Handling and Processing of Blood Specimen for Laboratory Testing
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Special Handling • (cold agglutinins, cyrofibrinogen, cryoglobulin)
Body Temperature
Special Handling • (ACTH, ACE, ammonia, cathecholamines, free fatty acids, gastrin, glucagon, homocysteine, lactic acid, parathyroid hormone (PTH), pH / blood gas (if indicated), pyruvate, renin)
Chilled specimen
Special Handling • (bilirubin, carotene, red cell folate, serum folate, Vitamin B2, Vitamin B6, Vitamin B12, Vitamin C, urine porphyrins, urine porphobilinogen
Light-sensitive specimen
Blood Specimen Processing order
IDENTIFIED →→ LOGGED OR ACCESIONED →→ SORTED BY DEPARTMENT AND TYPE OF PROCESSING →→ EVALUATED FOR SPECIMEN SUTIABILITY WHICH IS NECESSARY TO GET ACCURATE RESULTS
Blood specimen Any specimen will be rejected for the following reasons:
• Specimen is not identified properly. • It has inadequate volume to complete the test. • There is hemolysis. • Wrong tube for collection is used 5. Tube used is outdated • There is improper handling (improper mixing) • The specimen is contaminated. • Specimen is insufficient or “quality not sufficient” (QNS). • Collection time is incorrect. • Specimen is exposed to light. • Procedure did not follow testing time limits • There is a delay or error in processing.
Processing Specimen DELIVERY TIME Routine blood specimen – within __ minutes
45
Processing blood Specimen DELIVERY TIME Centrifugation – done in
1 hour
Processing blood Specimen DELIVERY TIME • – should not be centrifuged
Lavender or purple stopper
– priority specimen in terms of transportation, processing and testing
STAT (emergency)
Collection Priorities
• Routine Samples • Stat Samples
• tests that are ordered by the health-care provider to diagnose and monitor a patient’s condition. • usually collected early in the morning but can be collected throughout the day during scheduled “sweeps” (collection times) on the floors or from outpatients.
Routine Samples
• the sample is to be collected, analyzed, and results reported immediately. • highest priority and are usually ordered from the emergency department or for a critically ill patient whose treatment will be determined by the laboratory result. • The sample must be delivered to the laboratory promptly and the laboratory personnel notified.
Stat Samples
an apparatus that is used to separate cells, plasma, or serum of blood specimens.
centrifuge
Centrifugation is achieved by spinning the blood tubes inside the vessel at a high speed such that the centrifugal force will cause the of the __________ specimens.
separation
• It must be noted that the tubes should be ________ in a centrifuge; tubes of the same size and volume of specimen should be placed _________ one another. The process of centrifugation should not be repeated.
balanced, opposite
– collected in tubes with anticoagulants ; this should be centrifuged immediately and without delay
Plasma specimen
– needs to be completely clotted prior to centrifugation. (30 to 60 minutes at room temperature)
Serum specimen
Composition of Blood Total blood volume in an adult is 5 to 6 liters or 7 to 8% of the total body weight. Blood is analyzed in the form of
whole blood, plasma, or serum
• liquid portion of anticoagulated blood
Plasma
• liquid portion of clotted blood
Serum
refers to a portion of a sample specimen • taken for chemical analysis or testing. It is prepared when multiple tests are ordered on a single specimen. The preparation is done by transferring a portion of the specimen into one or more tubes that are labeled with the same information as the original specimen tube using a disposable transfer pipette. Specimens with different anticoagulants should not be put in the same aliquot tube. The phlebotomist must see to it that the tube is covered as soon as it is filled.
aliquot of specimen
Blood Specimen of Concern • hemolyzed specimens • icteric specimens • lipemic specimens
Specimen of Concern appear red because of the release of hemoglobin from RBCs
hemolyzed specimens
Specimen of Concern – appear yellow because of the presence of excess bilirubin
icteric specimens