Lipemic serum or plasma may not be a true indicator of the patient's physiologic state. 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. The impact on animal welfare. Always draw whole blood in an amount 2 times the required volume of serum required for a particular test. Fasting here is defined as no caloric intake for at least eight hours. It is critical, especially for any specimen collection tube containing an additive, to allow the tube to fill to the "fill line" marked on the tube. ALL RIGHTS RESERVED. Introduction to Maternity and Pediatric Nursing. Whether the sample is taken as a repeat or terminal procedure. Available on the Internet at https://mentalhealth.about.com/health/mentalhealth/library/weekly/aa072798.htm. Diagnosis of many endocrine diseases requires sequential sampling of blood and/or urine. Most patients needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. Hemolysis occurs when the membrane surrounding red blood cells is disrupted and hemoglobin and other intracellular components escape into the serum or plasma. Fasting or diet restrictions, such as low-fat diets, should be explained in detail, particularly to aged or overanxious patients or their caregivers. Instruct patients to look away from the equipment and the procedure to help prevent a vasovagal episode. The patient will then be asked to lie quietly in a flat position, without lifting their head, for one or more hours to avoid a potential post-test spinal headache. Abstract. Do not have patients make a fist or let their arm hang down during the blood sampling, because these maneuvers may cause various erroneous laboratory values (eg, increased potassium, lactate, phosphate). Too much pressure in drawing blood into a syringe or forcefully ejecting blood into a collection tube from a syringe may damage red cells. Plasma contains fibrinogen and other clotting factors when separated from the red blood cells. Centrifuge for at least 15 minutes at 2200-2500 RPM. o [ abdominal pain pediatric ] 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. Some samples are collected by simply running a swab over the affected area. Both types of samples are most often collected from the hip bone (iliac crest). The need for an arterial versus venous sample. Specimen Type Examples; Blood . Precautions to be observed must be determined by the physician, and the patient must then be told to avoid specified medications for the necessary periods of time prior to specimen collection. This form enables patients to ask specific questions about lab tests. If you are physically uncomfortable, discuss this with your healthcare provider. Most blood specimens can be obtained using routine phlebotomy techniques; however, there are some exceptions. Insert the needle proximally (ie, in the direction of venous blood flow), with the bevel facing up, along the midline of the vein at a shallow angle (about 10 to 30 degrees) to the skin. Proper identification of specimens is extremely important. Sputum should be relatively thick and not as watery as seen when producing saliva. 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. 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 Specimen and Culture 4.1. It is important to gain the patient's understanding and cooperation in obtaining an acceptable specimen. 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. Blood can be obtained from venous access devices and sometimes by fingerstick. Serum or plasma may be cloudy due to bacterial contamination or chronic or transient high lipid levels in the patient's blood. Collection of some samples from young children or patients with physical limitations may require assistance. Download the Specimen Collection & Transport Guide Need more help? Venous sampling is a diagnostic procedure that involves insertion of a catheter into a specific vein under imaging guidance to remove blood samples for laboratory analysis. If a flash still does not appear, withdraw the needle almost to the skin surface, change direction, and try again to advance the needle into the vein. It is performed while the person is lying on their side in a curled up, fetal position or sometimes in a sitting position. Latex hypersensitivity: Use latex-free gloves and tourniquet. bleeding from the arterial puncture site, bruising at the site of sample collection, infection, pain and tenderness around the site of sample collection, and ), Need for a venous blood sample for laboratory study, Infection or hematoma at a prospective venipuncture site, Intravenous catheter distal to a prospective venipuncture site (may affect laboratory results if IV fluids or drugs are infusing distal to the venipuncture site), Arteriovenous graft or fistula Arteriovenous Fistula An arteriovenous fistula is an abnormal communication between an artery and a vein. Available online at https://www.cdc.gov/hiv/topics/testing/resources/qa/oralfluidqandafin.htm throughhttps://www.cdc.gov. A whole blood sample can be temporarily stored at room temperature for up to 24 hours or in the refrigerator (2-8C) for 72 hours (optimum time) or maximum up to 5-6 days. Hemolysis: Hemolysis: What is it and How to Prevent it. Do not transfer red cells to the vial. The most common serum preparation considerations: Plasma Preparation. Verify the patient's identification. Detect and reduce unnecessary lab costs, while preserving quality and service for health plan members and providers. Obtain a clean-catch, midstream specimen. Mix by inverting specimen with additive immediately after collection. All primary specimen containers must be labeled with at least two identifiers at the time of collection. Indicate on specimen container and test requisition if specimen is plasma or serum. Depending on the site and the degree of invasiveness, some pain or discomfort may occur. Your doctor must have ordered your COVID-19 antibody testing or you must have purchased a test Evacuated tubes used to collect plasma specimens contain anticoagulant and, frequently, a preservative. Blood specimens are obtained in minimally invasive procedures conducted by specially trained physicians, nurses, or medical personnel. 21g or less 3. It is a special but relatively routine procedure. It may also be called blood draw or venepuncture. 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. Houts PS and Bucher JA, eds. Specific instructions for serial monitoring are found in the test description for the applicable test being monitored. 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. If multiple samples are being drawn, invert each specimen as soon as it is drawn. New York: Random House, 1996: 126. To access the external jugular vein, place the patient in Trendelenburg position with the head tilted slightly contralaterally. Centrifugation: When plasma is required, or when not using a serum gel separator tube, follow these instructions: Draw 12 mL of whole blood for each 5 mL of serum or plasma needed. Please confirm that you are a health care professional. In all settings in which specimens are collected and prepared for testing, laboratory and health care personnel should follow current recommended sterile techniques, including precautions regarding the use of needles and other sterile equipment. 2. Random, 24-hour. Blood is a rich biological sample routinely collected in clinical and epidemiological studies. This process is known as the order of draw. When using vacuum tubes containing no additives: In general, grossly or even moderately hemolyzed blood specimens may not be acceptable for testing. Enter search terms to find related medical topics, multimedia and more. If a wound or infection is deep, however, a needle and syringe may be used toaspiratea sample of fluid or pus from the site. The test request form and all specimens are sent in one container (box or plastic specimen transport bag). General Specimen Collection. Provide a complete 24-hour collection/aliquot or other timed specimen. Most often, all that is required is a blood sample. Wash your hands well after handling the sample. The plastic serum separator material extracts lipophilic substances (most drugs), resulting in a falsely low drug concentration result. Maintain and transport the specimen at the temperature indicated in the test requirements. Postprandial glucose may be performed two hours after a meal for a timed test that is helpful in diabetes detection. Perform venipuncture as with any other blood collection device. The primary dietary sources of lipids (fatty substances) are meats, butter, cream, and cheese. The back is cleaned with an antiseptic and a local anesthetic is injected under the skin. Adobe Stock. For children, swab the site 3 times using only alcohol. Complement your expertise with ours to improve test selection and interpretation. Blood Collection Tubes. In addition, vacutainers may contain additives to stabilize and preserve the blood sample. Allow collection site to dry after cleaning with the alcohol pad. Others are quick and easy to acquire because they reside in the bodys orifices. Blood tests are used to screen for, diagnose and monitor health conditions. 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. Other examples include such tests as occult blood, ova and parasites, and blood cultures. A urinalysis is a test of your urine. It's used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes. It's ugly because it usually means the time you spent drawing the specimen was wasted and the draw will have to be repeated. Alcohol used to clean the puncture site may cause contamination in a tube. These tubes are also used in comprehensive blood tests, which require the whole blood sample and all of its cells. For serum or plasma, draw approximately 2 1/2 times the requested volume. For serum, allow the blood to clot sixty minutes and separate by centrifugation. For routine collections, use a 21- to 22-gauge needle. (See appendices or individual tests for specific information.). See the articles on test/procedure preparation for infants, toddlers, preschoolers, and adolescents. However, samples of urine, saliva, sputum, feces, semen, and other bodily fluids and tissues also can be tested. Some samples such as urine, feces, and sputum can be collected as the body naturally eliminates them, while semen can be collected by the patient. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. Three popular methods of blood collection or sampling are: Arterial Sampling Venipuncture Sampling Fingerstick Sampling Arterial Sampling This form of blood collection most commonly takes place in a hospital environment. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. Philadelphia, Pa: W.B. unless it tinges the serum or plasma of the specimen you collected. If a suitable vein is difficult to locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate veins. Several different arteries can be used for blood collection. The purpose of the blood collection, e.g. 2023 Quest Diagnostics Incorporated. They also cause an increase in total serum thyroxine-binding globulin. 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. Provide a 24-hour urine volume when an aliquot from the 24-hour collection is submitted. Capillary blood obtained by fingerstick: Label pre-cleaned slides (preferably frosted-end) with the patient's name (or other identifier) and date and time of collection. Use OR to account for alternate terms All rights reserved. Use a separate test requisition when submitting a frozen specimen; frozen and non-frozen specimens must not be submitted on the same test requisition. Use clear tape to secure label to specimen transport tube. Usually, collecting these samples is painless, but obtaining them can occasionally be awkward and unpleasant because they involve elimination of bodily wastes and involve body parts and functions people prefer to keep private. Patients are instructed to cough upsputumfrom as far down in the lungs as possible. Serum should be clear and free from all red cells. American Medical Association Family Medical Guide. Reapply the tourniquet proximal to the selected insertion site. This type of sample may be collected using a swab or, if a larger volume is needed for testing, patients may be instructed to expectorate into a container without generating sputum. Clayman CB, ed. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). Do not recap nonsafety needles prior to disposal unless a sharps container is not immediately available. A. location such as a hospital room number is not an appropriate patient identifier. Saunders Company, 1995: 577. The specimen is collected by running a swab over the area of interest and processed for testing, such ascultures. If any preservative powder is visible, continue inverting the tube slowly until the powder is dissolved. Provide patients with adequate containers and instructions for 24-hour urine and stool collections. Let the specimen stand for 30 to 60 minutes and (preferably) not longer than 60 minutes prior to centrifugation. Provide the proper mixing of specimen with urine preservative as specified in the test requirements. Address this problem by collecting a fresh tube when blood flow is established or select another puncture site and, using sterile/unused equipment, collect a second specimen. Use of strategies that require multiple visits to collect blood for hepatitis C virus (HCV) testing should be discontinued and replaced by single-visit sample collection, according to research . The components of the blood may be examined along with the levels of red blood cells, white blood cells, and platelets. Stay up to date with the latest news and information from Testing.com by subscribing to our newsletter. The most common sensation is a feeling of pressure when the needle is introduced. Grossly or moderately hemolyzed specimens may be rejected and even slight hemolysis may alter certain test results. In venous blood sampling, a needle is inserted into a vein to collect a sample of blood for testing. An arterial blood sample is collected from an artery, primarily to determine arterial blood gases. If no flash appears in the hub after 1 to 2 cm of insertion, withdraw the needle slowly. Blood samples can be used for a variety of diagnostic, therapeutic, and research purposes. 3rd ed. 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. Hemolysis occurs when the red cells rupture and hemoglobin and other intracellular components spill into the serum. Phlebotomy Supervisor, Northwest Community Healthcare, Arlington Heights, Illinois. For lockbox instructions and Q&A, selectInstructions for Use. Centrifuge for at least 15 minutes at 2200-2500 RPM. Be as gentle as possible, drawing the blood evenly. You may find printed instructions on how to obtain urine or stool samples posted in the bathroom so you dont have to listen to a nurse tell you explicitly how to obtain a clean catch of urine or a fecal sample. To ensure an adequate specimen volume: The definition of specimen temperatures for storage and shipping is as listed below: Frozen: -1.0 to -80.0 oCFrozen Specimen Guide. The blood collection system is called "open" when, during the procedure, the blood is exposed to the environment and to healthcare professionals. Blood samples can be collected from blood vessels (capillaries, veins, and sometimes arteries) by trained phlebotomists or medical personnel. For clients whose specimen lockboxes must be placed outdoors, adding a frozen gel pack to the lockbox during warmer weather will help provide a moderate temperature inside the lockbox until specimens are collected by your LabCorp service representative. (A health practitioner may assist the patient in some situations.) Collecting the urine specimen is awkward but not in itself uncomfortable (An infection, however, can create a burning sensation during urination.). The duration and frequency of sampling. Labcorp sometimes offers reduced fees for serial tests when the following conditions are met: Monitoring a patient over time for a specific condition is a variation of sequential sampling. Whole blood and blood fractions comprise a major portion of biospecimen collections for population-based studies. Samples oftissue may be obtained from a number of different body sites, such as breast, lung, lymph node, or skin. Were helping Community health centers improve the engagement and health of their communities by providing access to efficient, high-quality, comprehensive health care, regardless of financial, geographic, or social barriers. Safety Needles, 22g or less 2. The site is cleaned with an antiseptic and injected with a local anesthetic, treating it as a typical surgical field. What is the purpose of blood collection? Saralynn Pruett, MT (ASCP). Use to remove results with certain terms Color-coded pediatric Vacutainer tubes are provided to facilitate special handling. 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. control the site you are about to enter and accepts no responsibility for its content. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. Do not delay. This requirement is important in order to achieve the proper blood-to-additive ratio; otherwise, the specimen may be found to be QNS. Real-time Priority and STAT results via Quest Lab Alert for Physicians, Empower better employee health with convenient care driven by clinical insights, Increase access to high quality healthcare to manage and prevent costly chronic conditions, With millions of SARS-CoV-2 tests processed, you can rely on Quest to screen your workforce, Quest offers molecular (PCR) and rapid antigen swab tests, as well as antibody blood tests, Make appointments, track your health history, and more, Our online business tool for physicians, hospital, and office staff. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Bacterial contamination may also cause cloudy serum. Lay the tube at a 45 angle to avoid tube breakage caused by expansion during freezing. For example, a rapidHIV testuses oral fluid. Blood sample collection is a routine procedure that involves the collection of blood from a patient's veins or arteries. Pipette the serum or plasma into a clean plastic screw-cap vial and attach the label. Re-collection: If it is confirmed that the blood volume is insufficient, the more common solution is to re-collect a blood sample. A special needle is inserted through the skin, between two vertebrae, and into the spinal canal. Blood Sample Collection Methods These veins extend through and branch within the antecubital fossa, creating the large antecubital and proximal forearm veins. Always freeze specimens in plastic tubes unless specifically instructed otherwise. Amniotic fluid surrounds, protects, and nourishes a growing fetus duringpregnancy. Hemolyzed serum or plasma is pink or red, rather than the normal clear straw or pale yellow color. Importance of Specimen Collection Nurses' Roles in Specimen Collection 1. There read more ). The most common considerations in the preparation of plasma: Urine Collection. Image content features models and is intended for illustrative purposes only. The Purple blood sample collection tubes contain an anticoagulant called EDTA, which is a short name for ethylenediaminetetraacetic acid, as this substance binds to calcium in the blood, preventing it from clotting. 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. All rights reserved. If you used a syringe to collect the blood, now transfer samples to collection tubes and bottles;* either insert the needle directly into the tops of the vacuum tubes, or remove the needle and attach a vacuum tube holder to the syringe. Todays technologies allow testing on an impressively wide variety of samples collected from the human body. Springhouse, PA: Springhouse Corp., 1994. Fill the tube completely, thereby avoiding a dilution factor excessive for total specimen volume (QNS). Blood samples may be collected from the veins in the arm or from capillaries in the fingers or heel. For certain tests,24-hour urine samplesare collected at home and must be refrigerated during the collection process. (See Figure 1.) Blood sample definition: an amount of a person's blood taken from their body for use in medical tests | Meaning, pronunciation, translations and examples KidsHealth. There will be some dead space at the top of the tube. symptoms-free for at least 10 days. * After removing a tube from the holder, gently invert the tube 6 to 8 times to mix the contents; do not shake the tubes. Use the container/tube indicated in the test requirements for appropriate specimen preservation. Pay in 1 of 3 convenient ways: online, by email, or with a credit, debit, or health savings card. Multiple tests for specific blood components, such as a glucose test or a cholesterol test, are often grouped together into one test panel called a blood panel or blood work. Unfortunately for entry-level phlebotomists or those in phlebotomy training, this process can be quite . Instructions for Use. Most often, all that is required is a blood sample. Materials provided by the laboratory for specimen collection can maintain the quality of the specimen only when they are used in strict accordance with the instructions provided. The sample is obtained by needle puncture and withdrawn by suction through the needle into a special collection tube. However, the sample used for testing is often determined by the purpose of the particular test: ablood glucose testis used to help diagnosediabetesand monitor blood glucose levels in diabetics while urine glucose is one of the substances tested when aurinalysisis performed, such as when aurinary tract infectionorkidney disorderis suspected. Use the collection container as specified in the test requirements, and refrigerate the specimen when bacteriological examination of the specimen is required. The sample may be sent to a laboratory for analysis (although a few tests can provide in-office results in just a few minutes). 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). Fill multiple collection tubes in the proper sequence. We work with ACOs to achieve better care for patients and better health for the population, through the delivery of high-quality, integrated, affordable health care.
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