SYRINGE EQUIPMENT

-The equipment used in venipuncture with syringe are the same with routine venipuncture, but a syringe is used in drawing the blood instead of an evacuated tube, because the stronger vacuum of the evacuated tube may collapse the vein for the patients having fragile or small veins. Blood drawn into a syringe is transferred to the appropriate evacuated tubes after the syringe is filled. A small needle is usually used for the draw and is replaced with a larger one before transferring the sample to the tubes. EQUIPMENTS for VENIPUNCTURE using a SYRINGE: Syringes Winged infusion sets( butterflies) Needles Needle disposal containers Needle holders Collection tube Marking pens Tourniquets Antiseptic cleaning solution Gauze pads Bandages Gloves Test Tube, Tape Cotton wool

EVACUATED TUBE TECHNIQUES EQUIPMENTS

A. EVACUATED COLLECTION TUBES Evacuated so that a measured amount of blood will flow easily Designed to fill with a predetermined volume of blood by vacuum Contains different sets of tube additives Color-coded rubber stoppers Tube tops are either Thick Rubber Stoppers or Rubber Stoppers with plastic tops (Hemogard Vacutainer System) Plastic tops minimizes the chance of aerosol spray forming when the stopper is removed Unused tubes must be discarded when they expire Out-of-date tubes may have decreased vacuum, preventing a proper fill, or they may have additives that degrade with time B. BLOOD SPECIMENS There are three (3) types of blood specimens used for analysis: 1. Whole blood is blood that has not been allowed to clot. Whole blood is used for most hematology tests, including blood type and cell counts.

2. Serum is the fluid portion of the blood that remains after clotting. Complete clotting takes 30 -60 mins centrifuged to separate the serum. It does not contain fibrinogen or some other clotting factors 3. Plasma is the fuid portion of the blood, including fibrinogen and other clotting factors. Plasma is obtained from whole blod by first adding an anticouagulant and then centrifuging. C. TUBE ADDITIVES Added to prevent or promote certain changes in the blood sample All tubes contain 1 or more additives except for red-topped tube Any tube containing additive must be inverted an mixed well after removal from the adapter. Many tubes are coated with silicone, which prevents blood from sticking to the sides and inhibits activation of clotting factors. 1. 2. 3. 4. Anticoagulants- prevent clotting Clot activators- promote clotting Thixotropic gel- separate components Preservatives & inhibitors- to maintain integrity of specimen

I.

ANTICOAGULANTS- prevent clotting that binds to calcium thereby inhibiting coagulation cascade a) EDTA - preserves blood cell integrity, prevents platelet clumping and compatible with blood staining b) Citrate - in yellow topped tube, it is combined with dextrose, which preserves blood cells c) Sodium Polyanetholesulfonate (SPS) - used for blood cultures since it inhibits certain immune system components that could otherwise destroy blood borne-bacteria and neutralizes antibiotics that the patient may be taking d) Heparin - preferred for plasma chemistry e) Potassium oxalate - combined with sodium fluoride or iodoacteate for glucose determination CLOT ACTIVATORS- promote clotting or coagulation a) Thrombin - increases clotting and is used for stat serum chemistry determinations(often prescribed to prevent recurrence of stroke) b) Glass or silica

II.

promotes clotting by providing more surface area for platelet activation

III.

THIXOTROPIC GEL- inert synthetic substance used to separate components whose density falls between that of cells and that of blood serum or plasma. When the specimen is centrifuged, the gel becomes liquid and moves between the lower ell layer and the upper serum or plasma layer