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Blood Collection
A SHORT COURSE
EDITION 2
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Blood Collection
A S H O RT C O U R S E
EDITION 2
Marjorie Schaub Di Lorenzo, MT(ASCP)SH
Adjunct Clinical Laboratory Science Instructor
Division of Clinical Laboratory Science
School of Allied Health Professions
University of Nebraska Medical Center
Omaha, Nebraska
Phlebotomy Technician Program Coordinator
Health Professions
Nebraska Methodist College – The Josie Harper Campus
Omaha, Nebraska
Susan King Strasinger, DA, MT(ASCP)
Faculty Associate
The University of West Florida
Pensacola, Florida
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Library of Congress Cataloging-in-Publication Data
Di Lorenzo, Marjorie Schaub, 1953-
Blood collection : a short course / Marjorie Schaub Di Lorenzo, Susan King Strasinger. — 2nd ed.
p. ; cm.
Rev. ed. of: Blood collection in healthcare / Marjorie Schaub Di Lorenzo, Susan King Strasinger. c2002.
Includes bibliographical references and index.
ISBN-13: 978-0-8036-1699-8
ISBN-10: 0-8036-1699-6
ISBN-10: (invalid) 0-8036-2056-X
1. Blood—Collection and preservation. 2. Phlebotomy. I. Strasinger, Susan King. II. Di Lorenzo, Marjorie Schaub,
1953- Blood collection in healthcare. III. Title.
[DNLM: 1. Phlebotomy—instrumentation. 2. Phlebotomy—methods. 3. Blood Specimen Collection—instrumen-
tation. 4. Blood Specimen Collection—methods. QY 25 D525b 2009]
RB45.15.D525 2009
616.07’561—dc22
2009002932
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To my husband, Scott,
and my children, Michael, Christopher, and Lauren
MSD
To Harry,
you will always be my Editor-in-Chief
SKS
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Preface
This short course textbook is designed to provide practicing health-care personnel with concise
information on the proper techniques to collect quality blood specimens with minimal patient
discomfort. The purpose of the book, Blood Collection: A Short Course,Edition 2, is primarily for
the cross-training and continuing education of health-care professionals currently performing
phlebotomy work or those who anticipate performing phlebotomy procedures in the future.
Today’s concept of developing health-care teams to help streamline patient care has evolved to
encompass the cross-training of nurses, respiratory therapists, radiographers, medical assistants,
certified nursing assistants, and medical technologists. Phlebotomy has become a major part of
this cross-training.
Topics emphasized in the text include the following:
• Types of blood required for specific lab tests
• Purpose of these tests, vein selection, and alternate sites
• Types of collection tubes and the purpose of anticoagulants
• Order of draw
• Test-specific handling
• Complications and remedies
• Storage and transportation conditions
In addition, Blood Collection, Edition 2, includes two new chapters on point-of-care testing,
and IVs and central venous access devices (CVADs). Information common to all health-care cur-
riculums, such as safety precautions, anatomy and physiology, quality assurance, and patient-
caregiver interactions, is covered only in the context of their relationship to the collection of
blood specimens.
This current comprehensive text provides a cost-effective, compact learning tool for phle-
botomy short courses. Coverage of the following topics is included in this edition:
• Blood collection equipment, including the newest safety devices
• Technical procedures for venipuncture and dermal puncture
• Special collection procedures, including access to central venous catheters and IV insertion
and care
• Specimen handling, storage, and transport procedures
• Methods to increase the quality of blood specimens
• Correlation of laboratory tests and clinical disorders
• Quality assurance procedures required by laboratory regulatory agencies as they relate to
phlebotomy
Note that all procedures are written to comply with the standards set forth by the
Occupational Safety and Health Administration, The Joint Commission, and the Clinical and
Laboratory Standards Institute.
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viii Preface
Moreover, the following pedagogical features are included in this text to facilitate learning:
• Learning objectives
• Technical tips, to avoid complications, such as hematomas and hemolysis
• Safety tips
• Practical situation problem-solving exercises
• Performance evaluation checklistsfor technical procedures
• Review questions
• Numerous illustrations, photographs, diagrams, charts, and tables
• Internet Help
This text provides a quick reference with the most current updates for blood collection skills.
Appendices list reference material, such as frequently ordered laboratory tests with the required
types of anticoagulants and volume of blood required. A summary of laboratory tests, their func-
tions, and their clinical correlation is included. Answer keys for the situation problem-solving
exercises and review questions sections also are available. A complete color tube guide lists all
the different types of collection tubes, the additives, number of inversions required, and labora-
tory uses of the tubes. A PowerPoint presentation, Lecture Outlines, and a Comprehensive Test
with answers provide instructors who adopt the book with additional instructional tools.
We specifically designed this text to meet the needs of nurses and other health-care profes-
sionals who want and need to add a new phlebotomy competency or to reinforce past learned
skills. It can be used to promote learning in academic settings, hospital-training sessions, or con-
tinuing education courses.
REFERENCES
Clinical and Laboratory Standards Institute. Procedures for the Collection of Diagnostic Blood
Specimens by Venipuncture, ed. 6. Approved Standard, H3-A6, Wayne, PA, 2007.
Clinical and Laboratory Standards Institute. Procedures for the Handling and Processing of
Blood Specimens, ed. 3. Approved Guideline, H18-A3, Wayne, PA, 2004.
Clinical and Laboratory Standards Institute. Procedures and Devices for the Collection of
Diagnostic Capillary Blood Specimens, Approved Standard, ed. 6. H4-A6, Wayne, PA, 2008.
Clinical and Laboratory Standards Institute, Tubes and Additives for Venous Blood Specimen
Collection, Approved Standard, ed. 5, Wayne, PA, 2003.
Elkin, Perry, & Potter, (2007). Nursing Intervention & Clinical Skills, 4th Edition. St. Louis,
Missouri: Mosby, Inc.
Policies and Procedures for Infusion Nursing, 3rd Edition, pages 168–172. Infusion Nurses
Society, 2006.
Strasinger, SK and Di Lorenzo, MS. The Phlebotomy Workbook, ed. 2. FA Davis, Philadelphia,
2003.
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Contributors
Brenda L. M. Franks, BS, MT(ASCP) Karen Maggio-LaRose, RN, MSN
Point-of-Care Testing Coordinator Staff Nurse
Nebraska Methodist Health System Joint Ambulatory Care Center
Omaha, Nebraska Gulf Coast Veterans Health Care System
Unit 7: Point-of-Care Testing Pensacola, Florida
Unit 8: Intravenous Insertion and Central
Venous Catheter Assess
Reviewers
Karen Gordon, CLS(NCA), MT(ASCP)SLS, PBT(ASCP) Brenna Ildza, MT (ASCP)SH, PBT
Clinical Education Coordinator Director of Phlebotomy Education Program
Phlebotomy Pathology Department
Northern Virginia University Saint Luke’s Hospital
Falls River, Virginia Kansas City, Missouri
Jeanne Griffith, BS Patty Janousek, BSN, CRNI
Director of Training Methodist Hospital
OIC Training Academy IV Team Leader
Fairmont, West Virginia Omaha, Nebraska
Frankie Harris-Lyne, MLT (ASCP), CLS Mary Shivers
Assistant Dean MLT Program Director
Allied Health Division Copiah-Lincoln Community College
Medical Laboratory Technology & Phlebotomy Wesson, Missouri
Programs
Diane Wolff, MLT(ASCP)
Northern Virginia Community College
Methodist Hospital
Springfield, Virginia
Phlebotomy Team Leader
Omaha, Nebraska
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