In many healthcare settings, the medical assistant is responsible for collecting blood specimens from patients and even performs some testing in the waived category. In order to properly collect the specimens, you will need to review the circulatory system and the function of blood. You will be introduced in this chapter to venipuncture and capillary collection procedures, and you will learn the appropriate supplies and equipment needed to perform these procedures.
CHAPTER 48 Collecting, Processing, and Testing Blood Specimens © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-2 Learning Outcomes 48.1 Discuss the role of the medical assistant when collecting, processing, and testing blood samples 48.2 Carry out the procedure for collecting a blood specimen 48.3 Discuss ways to respond to patients’ needs when collecting blood 48.4 Carry out the procedure for performing blood tests © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-3 Introduction • Medical assistant – Collects blood specimens – Performs waived testing – Knowledge needed • • • • Dealing with patients How to obtain a blood sample Appropriate supplies and equipment How to perform and screen common blood tests © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-4 The Role of the Medical Assistant • Phlebotomy • Putting the patient at ease • Processing specimens and conduct testing • Completing necessary paperwork © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-5 Apply Your Knowledge What is the role of the medical assistant related to collecting blood samples? ANSWER: The medical assistant will put the patient at ease during the procedure, process specimens, conduct testing, complete necessary paperwork, and make sure specimens are handled properly © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-6 Collecting Blood Specimens • Review the test order • Assemble equipment and supplies – Varies with test type – Collection devices ~ label correctly – Alcohol wipes; adhesive bandage – Tourniquet for venipuncture © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-7 Collecting Blood Specimens • Preparing the patient – Greet and identify the patient – Confirm pretest preparation – Explain the procedure and safety precautions – Establish chain of custody – Handle an exposure incident © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-8 Drawing Blood • Know your scope of practice for your state • Phlebotomy – Use Standard Precautions – Use appropriate PPE © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-9 Drawing Blood (cont.) • Venipuncture • Evacuation systems – Double-pointed needle and collection tube holder – Decreased chance of accidental exposure © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-10 Drawing Blood (cont.) • Needle and syringe systems • Butterfly system – Winged infusion set – Less trauma to vein © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-28 Hematologic Tests (cont.) • Hemoglobin – Sample must undergo hemolysis – Color then evaluated – Automated hemoglobin analyzers • Measure amount of hemoglobin in whole blood • Follow manufacturer’s instructions © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-29 Hematologic Tests (cont.) • Cell morphology – requires special training • Coagulation tests – PT and PTT – Automated devices ~ calculate International Normalized ratio (INR) © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-30 Hematologic Tests (cont.) • Erythrocyte sedimentation rate (ESR) – Measures rate of RBCs falling to the bottom of the blood sample – Tube must contain an anticoagulant – Read after one hour – Record as mm/hr © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-31 Chemical Tests • Specialized equipment and techniques • Subject to CLIA ‘88 regulations • New automated equipment – More readily available – Simpler to operate – Development of new waived tests © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-32 Chemical Tests (cont.) • Blood glucose monitoring – Routinely performed in POL – Glucometer – Patient education © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-33 Chemical Tests (cont.) • Hemoglobin A1c – Glucose molecules bind to hemoglobin – Provides overall picture of effectiveness of diabetes treatment – Options • Sent to outside laboratory • Perform in office • Home testing © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-34 Chemical Tests (cont.) • Cholesterol tests – Routinely performed in POL – Automated devices • POL • Home testing – Use a capillary sample © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-35 Serologic Tests • Detection a reaction to an antigen or antibody • Immunoassays – Western blot – Radioimmunoassay (RIA) – Enzyme-linked immunosorbent assay (ELISA) – Immunofluorescent antibody (IFA) test © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-36 Serologic Tests (cont.) • Rapid screening tests – Detect antibodies to certain infections • Infectious mononucleosis • HIV • Helicobacter pylori – Follow manufacturer’s instruction © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-37 Apply Your Knowledge Matching: ANSWER: D Hemoglobin A1c _ A ESR G Lysing RBCs/evaluating the color _ B Serology test _ F Shape or form of objects C Coagulation tests C Identify bleeding problems _ D Chemical test A Rate at which RBCs fall _ E Differential E Percentage of each type of WBC _ F Morphology B ELISA _ G Hemoglobin Super! © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-38 In Summary 48.1 As a medical assistant, you will collect and process blood specimens for examination, make sure the test results are handled efficiently and accurately, and complete the necessary paperwork before and after each test © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-39 In Summary (cont.) 48.2 Blood is collected by venipuncture or capillary puncture When collecting blood specimens, it is essential that you: • confirm the patient’s identity • cleanse the skin prior to collection • follow standard precautions • collect the sample needed in the appropriate tube or container • ensure the patient’s safety © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-40 In Summary (cont.) 48.3 Patients may have concerns when having blood drawn Good communication by the medical assistant is the key to easing these fears There are always patients who will have special needs Each patient will present a special set of challenges and should be treated with the utmost care and concern © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-41 In Summary (cont.) 48.4 Hematologic, chemical, and serologic tests require special care when performing them The medical assistant should review the manufacturer’s instructions carefully for important information about correctly performing each test © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 48-42 End of Chapter 48 Blood will tell, but often it tells too much ~ Don Marquis © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part .. .48- 2 Learning Outcomes 48. 1 Discuss the role of the medical assistant when collecting, processing, and testing blood samples 48. 2 Carry out the procedure for collecting a blood specimen 48. 3... 48- 3 Introduction • Medical assistant – Collects blood specimens – Performs waived testing – Knowledge needed • • • • Dealing with patients How to obtain a blood sample Appropriate supplies and. .. posted on a website, in whole or part 48- 4 The Role of the Medical Assistant • Phlebotomy • Putting the patient at ease • Processing specimens and conduct testing • Completing necessary paperwork