NHA Module 8 Phlebotomy

NHA Module 8

Patient Preparation and Procedure

This presentation provides an overview of patient preparation
instructions and the proper procedure for blood collection.

Patient Preparation Instructions

●Patient preparation instructions are essential for accurate test values.

●Fasting is the most common patient preparation instruction.

●Patients should not eat or drink anything but water for a certain period of
time before a blood draw.

●Most fasting blood tests require a 12 hour fast.

●Certain substances in the blood can be affected by fluid intake and food.

For example, patients should fast prior to having a lipid panel.Meal intake
prior to the test can lead to elevated lipid levels.

●Medication restrictions may also be a patient preparation requirement.

●Verify that all preparation guidelines were followed prior to phlebotomy
procedures.

Approaching Patients with
Care

●Introduce yourself and approach
each patient with a pleasant, warm
demeanor.

●Some patients have little or no issue
with blood collection, while others
may have anxiety.

●Make patients as comfortable as
possible and be sensitive to their
needs.

●Ensure effective communication and
accurate skills when dealing with
children.

Preparing for Venipuncture

●Seat the patient in a comfortable, well lit area.

●Position the patient with their arm extended out.

●Use a phlebotomy chair with an extended armrest if available.

●If not, have the patient make a fist with the opposite hand and place it
behind the elbow of the arm being used.

●This ensures the arm stays straight and stable during the procedure.

●For pediatric patients, a support person can assist in holding the patient's
arm still.

●Communication and accurate skills are necessary when dealing with
children.

●Question patients about previous blood draws and any reactions they have
had.

●Prepare for possible adverse reactions and make necessary adjustments
or accommodations.

Multiple Choice

Priya is scheduled for a blood test tomorrow. What is the most common patient preparation instruction she should follow for accurate test values?

• Medication restrictions

• Fasting

• Exercise

• Hydration

Multiple Choice

Ava needs to undergo a fasting blood test. How long should she fast before the test?

• 6 hours

• 8 hours

• 12 hours

• 24 hours

Multiple Choice

Emma is preparing for a blood test. What should she avoid consuming before the blood draw?

• Water

• Alcohol

• Food and drinks other than water

• Caffeine

Multiple Choice

Mia is scheduled for a lipid panel test. Why should she fast before having the test?

• To reduce stress

• To lower blood pressure

• To prevent elevated lipid levels

• To increase hydration

I

Phlebotomy procedure

Obtaining the provider's order
is the first step to begin any
phlebotomy procedure.

Review the provider's order for
blood work to determine the
tests needed.

Step 1: Obtaining the Provider's Order

Venipuncture procedures
should not be performed
without a provider's order.

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02

03

04

Review the laboratory

order and complete the

requisition form.

Use the laboratory

directory if unfamiliar

with a test.

The directory provides
information on specimen
requirements, patient
preparation, container
type, and
transport/processing
requirements.

A hard copy can be found
in most laboratories or a
digital copy online.

Step 2: Review the Laboratory Order

Step 3: Identify the
Patient

●Use two patient identifiers, usually
the full name and date of birth.

Multiple Choice

Maya is visiting the hospital for a check-up. What are the two patient identifiers usually used to identify her?

• Full name and date of birth

• Address and phone number

• Medical record number and insurance provider

• Blood type and allergies

Multiple Choice

Dr. Ava is filling out a laboratory requisition form. What information must she include for each test?

• Patient's favorite color

• Ordering provider's name and contact information

• Patient's dietary preferences

• Test location

Multiple Choice

Michael is filling out a laboratory requisition form for a blood test. What is the purpose of including a diagnosis code (ICD10) in this form?

• To identify the patient's insurance provider

• To correlate with the tests being ordered

• To determine the patient's age

• To specify the test location

Multiple Choice

Hannah is filling out a laboratory requisition form. What should she note regarding special specimen requirements?

• Patient's height

• Fasting requirements

• Test duration

• Patient's favorite food

Multiple Choice

Grace is filling out a laboratory requisition form. What additional information does she need to include besides test details?

• Patient's hobbies

• Patient demographics and insurance/billing information

• Patient's favorite movie

• Test equipment used

Step 4: Laboratory Requisition Form

●Complete a laboratory requisition form for each test.

●Include the ordering provider's name and contact information.

●Add the test and test code (unique to each lab).

●Include the diagnosis code ICD10) that correlates with the tests being
ordered.

●Note any special specimen requirements, such as fasting.

●Enter patient demographics and insurance/billing information.

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02

Step 5: Supplies and Equipment

General supplies include alcohol wipes, gauze,
adhesive bandages, biohazard sharps container, PPE
(including disposable gloves), tourniquet, collection
tubes, and needle system.

Supplies and equipment needed vary depending on
the venipuncture procedure.

Multiple Choice

When Maya visits the hospital for a check-up, what is crucial for the healthcare provider to do?

• Use complex medical terms

• Ensure effective communication and accurate skills

• Be indifferent to their needs

• Avoid explaining procedures

●There are three standard options for needle system preparation.

●Choose the needle length and gauge based on the vein depth and patient size.

●Vacutainer needles are typically 2022 gauge with a needle length of ¾ inch to 1 ½
inches.

Step 6: Needle System Preparation

Evacuated System

Winged Infusion Set,
or Butterfly System

Needle Syringe System

Phlebotomy Techniques

Evacuated system

Double-pointed needle, plastic needle holder/adapter, and collection
tubes. This method helps obtain multiple tubes of blood with one
venipuncture stick.

Winged Infusion Set, or Butterfly System

●Causes less trauma or bruising

●Needles are typically 21 to 23 gauge with a
length of ½ to ¾ inch

●Consists of flexible wings attached to needle
with flexible tubing

●Best for patients small or fragile veins.

Needle Syringe System

●Uses a needle and syringe to draw
blood from a vein

●Only allows a small amount of blood
to be obtained

●Suction can be controlled by the
syringe plunger

●16 gauge injection needle and syringe
are commonly used

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02

03
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05

Ensure all necessary supplies
are within reach

Hold the needle in the
dominant hand

Avoid switching hands once the

skin is penetrated

Arrange supplies in the order

needed

Proper Procedure

Place sharps container on the
dominant side

Multiple Choice

Mia is preparing for a medical exam and needs to gather supplies for venipuncture. Which of the following is NOT listed as a general supply for venipuncture?

• Alcohol wipes

• Gauze

• Stethoscope

• Tourniquet

Multiple Choice

During a lab session, Rohan was asked to gather venipuncture supplies. What does PPE stand for in this context?

• Personal Protective Equipment

• Professional Protective Equipment

• Public Protective Equipment

• Personal Prevention Equipment

Multiple Choice

Why do supplies and equipment vary for venipuncture procedures when Aiden is performing them?

• Due to the patient's age

• Depending on the venipuncture procedure

• Based on the time of day

• According to the weather

Multiple Choice

Rohan is learning about medical procedures. What factors should he consider when choosing the needle length and gauge?

• Patient's age and weight

• Vein depth and patient size

• Blood type and volume

• Skin color and texture

Multiple Choice

Mia is learning about different medical systems in her phlebotomy class. Which system is depicted with a safety cap in the diagram?

• Needle Syringe System

• Winged Infusion Set

• Evacuated System

• Intravenous System

Multiple Choice

Ava is learning about different medical tools in her nursing class. What is another name for the Winged Infusion Set?

• Needle Syringe System

• Butterfly System

• Evacuated System

• Safety Cap System

Multiple Choice

Ava is training to become a phlebotomist. What is the main advantage of using the evacuated system in her practice?

• It requires multiple venipuncture sticks.

• It uses a single venipuncture stick to obtain multiple tubes of blood.

• It is used for injecting medication.

• It is a manual blood collection method.

Multiple Choice

During a medical training session, Grace is learning about different blood collection methods. What is one of the main benefits of using a Winged Infusion Set, or Butterfly System?

• Causes more trauma or bruising

• Causes less trauma or bruising

• Increases risk of infection

• Is difficult to use

Blood Components

●Blood is composed of plasma, white
cells, red cells, and platelets

●Plasma contains water, waste products,
gases, proteins, and nutrients

●White blood cells defend the body
against bacteria and viruses

●Red blood cells carry oxygen
throughout the body

●Platelets limit blood loss when a vessel
is damaged

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Serum

●The liquid portion of the blood obtained after a
serum sample tube has clotted and centrifuged.

●Used for various diagnostic tests

●Liquid portion of blood obtained after clotting
and centrifuging

●Liquid portion of blood
obtained after centrifuging

●Blood specimen must be
collected in an anticoagulant
tube

●Contains various components
including water and proteins

Plasma

Multiple Choice

'What are the main components of blood?'

• Plasma, white cells, red cells, and platelets

• Plasma, red cells, and water

• White cells, platelets, and nutrients

• Red cells, proteins, and gases

Multiple Choice

'What does plasma contain?'

• Water, waste products, gases, proteins, and nutrients

• Oxygen, carbon dioxide, and enzymes

• Hormones, vitamins, and minerals

• Lipids, carbohydrates, and salts

Multiple Choice

'What is the function of white blood cells?'

• Carry oxygen throughout the body

• Defend the body against bacteria and viruses

• Limit blood loss when a vessel is damaged

• Transport nutrients to cells

Multiple Choice

What role do red blood cells play in the body?

• Defend against bacteria and viruses

• Carry oxygen throughout the body

• Limit blood loss when a vessel is damaged

• Produce antibodies

Multiple Choice

What is the liquid portion of the blood obtained after a serum sample tube has clotted and centrifuged?

• Plasma

• Serum

• Buffy Coat

• Erythrocytes

Multiple Choice

Which component of blood is obtained after centrifuging and must be collected in an anticoagulant tube?

• Serum

• Plasma

• Leukocytes

• Platelets

Multiple Choice

Which of the following is NOT a component of plasma proteins?

• Albumin

• Immunoglobulins

• Clotting factors

• Erythrocytes

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DETERMINE ORDER OF DRAW

Vacuum stopper tubes are identified by the color of the top of
the tube, which also identifies any additive within the tube. The
tubes must be drawn in the proper order to avoid
cross-contamination of the additives. If the tubes are not drawn
in the correct order, the additives could inadvertently affect
laboratory results.

The order of blood tube draw is critically important to avoid
errors. During the blood draw process, the additive from
one tube can carry over to another and affect test results.

Multiple Choice

What is the purpose of identifying vacuum stopper tubes by the color of the top of the tube?

• To match the patient's clothing

• To identify the type of blood

• To identify any additive within the tube

• To make the tubes look attractive

Multiple Choice

Why is it important to draw tubes in the proper order?

• To save time during the process

• To avoid cross-contamination of the additives

• To make the process more colorful

• To ensure the tubes are filled completely

Multiple Choice

What could happen if the tubes are not drawn in the correct order?

• The tubes might break

• The additives could inadvertently affect laboratory results

• The tubes will change color

• The process will be faster

Multiple Choice

Which tube should be drawn first?

• Light Blue

• Green

• Yellow

• Pink

Multiple Choice

Select the Correct Tube.

Contain the anticoagulant ethylenediamine tetra‑acetic acid (EDTA) and are used to obtain whole blood or plasma. The most common use is to collect a blood specimen for a complete blood count (CBC).

• Yellow

• Red

• Light Blue

• Purple

Multiple Choice

Which tube is used for hematology testing?

• Purple

• Yellow

• Green

• Red

Multiple Choice

Which tube does not contain anticoagulants?

• Yellow

• Red

• Purple

• Gray

Multiple Choice

The doctor orders a complete blood count. You will collect a...

• Yellow tube

• Gold tube

• Purple tube

• Green tube

Multiple Choice

The doctor orders a glucose tolerance test. You will collect a...

• Gray tube

• Pink tube

• Gold tube

• Purple tube

Multiple Choice

Coagulation test are collected in a....

• Light Blue tube

• Yellow tube

• Red tube

• Pink tube

Multiple Choice

When drawing blood cultures with a butterfly needle which tube should be collected first?

• Aerobic

• Anaerobic

Multiple Choice

When collecting blood cultures using a syringe which tube shouldd be collected first?

• Aerobic

• Anaerobic

Multiple Choice

Which tube should be collected first?

• Green

• Purple

• Light Blue

• Red

Multiple Choice

Select the correct tube.

Contain the anticoagulant ethylenediamine tetra‑acetic acid (EDTA) and are used to obtain whole blood or plasma. The most common use is to collect a blood specimen for a complete blood count (CBC).

• Red

• Purple

• Gray

• Light Blue

Multiple Choice

Select the correct tube.

Contain the anticoagulant potassium oxalate and are used to obtain whole blood or plasma; the most common use is to collect blood specimens to perform a glucose tolerance test.

• Green

• Yellow

• Gray

• Pink

DETERMINE VENIPUNCTURE SITE ACCESSIBILITY

The preferred vein within the antecubital space is the median cubital vein, as this
area tends to cause less pain and this vein is the least likely to roll during the
procedure. If the median cubital vein is not easily palpated or is covered with scar
tissue, the cephalic vein and basilic veins—found on either side of the median
cubital vein—are often strong alternatives.

If these veins within the antecubital space are inaccessible, the back of the hand,
wrist, and foot are also options. Blood draws from the foot should only be
performed under the supervision of a provider due to the risk of deep vein
thrombosis (DVT). When drawing from the hand, be aware that these veins are the
most likely to roll. Additionally, the back of the hand contains many nerves, which
can lead to more discomfort for the patient. Reasons for looking at these alternative
sites include circumstances in which both antecubital spaces have scars, bruises, or
burns or are swollen

Multiple Choice

Why do supplies and equipment vary for venipuncture procedures when Aiden is performing them?

• Due to the patient's age

• Depending on the venipuncture procedure

• Based on the time of day

• According to the weather

Multiple Choice

Rohan is learning about medical procedures. What factors should he consider when choosing the needle length and gauge?

• Patient's age and weight

• Vein depth and patient size

• Blood type and volume

• Skin color and texture

Multiple Choice

During a medical training session, David is learning about the typical gauge range for Vacutainer needles. What is the typical gauge range for Vacutainer needles?

• 18-20 gauge

• 20-22 gauge

• 22-24 gauge

• 24-26 gauge

Multiple Choice

During a medical training session, Abigail was asked about the typical needle length range for Vacutainer needles. What should she answer?

• 1/2 inch to 1 inch

• 3/4 inch to 1 1/2 inches

• 1 inch to 2 inches

• 1 1/2 inches to 2 inches

Procedure

To begin site selection, have the patient extend an arm out and straighten the
elbow. Always inspect both arms. Palpate the antecubital area by pushing up and
down on the patient’s skin. Veins have a bouncy feel. The size, depth, and direction
of the vein should be determined. Veins that are highly visible but do not have
bounce to them should be avoided, as a successful draw is unlikely.

Tourniquet Application

A tourniquet should be applied to the patient’s arm about 3 to 4 inches above the
draw site to make the vein easier to palpate and more readily accessible for the
blood draw. A tourniquet should not be left in place for longer than 1 minute.
Leaving the tourniquet on longer than 1 min can cause hemoconcentration and
alter test results.

Site Restrictions

During site selection, check with the patient regarding possible restrictions due to
fistulas, ports, or mastectomy. Avoid drawing blood from the same side of the
body in which any of these conditions are present.Additionally, avoid selecting site
locations with scar tissue, injuries, burns, or wounds.

Multiple Choice

23. Where should the tourniquet be placed on the patient during the venipuncture procedure?

• A. 1 inch above the vein puncture site

• B. Over the vein puncture site

• C.3-4 inches above the vein puncture site

• D. 3 inches below the vein puncture site

PREPARE SITE FOR VENIPUNCTURE

Cleanse the site with antiseptic, wiping in an upward-and-downward motion with friction. Allow the site to
air-dry, and the tourniquet will be reapplied after the site is dry. Avoid touching the site again after cleansing,
even with gloves on. Avoid blowing on the area or waving hands over it to dry the alcohol faster, as this can
contaminate the skin.

PERFORM VENIPUNCTURE

●To begin the procedure, anchor the vein by grasping the skin firmly about 2 to 3 inches below the
puncture location, holding the skin taut. This ensures the vein is stabilized.

●When drawing from the arm, insert the needle smoothly and quickly at about a 15- to 30-degree angle
depending on the depth and position of the vein.

●When drawing from the patient’s hand, the correct angle of insertion is lower, about 10 to 15 degrees, as
the veins in the hand are smaller and thinner.

●The bevel of the needle should be facing upward.

●Once the needle is in place, with the nondominant hand, insert the evacuated stopper tube into the
needle holder until blood flow is established. Watch the needle and avoid any additional movement of the
needle.

●Once proper blood flow is established, release the tourniquet with the nondominant hand.

●When the tube has exhausted the vacuum and the tube is full, remove the tube, gently
inverting as necessary. If more than one tube is required, fill up the remaining tubes
using the correct order of draw.

●Once all needed tubes are full and inverted as needed, apply the gauze over the needle
with the nondominant hand, not applying pressure until the needle is out of the patient’s
arm.

●With the dominant hand, close the needle safety guard and dispose of the needle in the
biohazard sharps container.

●

PERFORM CAPILLARY PUNCTURE

Capillary punctures are performed when only a small amount of blood is needed for testing or
when immediate results can be acquired. It is the preferred method of blood collection for
infants and young children, but it can also be utilized with adults. Capillary blood is a mixture of
blood from arterioles, venules, capillaries, and intracellular and interstitial fluids. Due to this
mixed composition, not all testing should be performed using capillary blood.

Location of Capillary Punctures for Adults and
Infants

The preferred puncture site for obtaining a capillary puncture in adults and
children is the middle or ring finger of the nondominant hand. This procedure is
also commonly referred to as a fingerstick. Perform the puncture slightly off-center,
avoiding the central fleshy part of the fingertip, fingernail, and nail bed.

Infant capillary puncture will be performed on the outer edge of the underside of
the heel.
Note:
Never perform capillary puncture on the finger of an infant, as risk of damage to
the bone is high.

Infant capillary puncture will be performed on the outer edge of the
underside of the heel.

The preferred puncture site for obtaining a capillary puncture in
adults and children is the middle or ring finger of the nondominant
hand.This procedure is also commonly referred to as a fingerstick.
Perform the puncture slightly off-center, avoiding the central fleshy
part of the fingertip, fingernail, and nail bed.

Take Note
Never perform capillary puncture
on the finger of an infant, as risk
of damage to the bone is high.

●Warm the patient’s hands prior to the procedure by having the patient rub them together or run
them under warm water. For infants, heel warmers can be used on the infant’s heel prior to
performing the puncture.

●Cleanse the area with a 70% isopropyl alcohol pad and allow the site to air-dry completely. Avoid
touching the site after cleaning.

Performing the Puncture

Hold the patient’s finger between your thumb and forefinger firmly but gently. Hold the lancet device in your
dominant hand and at a right angle to the desired puncture site on the patient’s finger or heel. Activate the
spring or trigger system on the lancet and discard the used lancet into a sharps container immediately.

Wipe away the first drop of blood unless performing a prothrombin time (PT) test. This is to obtain a clean
sample without any tissue or fluid contaminants. Collect the required amount of blood. If the blood is slow to
flow, a gentle pressure and rubbing can be applied to the patient’s finger.

Once the specimen has been collected, place a clean gauze pad over the puncture site and ask the patient to
apply pressure to the area. Properly handle the collection container. Once the specimen and container are
intact, remove the gauze from the patient’s finger to assess hemostasis. If blood flow has slowed or stopped, a
bandage can be applied. If blood flow is still considerable, apply additional gauze and pressure. For excessive
blood flow from the puncture site, elevate the arm over the level of the heart to aid in hemostasis.

Order of Draw for Microcapillary Tubes

The recommended order of draw for capillary blood collection is different from blood
specimens drawn by venipuncture. The Clinical and Laboratory Standards Institute
recommends the following order of draw for skin puncture.

●Blood gases

●EDTA tubes

●Other additive tubes

●Serum tubes

Following phlebotomy or capillary puncture, apply a gauze pad over the puncture site
with pressure until the bleeding stops. The arm should be extended and elevated
above the level of the heart if needed. Once bleeding has stopped, apply a clean gauze
pad and bandage to the area.

Instruct patients to leave the bandaging in place for a minimum of 15 min.

Match and Label Specimen to Patient and Completed
Requisition

Labeling of specimen containers is another key step in proper specimen handling. Laboratory errors can occur
due to mislabeling of specimens. Blood collection tubes should be labeled immediately after the procedure is
completed—before the tubes are moved away from the area where the procedure takes place.

If the office does not have printed labels for specimens, the specimen label will need to be handwritten using
permanent marker, labeling the patient’s full name, date of birth, date and time of collection, and the MA’s
initials. Many lab requisitions come with adhesive numbered labels that can be affixed to all specimen
containers associated with the requisition. This is another verification step to help avoid errors.

Match each specimen tube with the laboratory requisition form when placing it in a biohazard transport bag.

Multiple Choice

Oliver is starting his first day as a phlebotomist at the hospital. What is the first step he should take to begin any phlebotomy procedure?

• Preparing the equipment

• Obtaining the provider's order

• Sanitizing the area

• Labeling the samples

Multiple Choice

Arjun is a medical assistant. Why is it important for him to review the provider's order for blood work?

• To determine the tests needed

• To check the patient's identity

• To ensure the equipment is sterile

• To confirm the appointment time

Multiple Choice

During a medical training session, what should not be performed by Grace without a provider's order?

• Blood pressure measurement

• Venipuncture procedures

• Temperature check

• Heart rate monitoring

Multiple Choice

Michael is working in a hospital and receives a laboratory order. What is the first step he should take in reviewing it?

• Complete the requisition form

• Use the laboratory directory

• Review the laboratory order

• Prepare the specimen

Processing and Labeling Requirements

Some specimen tubes require processing prior to being transported to the laboratory. Ensure all
specimen tubes are labeled prior to processing. Check blood processing requirements in the laboratory
directory if needed.

●Serum must be allowed to stand upright at room temperature for 30 to 45 min before being

centrifuged. However, blood specimens should not be allowed to stand for longer than 1 hour.

This will cause leaching of substance changes and changes to the integrity of the serum.

●Clotted blood must stand upright at room temperature for 30 to 45 min.

HANDLE BLOOD SAMPLES AS REQUIRED FOR DIAGNOSTIC PURPOSES

Each specimen has specific handling instructions, including whether the tube should be centrifuged, proper
storage temperature (room air, refrigerated, or frozen), and guidelines regarding exposure to light. The
reference laboratory where the specimen will be sent for testing can be called for assistance with specimen
handling guidelines.

There are some blood tests that require specific timing, specific patient preparation, or handling of the
blood specimens.

PROCESS BLOOD SPECIMENS FOR LABORATORY

Centrifuge and Aliquot

During centrifugation of blood specimens, the blood collection tubes rotate at a high rate of speed. The amount of
time a specimen needs to be centrifuged varies. Allow serum specimens to clot prior to centrifugation.

The weight in the centrifuge must always be balanced. If the MA has multiple tubes of blood to be spun, place
tubes of the same size and containing similar amounts of blood across from one another. This ensures balanced
weight distribution while the centrifuge is in motion.

Aliquot Samples

Aliquot occurs when a single specimen
must be divided into multiple tubes for
testing on different equipment.

Use a single-use pipette for transfer of
the serum from one tube to another.

Always use a disposable pipette to
avoid splashing and spills. Label the
tubes appropriately.

PREPARE SAMPLES FOR TRANSPORTATION TO A REFERENCE (OUTSIDE) LABORATORY

Arrange transportation of the samples as soon as possible after collection. Have all specimens
labeled, requisitions completed, and everything packaged together in anticipation of the
laboratory transport arrival. Confirm specimen pickup before leaving the clinic each day.

Storage Conditions Related to Sensitivity to Light and

Temperature

All specimens should be placed into a clearly marked biohazard bag. Specimens that are to be stored and
transported at room air temperature do not require any special management. Extra care should be taken
for these specimens if they will be left in a lockbox outside the clinic for pickup by the lab when the
outdoor temperature is extremely high or low. Specimens that are to be refrigerated should be kept in a
medical-grade refrigerator that is not used for anything other than specimens. They should be packaged
according to lab instructions for transport. Specimens needing to be stored frozen should be kept in a
medical-grade lab freezer used only for specimens until the time of transport. Note that a specimen
should never be moved to the cooler bag until it is already completely frozen.

Specimens for certain tests must be protected from light to avoid changes to the specimen that could
impact results. When processing these samples, keep the lights in the lab low or off. Once the specimen
has been processed, it should be wrapped in foil to block out light or moved to a special amber transport
tube designed for light protection. Always store specimens following their specific handling requirements
while awaiting retrieval by the laboratory transportation service.

Requirements for Transportation

Specimen bags should be leak proof and free from punctures or tears .Each tube must be labeled with the
appropriate laboratory requisition with the patient’s name and identification information and contained
within the same biohazard bag to process the specimens. Use a separate biohazard bag for each patient’s
specimens.

FOLLOW GUIDELINES IN DISTRIBUTING LABORATORY RESULTS

Laboratories can send patient laboratory report results via email, fax, or directly to the
electronic medical record. Providers are required to review and acknowledge all results
prior to their inclusion in the medical record. Ensure the provider reviews the lab
reports in a timely manner and patients are contacted accordingly. The role of the
medical assistant often includes notifying patients of their results as directed by the
provider, instructing or educating patients on any changes due to laboratory results,
and scheduling follow-up appointments for patients to review the results with the
provider.

RECOGNIZE AND RESPOND APPROPRIATELY TO OUT-OF-RANGE TEST RESULTS

●When reporting abnormal or out-of-range laboratory results, some circumstances require immediate
notification of the ordering provider and documentation that the provider was notified.

●The provider should review all laboratory reports and be notified of out-of-range results. Emergent results
can be referred to as critical lab results or critical lab values.

●In general, critical results are those that indicate a life-threatening emergency for the patient if immediate
intervention does not occur.

●It is within the scope of the medical assistant to receive this information and report it to the provider.
Understanding the impact on the patient should there be any delay in the process is crucial for effective
time management and prioritization of the patient.

Multiple Choice

7. Which of the following is a commonly used intravenous device that is sometimes used in the collection of blood from patients who are difficult to collect blood by conventional methods? 

• A. Heparinized Natelson tube

• B. BD Unopette

• C. Butterfly needle

• D. BD microtainer

Multiple Choice

9. Proper finger puncture technique includes all of the following EXCEPT: 

• A. Avoid squeezing or vigorous massaging

• B. Puncture parallel to the whorls of the fingerprint

• C. Puncture the middle or ring finger

• D. Wipe away the first drop of blood

Multiple Choice

12. In which instance is needle recapping recommended?

• A. After collecting a specimen in a syringe

• B. After collecting a specimen in the emergency room

• C. After collecting blood gases

• D. Recapping is never recommended procedure

Multiple Choice

14. You need to collect blood cultures, a gray top, and a lavender top on an adult with difficult veins. Which specimens can be collected by skin puncture?

• A. All of them

• B. Blood cultures and gray top only

• C. Gray top and lavender top only

• D. None of them

●Performing phlebotomy and other blood collection procedures is a vital role for the
medical assistant.

●Using correct venipuncture techniques is essential in maintaining the integrity of the blood
specimen.

●Correct handling and transport are essential in the medical assistant’s responsibilities
when performing venipuncture.

●Providers rely on medical assistants to be knowledgeable in specimen collection and
handling processes to ensure the accuracy of the tests they have ordered. By performing
these skills correctly, the medical assistant helps provide the best care possible to
patients.