Why is the Order of the Draw Important?
The order of the draw is important because it helps to prevent contamination of the samples, which could lead to inaccurate test results. Different blood collection tubes contain different additives that can affect subsequent tests if mixed. For example, if an anticoagulant from one tube contaminates the serum in another tube, it could artificially alter values in tests performed on that serum.
What is the Correct Order?
The correct order of draw, according to standard guidelines (such as those set by the Clinical and Laboratory Standards Institute - CLSI), when drawing blood for the tests you mentioned is:
- Light Blue Top (for pro-time - PT, which requires citrate)
- Red Top (for serum tests like A1C)
- Lavender/Purple Top (for complete blood count - CBC, which contains EDTA)
- Green Top (for TSH - thyroid-stimulating hormone, which may be heparinized depending on lab policy)
Note that the order may vary slightly based on specific protocols in place at different laboratories but generally follows this sequence.
What Area and Technique Would You Use?
The blood draw should be performed in a clean clinical area that is equipped for phlebotomy, such as a treatment room with appropriate seating, equipment, and disposal options.
Technique:
- Preparation: Ensure everything needed is within reach: tubes, gloves, alcohol swabs, gauze, bandages, and trash.
- Hand Hygiene: Perform hand hygiene in accordance with clinical guidelines.
- Patient Preparation: Identify the patient, confirm the order, and position them comfortably.
- Site Selection: Clean the venipuncture site typically in the antecubital area with an alcohol swab, allowing it to dry.
- Venipuncture: Use a sterile needle, inserting at the correct angle, and start drawing blood into the tubes according to the proper order.
- Aftercare: Apply pressure and bandage after the draw.
What is the First Thing That an MA Needs to Do When They Receive a New Instrument in the Office?
When a medical assistant (MA) receives a new instrument or equipment, the first thing they need to do is to read the manufacturer's instruction manual. This will help them understand the proper setup, calibration, and usage of the equipment as well as any safety precautions that need to be followed.
Define CLIA-Waived Testing
CLIA-waived testing refers to laboratory tests that are simple to perform, carry a low risk of erroneous results, and are allowed under the Clinical Laboratory Improvement Amendments (CLIA) to be performed in non-laboratory settings, such as physician offices or clinics. These tests meet certain criteria that ensure they can be performed safely and effectively by non-laboratory personnel.
When Performing CLIA-Waived Testing, What Are Some of the Things That Need to Be Done to Ensure That Machines Are Functioning Correctly?
When performing CLIA-waived testing, several steps need to be taken to ensure that machines are functioning correctly:
- Calibration: Regularly calibrate the equipment according to the manufacturer’s guidelines.
- Quality Control (QC): Perform daily quality control tests with known control materials to verify the accuracy of the results. This typically involves running control tests before patient tests.
- Maintenance: Regularly maintain and clean the equipment as recommended by the manufacturer—this can include changing filters, cleaning surfaces, and ensuring that the instrument is free from dust.
- Documentation: Document all calibration and quality control results, including any corrective actions taken if issues arise.
- Training: Ensure that all staff performing the tests are trained and familiar with the procedures and interpretive criteria.
- Keep Records: Maintain records of quality control and calibration results for compliance and regulatory purposes.
These practices help maintain the reliability of CLIA-waived tests and safeguard patient health.