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Jimmy Hall, RN, BSN
Identify phlebotomy process Identify common lab tests Identify common tubes used
Verify order/requisition for tests ordered Identify any special requests (some lab
tests may need to be sent on ice, etc.) Gather supplies
Tourniquet Alcohol Needle/Syringe/butterfly Tubes Gauze Band-aid
Identify patient Get patient to state name and social security
number if possible Select a site for venipuncture
Always best to stick distal If receiving IV fluids, use opposite arm if
possible If not possible, stick below IV site or turn IV fluids
off for at least 2 minutes before sticking above IV site
Place tourniquet – tourniquet should not remain on the arm longer than ONE MINUTE
Sites to Avoid Arms in a cast Arms with IV Edematous arm Cannula Fistula Vascular graft Areas of extensive scarring Side of the body that a mastectomy was
performed
Prepare equipment, the patient, and the puncture site. Explain procedure to patient Place supplies nearby Clean site (Chloraprep, alcohol)
Cleanse site in a circular motion from the center outwards with a 70% isopropyl alcohol solution
Allow site to dry
Puncture vein with bevel edge up at a 15 degree angle
Release tourniquet once blood flow begins Fill each tube until blood flow stops flowing into the
tube Place a gauze to over puncture site and remove
needle. Invert tubes 5-10 times when tube contains additive Place bandage to site
***Place needles and all sharps in sharps container immediately.
DO NOT PLACE SHARPS ON BED!
Insert tubes into holder in the correct order of draw: Blood culture tubes Light blue top tubes Red/Gold top tubes Green top tubes Lavender top tubes Gray top tubes
**When using a butterfly collection set for venipuncture and a light blue top tube is first tube to be drawn, a discard tube should be drawn first**
Specimen label should include: Patient’s first and last name Identification number (account # or medical
record #) Date and time of collection Initials of person collecting the specimen
Light Blue PT, PTT, Fibrinogen, Fibrin D-Dimer, other
coagulation testing Invert gently 3-4 times
Red top (red/black and red/gold)
For tests requiring serum; contains clot activator Common tests:
Red/Black: type/cross match Red/Gold: CMP, BMP, drug levels
Light Green (Lithium Heparin)
Troponin, Metabolic Panels, Lipid, Liver Panels, Ammonia (on ice), HIV Rapid Anti-body
Bright Green (Sodium Heparin)
Mycobacteriology (AFB) Blood Culture, HLA-B27, Chromosome Studies
Dark Green (Lithium Heparin)
Ammonia (on ice), Ionized Calcium
Lavender tube: Hematology : CBC, Platelet, Sed. Rate Chemistry: CD4, CD8, G6PD, Hemoglobin
A1C, and Hemoglobin Variants
Gray Lactate (Lactic Acid) on ice
University of California, San Francisco. Plastic tube top color and order of draw. March, 2009. Retrieved April 2, 2010, from http://labmed.ucsf.edu/sfghlab/test/pdf/Plastic%20Tube%20Top%20Color%20and%20 Order%20of%20Draw%20Chart.pdf
University of Mississippi Medical Center. October 20, 2009. Phlebotomy procedure.
Retrieved April 2, 2010, from http://pathology.umc.edu/phlebotomy_pro cedure.html
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