027

Document Sample
027 Powered By Docstoc
					Lab Nursing Manual


HEMOSTASIS/THROMBOSIS – ROUTINE BLOOD COLLECTION AND TRANSPORT


     Obtain venous blood by clean venipuncture. Avoid slow flowing draws and/or
      traumatic venipunctures.

     Do not use needles smaller than 23 gauge. (Ideal needle gauge is 21 to 19).

     For an uncomplicated direct venipuncture involving only a needle and vacuum
      collection tube, a discard (pilot) tube is not needed. Specimen can be collected
      directly in light blue HEMOGARD top vacuum tubes (3.2% buffered sodium
      citrate).

     If a blood collection set (i.e. butterfly) is used, always draw a pilot tube (plain red
      top tube – no additives) before drawing coagulation specimens in light blue
      HEMOGUARD top vacuum tubes (3.2% buffered sodium citrate).

     Discard the pilot tube or use for other suitable Laboratory testing.

     Draw coagulation specimens BEFORE any other additive tubes.

     Fill light blue HEMOGUARD top tubes as far as vacuum will allow, an exact ratio
      of 9 parts blood to 1 part anticoagulant must be maintained: Mix by gentle
      inversion exactly 2.7 mL of blood to 0.3 mL of 3.2% sodium citrate.

     Deliver collected specimen immediately (within 30 minutes) to Laboratory at
      room temperature to ensure testing within 2 hours of collection.

     NOTE: Heparin interferes with most clotting assays. Samples containing
      heparin SHOULD NOT be used for coagulation studies. Do not have the IV
      Team or nurse draw coagulation specimens from any line in which heparin is
      being infused or that has been flushed with heparin. (The only exception to this
      is from direct conversation with or written orders from the ordering physician,
      mandating analysis of such specimen). Venipuncture is preferred from arm
      opposite the infusion site. If no alternate site is available, have heparin therapy
      stopped for 3-5 minutes before the draw to avoid contamination. Draw “Waste”
      tube of 8-10 mL of blood and then collect blue tope. Notify Hematology of the
      method of collection.




N: 27, 8/13/03; Rev. 9/1/04; 09/12/06; 05/08/07                                   Page 1 of 1

				
DOCUMENT INFO