Draw blood in the appropriate containers as recommended under the “Test Catalog”. Blood drawn for tests to be performed on serum should be allowed to clot for 30 min at room temperature. After clotting, if the specimen is drawn in an SST tube it should be centrifuged and the entire tube shipped to Delta Lab. If the specimen is drawn in a red top tube the serum should be separated into an appropriate container and forwarded to Delta Lab.
Please follow test directions as to whether the serum should be stored at room temperature, refrigerated, or frozen. If a centrifuge is not available the patient should be drawn at a facility where serum separation can be accomplished.
Samples for plasma analysis should be drawn in the appropriate tubes as indicated under “Test Catalog”. These will either be heparin tubes, EDTA tubes, or citrate tubes. The specimen should be centrifuged immediately after collection. The plasma should be separated into an appropriate tube and stored at the temperature indicated in the catalog.
1- Patient Identification:
Before performing any component of the phlebotomy procedure, the phlebotomist must properly verify the identity of the patient with the collection request using two distinct identifiers as follows:
Ask the patient to verbally state or spell their complete name. Do not ask the patient to confirm their identity by requesting a yes/no response. Compare this information with the name on the test request form.
A second identifier such as date of birth must also be verbally stated by the patient. Do not ask the patient to confirm this information by requesting a yes/no response. Compare this information with the birth date on the test request form.
Patients who are not capable of giving their name or children may be identified through verbal verification by another adult who can personally identify the patient. Compare this information with the name on the test request form.
2- Patient Preparation:
Hands must be washed prior to and after all phlebotomy procedures. Using soap and warm water, scrub vigorously for 10 to 15 seconds, rinse well and repeat. A hand sanitizer product can be used in place of soap and water.
Gloves are to be worn when performing all phlebotomy procedures.
Inform the patient of the procedure(s) that you are about to perform and obtain their permission and cooperation.
Perform phlebotomy only if approved by appropriate healthcare professional and/or approved by the patient or patient’s guardian.
3- Phlebotomy Procedure:
– Venipuncture Specimens
Prepare patient as mentioned in “Patient identification” and “Patient Preparation” sections.
Wash hands. Put on properly fitting gloves.
Position or instruct the patient so that the patient’s arm is comfortably extended.
Apply the tourniquet 3 to 4 inches above the venipuncture site with enough tension to compress the vein, but not the artery.
Palpate or feel for the vein even when it can be seen.
If a vein is difficult to find, it may become easier to see after massaging the arm from the wrist to elbow, which forces blood into the vein. A warm moist towel (warm to the touch, but not hot) can also be used. You may need to examine the patient’s other arm if you are having difficulty finding a vein
Cleanse the area for venipuncture in a circular motion from the center outward with an alcohol swab and allow to air dry.
Anchor the vein by placing your free thumb below the venipuncture site where the needle is to enter and pull skin taut.
Introduce the vacutainer needle apparatus with the bevel up at a 15- to 30-degree angle to the skin and parallel to the vein.
Once the needle is properly positioned in the vein, anchor the needle by grasping the holder with thumb on top and other fingers under the holder, resting securely on the patient’s arm. Push the appropriate vacutainer tube into the holder with gentle pressure in order to puncture the cap. The tube will automatically fill with blood.
Watch the blood as it flows into the vacutainer tube until collection is complete.
Release tourniquet within one minute.
When all tubes are filled, withdraw the tube, place gauze square over the site and withdraw the needle.
Discard the activated needle and holder into the sharps container. Never re-cap the needle.
Inspect the puncture wound. When bleeding has stopped, apply a bandage. If bleeding continues, apply pressure for an additional three-five minutes. Prolonged bleeding may be related to the patient’s disease or medication.
Label the specimen tubes with the barcode number of the test request form and/or the barcode used in your facility which includes the patient information, before leaving the patient.
Wash hands thoroughly after removing gloves.
– (Butterfly) with Evacuated Tubes or Syringe:
Holding the wings of the butterfly with your dominant hand, smoothly insert the needle with the bevel up, parallel to the vein, at approximately a 10- to 15-degree angle.
Once the needle is properly positioned in the vein, hold one wing of the winged collection set and insert evacuated tubes using the vacutainer holder according to the order of draw. For syringe draws, gently pull on the plunger to allow blood to flow into syringe. Pulling on the plunger too fast may cause possible collapse of the vein and restrict blood flow into the syringe and/or hemolyze the sample.
If a syringe was used with the butterfly, properly discard butterfly device into a sharps container, and attach a transfer device to the syringe. Fill the appropriate tubes without applying force on the plunger