD PPT™ upright at room temperature until centrifugation. Blood samples should be centrifuged within 45 minutes to two hours depending on the exam(south). Please refer to the specimen requirements for the test(due south) of interest bachelor in the Directory of Services. Centrifuge BD PPT™/blood sample at room temperature at minimal of 1100 RCF (relative centrifugal strength) for a minimum of 10 minutes in a swinging saucepan rotor blazon centrifuge. (Use of a fixed bending rotor centrifuge does not let the gel bulwark to form properly and may result in incomplete separation of plasma from the cellular components.)
7. Allow centrifuge to come up to a complete stop before attempting to remove tubes. Examine tube to ensure that the gel barrier has formed between the plasma and the cellular elements.
8. Once centrifuged, the plasma in the BD PPT™ can be transported to the lab without transferring to another tube. The gel bulwark prevents the remixing of the plasma with the cellular elements of the claret. The plastic BD PPT™ tin be frozen at -80°C prior to shipment.

Blood Film (Blood Smear) Slide Training

The blood film (ordinarily called a claret smear) tin be a vital part of clinical testing. When performed, it enables the technologist to view the actual concrete appearance of the red and white claret cells microscopically. Well-prepared films can be used in performing the differential white cell count, for examining the morphology (size, structure, and shape) of ruddy and white cells to determine the presence of abnormal cells, and also for the examination of the size and number of platelets. The distribution of the cells, as well as their morphology, can be contradistinct by poor slide preparation.

The about appropriate slide consists of a film that is exactly i prison cell thick for maximum visualization of all cell types microscopically.

Blood films may be prepared from venous blood (venipuncture) or capillary puncture blood. Slide preparation using venous blood is described below.

Preparing Slides Using Venous Blood Collected From Venipuncture

Follow the steps outlined below.

i. Put on laboratory personal protective equipment.

2. Select 2 make clean, grease-free glass collection slides with frosted ends (new ones whenever possible).

3. Impress the patient'south proper name and date on the frosted ends of both slides. (See Figure 12.)

Effigy 12

4. Handle all slides simply past the frosted ends or by the edges.

5. Place the collection slides frosted side upward and to your right on a padded, flat surface near the chair or bed where the specimen is to be nerveless.

6. Immediately subsequently removing the needle from the vein, gently bear on the tip of the needle to ane of the clean slides, producing a small drib of blood well-nigh 1 to 2 mm in diameter, nigh the size of a match head. The drop of blood should exist in the heart line, approximately ¼ inch from the frosted end. Repeat for the second collection slide. Actuate the needle'south safety feature and dispose of the needle in a sharps container.

7. Hold the left corners of the collection slide with the left pollex and forefinger.

viii. Hold the spreader by the frosted cease betwixt the right thumb and the alphabetize finger.

9. Rest the left end of the spreader at a 45° bending, approximately ½ inch opposite the drop of claret on the slide. This bending prevents the white cells from bunching along the edges.

Figure 13

Figure 14

x. Draw the spreader slide steadily back toward the drop of claret. When the slide contacts the drib, the claret will kickoff to spread to the edges of the spreader slide. (See Figure 13.)

11. Keep the spreader slide at a 45° angle, maintaining light only business firm pressure with the spreader slide against the horizontal slide. Push the spreader slide apace over the entire length of the slide, pulling a thin smear of claret behind it. A feathered border usually characterizes a proficient blood film. The claret should non extend past ³/_iv the length of the slide. (Meet Effigy 14.)

12. Prepare the second film in the same manner.

13. Allow the claret films to air dry. Do not blow on the slides. Practice non apply fixative. After the slides are completely dry, place them in a labeled slide holder for ship to the laboratory.

Special Notes on Slide Preparation

1. Slides must non be touched on any surface area except the long slide edges or frosted ends.

two. Ready the moving-picture show immediately, as soon as the drop of claret has been placed on the slide. Any delay will result in abnormal distribution of the white cells, with many of the larger white cells accumulating at the thin edge of the smear. Rouleaux of the cerise cells (stacking similar piles of coins) and platelet clumping will likewise occur.

3. Criteria:

• The sparse portion should be nigh 1 inch long, and the entire film should embrace approximately half of the area of the entire slide.
• No portion of the film should extend to the edges of the slide.
• The film should be gratuitous of waves, holes, and ridges, and it should have a shine advent and feathered edge.
• All microscopic slides, besides as paraffin blocks, should exist clearly labeled using ii patient identifiers.
• The accession designation used in the pathology report should include the case type, year, and a unique accession number.

4. Mutual causes of a poor blood film. (See Figure fifteen.)

Figure 15

• Too long a delay in transferring the drop of fresh blood from collection tube to slide.
• Drop of blood besides large or too small (usually also large).
• Spreader slide pushed across the slide in a jerky manner.
• Greasy or muddy slides, or use of a spreader slide with a chipped or unpolished end.
• Failure to keep the unabridged edge of the spreader slide confronting the slide while making the film.
• Failure to keep or have the spreader slide at approximately a 45° angle. (Increasing the angle results in a thick flick, while a smaller angle will produce a thin picture show.)
• Failure to push the spreader slide completely across the flat slide.

Blood Civilization

Blood cultures should be collected directly into the blood civilisation bottles provided by LabCorp. Please follow the instructions that come up with the kit and call your LabCorp representative if y'all accept any questions. You lot tin too go the test clarification for Blood Culture, Routine [008300] in LabCorp's online directory and refer to the Microbiology Specimen Drove and Send Guide attached in the Related Documents field for additional information on claret culture specimen collection.

Source: https://www.labcorp.com/resource/blood-specimens-chemistry-and-hematology

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