1. Phlebotomy Two
Order of draw

2. Which Test first?
Blood Cultures First ( Yellow or glass tops) Looking for Pathogens in the blood. Because you don’t know if it is anaerobic or aerobic you draw for both ( aerobic first) Or
Blue (Coagulation Studies) Sodium Citrate PTT/ PT ( Clotting times)

3. Blood Cultures first
Blood Cultures First ( Yellow or glass tops) Looking for Pathogens in the blood. Because you don’t know if it is anaerobic or aerobic you draw for both ( aerobic first)

4. Which do you draw first
Blue (Coagulation Studies) Sodium Citrate PTT/ PT ( Clotting times) Or
Lavender (CBC) EDTA additive ( invert 8 times to prevent clotting)

5. CBC First:
BLUE CANNOT BE THE FIRST TUBE DRAWN

6. Which would you draw first?
Green : Heparin tubes: For chemistries or
Lavender (CBC) EDTA additive ( invert 8 times to prevent clotting)

7. Green: Chemistries come before CBC in the order of the draw

8. Which would you draw first?
Gray Glycolytic additive ( Alcohol/ Blood Glucose or
Dark Blue( Fibrin Degradable Products) Toxicology, zinc. Lead, drug levels

9. Gray is before dark blue

10. How do we label a tube?
Patient name & DOB
Patient ID (Bar code from lab slip or printed label)
Date/ Time
Initials of phlebotomist

11. Lab # 2 2. Collect supplies/ identify patient 3. Prepare arm and tubes
1. Practice tourniquets on peers
2. Collect supplies/ identify patient
3. Prepare arm and tubes
4. Draw two tubes in correct order and label specimen tubes
5. Clean area

12. Lab 3 Objectives Define test acronyms
Continue with order of draw selections
Label lab testing slips
Complete check off after practicing

13. Abbreviations Thyroid Stimulating Hormone (TSH)
A thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland problems.
Prostate-specific antigen (PSA )
Prostate-specific antigen, or PSA is a protein produced by cells of the
prostate gland. The PSA test measures the level of PSA in a man's blood.
Human Chorionic Gonadotropin ( HCg)
HCG blood test checks if there is a hormone called human chorionic
gonadotropin in your blood produced in the body during pregnancy.

14. Needles Correct size? 21 gauge Used with evacuated tube systems
What size is used with a butterfly?
23 gauge
Which size is too small?
25 gauge often causes hemolysis of blood

15. CBC Lavender This is a complete blood count
Erythrocytes ( Red Blood Cells)
Leukocytes ( White Blood Cells)
Thrombocytes ( Platelets)
blood banking(ABO/Rh)
ESR

16. Cholesterol Panel: part of chemistry
Total blood (or serum) cholesterol ( TOTAL)
Your total cholesterol score is calculated using the following equation: HDL + LDL + 20 percent of your triglyceride level. HDL (good) cholesterol
With HDL cholesterol, higher levels are better.
LDL (bad) cholesterol A low LDL cholesterol level is considered good for your heart health.
Triglycerides
Triglyceride is the most common type of fat in the body. Normal triglyceride levels vary by age and sex.

17. Other Chemistries
chemistries *electrolytes *thyroid (THS, T4) *hormone *liver *kidney *lipid studies

18. PT & INR ( light Blue)
The PT and INR monitor the effectiveness of the anticoagulant warfarin. This drug affects the function of the coagulation cascade and helps inhibit the formation of blood clots.
This balance requires careful monitoring. The INR can be used to adjust a person's drug dosage to get the PT into the desired range that is right for the person and his or her condition
Sodium citrate No clot ~Used for Coagulation studies(PT, PTT) -Tube must be filled to the proper level (inverted "rocked") (must be filled to line)

19. Chilled specimens
Ammonia Lactic acid PTH ABGph/blood gas Catecholamine Gastin

20. What causes hemolysis?
i. too strong a vacuum for size of vein ii. too small needle gauge iii. plunger pulled too quickly iv. Pt. has hemolytic disorder v. shaking tube vi. taking too long to complete draw

21. Order of the draw in capillary collection Finger stick or heel
Different from regular draw order
Pediatrics draw
EDTA
additive tube
serum tubes

22. Labeling before you draw
Read Doctor’s order
Gather tubes and place in order
Do not use tubes that are missing a label
Check the expiration dates on the tubes and needles
Check the seals and do not use if broken
Make sure needles have safety devise : do not use if removed

23. Accessing sites Which veins are primarily used in phlebotomy?
Veins of the antecubital fossa
-median cubital ( most common )
-basilic
-cephalic