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Collection of Blood Specimen

The document outlines the procedures and safety measures for blood specimen collection, including capillary, venous, and arterial methods. It emphasizes the importance of proper technique, patient handling, and equipment use to ensure reliable test results and minimize risks of contamination and infection. Additionally, it details the anatomical sites for blood collection and the differences between capillary and venous blood samples.

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0% found this document useful (0 votes)
5 views50 pages

Collection of Blood Specimen

The document outlines the procedures and safety measures for blood specimen collection, including capillary, venous, and arterial methods. It emphasizes the importance of proper technique, patient handling, and equipment use to ensure reliable test results and minimize risks of contamination and infection. Additionally, it details the anatomical sites for blood collection and the differences between capillary and venous blood samples.

Uploaded by

megersam24
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Collection of Blood Specimen

1 05/09/2025
Objectives
 Upon completion of this content, the student will be able to:
 Identify the tests that are done on capillary blood
 Indicate the anatomical sites of capillary blood collection
 Perform the procedure of capillary blood collection by skin puncture
 Distinguish the laboratory tests for which venous blood is required
 Indicate the anatomical sites of venous blood collection
 Perform venous blood collection
 List the advantages and disadvantages of capillary and venous
blood sample
 Explain the difference between capillary and venous blood
 Recognize complications of venous blood sample collection
 Describe arterial blood collection
 Exercise ethical handling of patients
 Adhere to the safety precautions that should be taken in blood
collection
2 05/09/2025
Collection of blood specimen
 Proper collection and reliable processing of blood specimens

is a vital part of the laboratory diagnostic process in


hematology as well as other laboratory disciplines.
 Blood must be collected with care and adequate safety

precautions to ensure:
 Test results are reliable

 Contamination of the test sample is avoided and

 Infection from the blood transmissible pathogens is prevented.

 All material of human origin should be regarded as

potentially infectious
3 05/09/2025
Collection of blood specimen cont’d…

 When collecting blood sample, the operator should wear

disposable rubber gloves


 The operator is also strongly advised to cover any cuts,

abrasions or skin breaks on the hand with adhesive


tape before wearing gloves
 Used disposable syringes, needles, other sharp items

such as lancets must be placed in puncture-resistant


container for subsequent decontamination or disposal

4 05/09/2025
Collection of blood specimen
cont’d…
 Care must be taken when handling syringes and
needles
 Do not recap used needles by hand
 Needle-stick injuries are the most commonly encountered
accidents
 If a needle-stick injury occur:
 Immediately remove gloves
 Vigorously squeeze the wound while flushing the
bleeding with running tap water
 Thoroughly scrub the wound with cotton balls soaked in
0.1% hypochlorite solution
 Report to supervisor immediately
 Adhere to national guideline on HIV exposure risk
5 regarding post exposure prophylaxis (PEP) 05/09/2025
Collection of blood specimen
cont’d…
 (Q) Difference between specimen and sample?

 Blood specimen can be

 Capillary blood

 Venous blood

 Arterial blood

 Venous blood specimen (Venipuncture) can be

collected in two ways


 Vacutainer method (vacutainer tube holder and Two-

way needle)
6 05/09/2025

Venous Blood Collection/Venipuncture
Venous Blood Collection/Venipuncture

 Necessary for most tests that require anticoagulation or

larger quantities of blood, plasma or serum


 Veins of the forearm are preferred; wrist or ankle can

also be used as sites of puncture


 Veins in the antecubital fossa of the arm are the

preferred sites
 They are larger than those in the wrist or ankle regions

 Hence are easily located and palpated in most people

7 05/09/2025
Venous Blood Collection Cont’d…
 The three main veins in the
forearm
 Medial Cubital
 First choice well anchored
and easy to penetrate
 Cephalic
 On the outside surface
 Well anchored
 Basilic
 Not well anchored, tends
to roll, painful and can
cause nerve damage
Anterior surface of the left arm
showing veins most suitable for
8 05/09/2025
venipuncture
Venous Blood Collection Cont’d…

 Venous blood collection in infants and children

presents special problems


 Small size of the veins

 Difficulty in controlling the patient; needs excellent

interpersonal skill
 Require experience

 Areas also used for obtaining blood

 External jugular vein in the neck region

 Femoral vein in the inguinal


9 05/09/2025
Venous Blood Collection Cont’d…
 Materials used for venous blood sample
collection
Gloves
Vacutainer tube
Vacutainer tube holder and Two-way needle
Sterile syringe and needle (if the syringe method is used)
Tourniquet
Gauze pads or cotton,
70% alcohol or suitable skin antiseptic
Test tubes with or without anticoagulant (for syringe
method)
Sharp container
Band Aid (to stop further bleeding)
10 05/09/2025
Venous Blood Collection Cont’d…

Vacutainer Tubes with their color code

Vacutainer tube
holder

11
Tourniquet 05/09/2025
Venous Blood Collection Cont’d…
 Vacutainer technique of venous blood
collection
1. Assemble the necessary materials and equipment
3. Identify the right patient and allow the patient to sit
comfortably preferably in an armchair
4. Reassure the patient
5. Apply the tourniquet
 Position the tourniquet 7.5 – 10 cm above the venipuncture
site with strip equal on both sides
6. Prepare the arm by swabbing the antecubital fossa with
a gauze pad or cotton moistened with 70% alcohol
12 05/09/2025
Venous Blood Collection Cont’d…

 Cleaning the Arm

Clean the arm using 70% isopropyl

alcohol
Clean area in concentric circles

starting at site and ending outside


of site
 Do not re-touch the cleaned area

Let air dry

13 05/09/2025
Venous Blood Collection Cont’d…
7. Grasp the back of the patient’s arm at the elbow and anchor

the selected vein by drawing the skin slightly taut over the
vein

8. Insert the needle properly into the vein


 The index finger is placed along side of the hub of the needle

with the bevel facing up


 The needle should be pointing in the same direction as the vein

9. Then the point of the needle is advanced 0.5-1.0 cm into the

subcutaneous tissue (at an angle of 450) and is pushed


forward at a lesser angle to pierce the vein wall
14 05/09/2025
Venous Blood Collection Cont’d…

10. When the needle is properly in the vein, the vacuum


tube is pushed into the needle holder all the way so
that the blood flows into the tube under vacuum
11. The tourniquet should be released the moment
blood starts entering the vacuum tube
 Otherwise, some hemoconcentration will develop after
one minute of venous stasis
12. After drawing the required blood sample, apply a
ball of cotton to the puncture site and gently
withdraw the needle
13. Instruct the patient to press on the cotton

15 05/09/2025
Venous Blood Collection Cont’d…
14. Remove the tube from the vacutainer holder and if the

tube is with anticoagulant, gently invert several times


 Invert 8-10 times for EDTA tube

15. Label the tubes with patient’s name, hospital number and

other information required by the hospital (before the


patient leaves the collection area)
16. Re-inspect the venipuncture site to ascertain that the bleeding has

stopped

17. Do not let the patient go until the bleeding stops


 If bleeding does not stop apply band aid

18. Bid farewell to the patient with smile


16 05/09/2025
Venous Blood Collection Cont’d…

1 2

1. Venipuncture technique using an evacuated container; the distal


end of the needle has been screwed into the holder and the
proximal needle has then been unsheathed and inserted into a
suitable vein
2. Venipuncture technique using an evacuated container; the
evacuated container has been inserted into the holder and forced
onto the sharp end of the needle

17 05/09/2025
Venous Blood Collection Cont’d…
Syringe & needle method of venipuncture
 Syringe method a needle is attached to a syringe
and inserted into the vein
 The plunger of the needle is drown back to creates
suction pressure to draw the blood in to the needle
1. Remove the syringe from its protective wrapper and
the needle from the cap
2. Assemble them allowing the cap to remain covering
the needle until use
3. Attach the needle so that the bevel faces in the
same direction as the graduation mark on the
syringe
18 05/09/2025
Venous Blood Collection Cont’d…
4. Check to make sure:
 The needle is sharp
 The syringe moves smoothly
 There is no air left in the barrel

5. Identify the right patient and allow him/her to sit


comfortably preferably in an armchair stretching
his/her arm
6. Reassure the patient
7. Apply the tourniquet
8. Prepare the arm by swabbing the antecubital fossa
with a gauze pad or cotton moistened with 70%
alcohol
19 05/09/2025
Venous Blood Collection Cont’d…
9. Grasp the back of the patient’s arm at the elbow and anchor
the selected vein by drawing the skin slightly taut over the
vein
10. Using the assembled syringe and needle, enter the skin first
and then the vein
11. Insert the needle properly into the vein
 The index finger is placed along side of the hub of the needle
with the bevel facing up
 The needle should be pointing in the same direction as the
vein
12. The plunger is drown back to create suction pressure to draw
the blood
13. After this, all the procedures of vacutainer method is applied

20 05/09/2025
Venous Blood Collection Cont’d…

Venipuncture technique using needle and


21 syringe 05/09/2025
Capillary Blood Collection
 Capillary blood collection is referred to as micro blood samples

collection/dermal puncture
 Is collecting blood after an incision is made to the skin with a lancet

 It is preferred when only small quantities of blood are required

like:
 For hemoglobin quantitation

 For manual WBC and RBC counts

 For blood film preparation (dx. of hemoparasite, morphological

study and diff count)


 Blood group detection

 Blood sugar determination (FBS/RBS)


22 05/09/2025
Capillary Blood Collection cont’d…
 Capillary blood also used when venipuncture is impractical :

 In infants

 In cases of severe burns

 In extreme obesity where locating the veins could be a

problem
 In patient whose arm veins are being used for intravenous

medication
 Sites of Puncture

Adults and children: Palmar surface of the tip of the ring or

middle finger or free margin of the ear lobe


23 Infants: plantar surface of the big toe or the heel 05/09/2025
Capillary Blood Collection cont’d…

Finger Prick

 Fig: Infant heel prick (plantar surface)


 The areas of the foot of a baby or infant
that are suitable for obtaining capillary
blood

24 05/09/2025
Capillary Blood Collection cont’d…
 Considerations during capillary blood collection:

 Edematous, congested and cyanotic sites should not be

punctured
 Cold sites should not be punctured as samples collected from

cold sites give falsely high results of hemoglobin and cell counts
 Site should be massaged until it is warm

 Materials required

 Cotton or gauze pads

 70% alcohol or other skin antiseptic

 Sterile disposable lancet


25 05/09/2025
Capillary Blood Collection cont’d…

Technique:

1. Rub the site vigorously with cotton or a gauze pad


moistened with 70% alcohol
 To remove dirt and epithelial debris and

 To increase blood circulation in the area

 If the heel is to be punctured, it should first be

warmed by immersion in a warm water or


applying a hot towel compress
 Otherwise values significantly higher than those in
26 05/09/2025
venous blood may be obtained
Capillary Blood Collection cont’d…
2. After the skin has dried, make a puncture 2-3mm
deep with a sterile lancet
NB:
 A rapid and firm puncture should be made with control
of the depth
 A deep puncture is no more painful than a superficial
one and makes repeated punctures unnecessary
 The first drop of blood which contains tissue juices
should be wiped away
 The site should not be squeezed or pressed to get blood
since this dilutes it with fluid from the tissues
o A freely flowing blood should be taken or a moderate pressure

27
some distance above the puncture site is allowable 05/09/2025
Capillary Blood Collection cont’d…

3. Stop the blood flow by applying slight pressure at


the site preferably with a gauze pad
 Cotton balls are not recommended, because
they stick to the site and can initiate bleeding
 Advantages of Capillary Blood

Obtained with ease

The preferred specimen for making peripheral

blood films since no anticoagulant is added that


28 may affect cell morphology 05/09/2025
Capillary Blood Collection cont’d…
 Difference Between capillary and Venous Blood
 Higher values in peripheral blood than in venous blood for
 PCV
 RBC
 Hgb
 WBC
 Neutrophil
 Monocyte (by about 12%)
 Higher values in venous than peripheral blood for
 Platelet (by about 9%); may be due to adhesion of
platelets to the site of the skin puncture
29 05/09/2025
Arterial blood collection
 An ideal specimen for many analyses because of the
consistent composition throughout the body
 Venous blood varies relative to the metabolic needs of the

areas of the body it serves


 Arterial blood primarily used for evaluation of arterial blood

gases (ABGs)
 Its is critical for the diagnosis and management of

respiratory diseases
 Assessment of oxygenation problems in

o Pneumonia/pneumonitis

30
o Pulmonary embolism etc. 05/09/2025
Arterial blood collection cont’d…
 Arterial blood is not used for routine tests

because
 Technically difficult and more invasive

 Prone to a lots of pre-analytical interferences:

o Exposure to air before testing

o Delay in transport

o Requires proper specimen collection

 Pressure in arteries makes more difficult to stop

bleeding leads to hematoma


31 05/09/2025
Technical tips in blood collection
 Prevention of Hemolysis

 Use syringe, needle and test tubes that are dry and free from

detergent
 Use smooth and good quality sharp needles

 Avoid rough handling of blood at any stage

 Do not eject the blood from the syringe through the needle

It may cause mechanical destruction of the blood cells

 Transfer the blood from the syringe by gently ejecting down the

side of the tube


 Mix blood with anticoagulant by gentle inversion not by shaking
32 05/09/2025
Technical tips in blood collection (2)

 Prevention of Hemolysis …..

 Tourniquet should not be too tight and should be released

before blood is aspirated


 If examination is to be delayed beyond 1-3 hours, apply

stopper and store in a refrigerator at 4 0C overnight


 Blood should not be stored in a freezer because the red cells

will hemolyze on thawing


 When obtaining blood by skin puncture:

 Make sure the skin is dry before pricking

 Allow the blood to flow freely 05/09/2025


33
Inpatient or Ward Contact
 Before entering a patient’s room
 Always knock before entering
 Greet patient in a friendly manner
 Always make your presence know before proceeding
into the room and pulling back the curtain
 Identifying Yourself
 State your name, where are from and the purpose of
your visit
 If a patient is sleeping, wake gently
 Speak softly
 Never turn on a bright light
 Never attempt to draw blood from a sleeping patient

34 05/09/2025
Inpatient or Ward Identification

Emergency Room patients:

 Should have a identification band on

 Can be asked directly if conscious or put a

temporary band on
 Always make sure all information matches

Young children:

 Confirmed by parents or relatives

35 05/09/2025
Unconscious Patient & Handling Difficult Clients

Unconscious Patient
 Identify yourself and inform the patient of your intent
 Ask caregiver to identify the patient
 Compare this information to the identification bracelet
 Continue to speak to the patient
 Ask for help in holding the patient because they can
sense pain but can not control their reactions
Handling Difficult Clients
 Remain calm and professional
 Treat the client in a caring manner under any
circumstances
 Never force a client to do anything that they do not want

36
to do 05/09/2025
Test Request Form

 Lists the information

needed for collection


 Includes:

 Client’s complete name

 Client’s date of birth/age

 Date and Time specimen is

to be drawn
 Types of tests

 Physician name
37 05/09/2025
Explain the Procedure
 Some clients may have had their blood drawn for testing
 State to the client “I’m going to draw some blood from you
today.”
 Serves two purposes:
 Client aware of what is to happen
 Gives you consent to proceed
Client Inquiry About Tests
Most often asked question is “What are these tests
for?”
If you do not feel comfortable about the question, refer
them to their doctor
If the tests are routine and non threatening you can
explain “ a kidney function test”
All test results are given to the doctor
38 05/09/2025
Needle Disposal

 Needle disposal is done immediately after

the draw
 Dispose needle in a Biohazard SHARPS

container
 Needle and holder are disposed of

together
 Do Not Re-Use Needles or holders

 They are for single use only

39 05/09/2025
Specimen Labeling
Proper and accurate labeling is one of the
most important aspects of Specimen
collection.
Label all tubes after blood is in them
 Labeling is immediately after collection

Should contain:
 Client’s full name
 ID number
 Time of collection
 Date

40
 Phlebotomist initials 05/09/2025
Failure to Obtain Blood
 Remain calm

Check:

Needle Position

 Reposition

Vacuum of the tube

 Replace with a new tube

Tube position

 Lift up or down
41 05/09/2025
Needle Position
 Needle not deep enough
 Slightly push the needle back in

 Needle bevel against vein wall


 Blood flow will be impaired if the
bevel is not in the up position

 Correct angle

 Needle too deep

 Pull back slightly


42 05/09/2025
Needle Position cont’d…
 Needle has slipped beside vein:

 Vein not anchored well, try to redirect slightly

 Needle position can not be determined:

 Try to feel for the vein above or below the site of the needle

 If you can feel the vein, again try to redirect

 If you can’t feel the vein, do not probe blindly, it hurts

 Remove the needle and begin again

 A phlebotomist should only attempt twice to obtain the

specimen

43 05/09/2025
Collapsed Vein
 Sometimes the vacuum in the

tube will cause the vein to


disappear
 Reapply the tourniquet; it may

increase the flow into the area


 If you still don’t feel the vein,

remove the needle and begin


again
44 05/09/2025
Complications in Blood Collection (1)
 SITE SELECTION

 Avoid scars and burns

 Mastectomy:

 Venipuncture should never be performed from the

arm on the same side of the mastectomy


 Edema:

 Abnormal accumulation of fluid in the tissues.

 Lab results will be inaccurate


45 05/09/2025
Complications in Blood Collection (2)

 Hematoma:

 It is a swelling or mass of blood under the skin.

 This area is usually sore and painful.

 Should be avoided

 Obesity:

 Veins may be deep.

 The cephalic is the vein of choice

 Damaged veins:

 Feel hard and cord like, difficult to penetrate and


46 05/09/2025
should be avoided
Complications Affecting the Client
 Allergies:
 May have a reaction to the alcohol or band-aid
 Seizures:
 Remove the needle immediately
 Hold pressure to the site without restriction of the
client’s movements
 Excessive Bleeding:
 Pressure should be maintained for more than 5 minutes
Fainting:
 If there is history, lie the client down.
 If the client faints during the procedure, remove the
needle immediately.
 Put the client’s head between their knees and make
47 05/09/2025
them take deep breaths.
Complications Affecting the Client cont’d…
 Hematoma:
 If one starts to form during the procedure, remove needle
and apply pressure
 Nausea: Client should be made comfortable, deep breaths

 Infection: Rare occurrence, clean site properly and apply


a band-aid
 Pain: A little pain is associated with the procedure

 Petechiae:
 Red spots under the skin which appear when a tourniquet
is left on.
 Usually there is capillary fragility

48 05/09/2025
Collection Techniques Affecting the Specimen
Partially filled tubes:

 Filling additive tubes until the vacuum is exhausted

is important for proper ratio of anticoagulant to blood


 Very important for coagulation studies, under filled

tubes are not acceptable


Specimen Contamination:

 Alcohol can cause contamination, touching the site

not following order of draw

49 05/09/2025
Safety Reminders
 Always use standard or universal blood precautions

when drawing blood


 Always wear gloves when drawing blood

 Identify patient by asking for a name or check

armband
 Do not allow tourniquet to remain on the arm for

more than one minute


 Properly label tubes after the blood is in them

50 05/09/2025

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