Blood Collection - Ccma

Which action should you take immediately after blood flow is established in a venipuncture?

Release the tourniquet. This step prevents hemoconcentration and reduces venous pressure, ensuring accurate sample quality and patient comfort.
Which order of draw is correct for capillary collection to minimize additive contamination?

Blood gases, EDTA, other additive, serum. This sequence minimizes platelet activation and additive carryover effects unique to capillary blood collection.
What is the maximum time a tourniquet should remain in place before blood draw to avoid hemoconcentration?

No longer than 1 minute. Exceeding this duration can cause hemoconcentration, leading to inaccurate test results by altering blood composition.
Identify the correct direction for bevel orientation when inserting a venipuncture needle.

Bevel up. This orientation allows for better vein penetration and minimizes patient discomfort by aligning with the natural vein structure.
Which option best describes the correct order of draw for evacuated tubes (CLSI standard sequence)?

Blood cultures, light blue, serum, green, lavender, gray. This sequence prevents cross-contamination of additives, preserving sample integrity for various laboratory analyses.
Which tube top color is typically used for complete blood count (CBC) testing?

Lavender (EDTA). EDTA preserves cell morphology and prevents clotting, essential for hematological evaluations like cell counts.
Which action prevents additive carryover and ensures proper anticoagulant-to-blood ratio in tubes?

Fill tubes to the indicated volume. Proper filling maintains the correct additive ratio and prevents contamination between tubes during multi-draw procedures.
Which tube top color is used for coagulation studies and must be filled to the proper level?

Light blue (sodium citrate). It maintains the precise blood-to-anticoagulant ratio required for accurate coagulation testing results.
What is the correct technique for mixing additive tubes immediately after collection?

Gently invert the tube the required number of times. Inversion ensures thorough mixing of blood with additives without causing hemolysis, preserving sample quality.
Which option best describes the correct puncture direction for a fingerstick capillary puncture?

Across the fingerprint ridges (perpendicular to ridges). This direction promotes formation of a round blood drop and reduces tissue trauma for better sample collection.
Which antecubital vein is generally the second-choice site if the median cubital vein is not usable?

Cephalic vein. It serves as an alternative when the primary vein is inaccessible, offering good visibility but potentially more rolling in some patients.
Which tube top color is commonly used for glucose testing when glycolysis must be inhibited?

Gray (fluoride/oxalate). These additives preserve glucose levels by inhibiting glycolysis, ensuring reliable results for metabolic testing.
What is the correct skin antiseptic for routine venipuncture when blood cultures are not ordered?

70% isopropyl alcohol. It effectively cleanses the skin of surface bacteria without interfering with most laboratory tests, ensuring sample integrity.
Which option is the correct response if a patient develops a hematoma during venipuncture?

Stop draw, remove needle, apply firm pressure. This protocol minimizes hematoma expansion and promotes hemostasis, ensuring patient safety during complications.
Which site is preferred for capillary puncture in an adult or child older than 1 year?

Palmar surface of the distal middle or ring finger. This location provides adequate blood flow with minimal risk of nerve damage or excessive pain in older patients.
Which antecubital vein is typically the last choice because of proximity to nerves and the brachial artery?

Basilic vein. Its location increases the risk of nerve damage or arterial puncture, making it suitable only when other options are unavailable.
What is the correct action for the first drop of blood obtained during capillary puncture?

Wipe away the first drop. It removes tissue fluid and contaminants, ensuring a purer blood sample for accurate testing.
Which antiseptic is commonly used for blood culture collection when iodine is not contraindicated?

Chlorhexidine or povidone-iodine. These agents provide superior antimicrobial action necessary to prevent contamination in sensitive blood culture specimens.
Which site is recommended for capillary puncture in an infant younger than 1 year?

Medial or lateral plantar surface of the heel. These areas offer sufficient capillary blood while avoiding calcaneus bone penetration in young infants.
Which tube type is used for serum testing and contains a clot activator and gel separator?

Serum separator tube (SST), gold or tiger top. The activator promotes clotting, while the gel separates serum from cells, facilitating clean serum extraction for testing.
At what angle should the needle typically enter the skin for venipuncture with an evacuated tube system?

Approximately $15^\circ$ to $30^\circ$ . This angle facilitates smooth vein entry and reduces the risk of piercing through the vein wall during the procedure.
Which option is the correct response if a patient faints during or after venipuncture?

Stop draw, remove needle, protect patient, notify provider. These steps prevent injury from falls and ensure prompt medical attention for syncope-related complications.
Which vein is the preferred first-choice site for routine venipuncture in the antecubital fossa?

Median cubital vein. This vein is preferred due to its large size, superficial location, and stability, minimizing complications during routine blood collection.
What is the minimum drying requirement for alcohol antiseptic before performing venipuncture?

Allow the site to air-dry completely. Drying ensures effective disinfection and prevents hemolysis or dilution of the blood sample from residual antiseptic.
What is the maximum recommended depth for an infant heel puncture to avoid bone injury?

No deeper than $2.0\ \text{mm}$ . Limiting depth prevents penetration to the calcaneus bone, reducing the risk of osteomyelitis in infants.

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