A - CHAPTER III: PHLEBOTOMY
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– collection of minute sample of blood through capillary puncture
MICROSAMPLING
INFANTS up to 1 year of age
• Plantar surface of the big toe • Median or lateral side of the heel • Depth of puncture: up to 2.4 mm
ADULTS:
• Middle or ring finger • Puncture must be slightly off-center, perpendicular to the fingerprint • Margin of the earlobe • Depth of puncture: up to 3.1 mm
– collection of a greater volume of blood from the veins or arteries
MACROSAMPLING
ARTERIAL PUNCTURE:
• Collection of arterial blood for blood gas analysis or blood pH determination • Common sites: radial artery, brachial artery, femoral artery
• Collection of venous blood
VENIPUNCTURE
Infants up to 18 months:
External jugular vein Superior longitudinal sinus Temporal vein
18 months to 3 years:
Popliteal vein Femoral vein Long saphenous vein Ankle vein
3 years to adulthood:
Veins on the antecubital fossa Wrist vein Veins on the dorsal of hands & feet
3 years to adulthood:
Veins on the antecubital fossa Wrist vein Veins on the dorsal of hands & feet
METHODS OF PERFORMING VENIPUNCTURE:
I. OPEN SYSTEM II. CLOSED SYSTEM
– use of syringes
OPEN SYSTEM
• The hub of the needle is color-coded, corresponding to its gauge
OPEN SYSTEM
• The lower the gauge, the bigger the bore of the needle
OPEN SYSTEM
– use of an evacuated system (evacuated tube, two-way needle and adapter)
CLOSED SYSTEM
• Evacuated tubes are equipped with a hemogard (color-coded in accordance to the additive present)
CLOSED SYSTEM
• Multiple sampling can be carried out
CLOSED SYSTEM
– liquid portion of clotted blood
SERUM
– liquid portion of anti-coagulated blood
PLASMA
: preparation involves the removal of proteins from any biological specimen to prevent direct colorimetric interference by the formation of zwitterions at isoelectric pH where proteins exhibit maximum precipitation and minimum solubility
PROTEIN-FREE FILTRATE (PFF)
METHODS of PFF PREPARATION:
A. Physical Methods: 1. Heat 2. Ultracentrifugation B. Chemical Methods (ACID Method) 1. Folin-Wu 2. Hayden’s method 3. Van Slyke 4. TCA (5%) (BASE Method) 1. Nelson-Somogyi
▪ Specimen: whole blood; plasma/serum ▪ 2/3 N Sulfuric acid ▪ 10% sodium tungstate
Folin-Wu
▪ Specimen: serum ▪ N/12 Sulfuric acid ▪ 10% sodium tungstate
Hayden’s method
• makes use of a pre-mixed acid
Van Slyke