1. Practical 1
Methods of Obtaining Blood Samples, Choice of
Anticoagulants and Preservation.
By; Dr. Waheed Ali
https://www.youtube.com/watch?v=DzTmDlcE_3U

4. What to See on and Inside the Vacutainer?

5. Specimen Rejection Criteria:
• Improperly labeled or unlabeled
• Improperly collected or preserved
• Submitted without properly completed request form
• Contaminated form
• Improperly volume & leakage sample

6. Patient’s specimen:
• A properly labelled sample is essential so that the results of the test
should match the patient.
• Label with patient’s ID or the sample number provided for the
patient.

7. Sites of Blood Collection
Blood can be collected from 3 different sources:
• Capillary blood.
• Venous blood.
• Arterial blood.

8. Capillary Blood Collection
Method of Collection :
• Select the least used finger.
• Cleanse the site with alcohol swab.
• Puncture across the grain of the skin
• And transfer blood to a strip or small container.
Indications:
• To draw a small amount of blood
• In a microtube or strip for blood sugar and
• Bleeding time tests.
• For infants and young children.

9. Capillary Blood Collection

10. Arterial blood Collection
Equipment required:
• Tourniquet.
• Vacutainer and syringe.
• Alcohol swab.
• Bandage
Indications:
• Specially required for estimation of blood gases ABG, PH, CO2 and O2.
• Collect quickly, fill completely and seal both ends immediately
Artries
• Radial artery and brachial artery
• Femoral artery
• Temporal artery

11. Arterial blood Collection

12. Venous Blood Collection
• Equipment required
• Tourniquet
• Vacutainer and syringe
• Alcohol swab
• Bandage
• Majority of routine tests are performed on venous blood.
• Blood can be taken directly from the vein.
• The best site - deep veins of the ante-cubital fossa.
• Fore arm vein:
• Other sites are: Dorsum of hand:
• Femoral vein:
• Jugular vein
• Scalp vein

13. Venous Blood Collection

14. Why tourniquet is applied?
• A tourniquet to help locate and define peripheral veins to achieve
successful and safe venipuncture.

15. Phlebotomy
• A procedure in which a needle is used to take blood from a vein,
usually for laboratory testing.

17. Plasma vs Serum

19. Phlebotomy

20. 70% Alcohol
• Circular motion and from the site to outward.

21. - Fasting blood Sample
- Postprandial blood sample
Approximately 8 to12 hours fast before blood
test.
-Drink only water
- Regular drug allow
2 Hours after Regular major Meal

22. Method Of Blood Collection
1. With Syringe and non-vacuum Vacutainer
2. With vacuum Vacutainer
3. With Butterfly Needle
4. Lancet

23. 1) With Syringe and Non-vacuum Vacuette
• Advantage:
• Cheaper
• Not extra accessory require
• Disadvantage:
• Improper volume – especially when blood
collection is require for coagulation profile
• Haemolysis

24. 2) With Vacuum Vaccutiner
Advantages:-
• Maintain proper volume of blood
• Safe & Speedy
• Reducing the risk of haemolysis
Disadvantages:-
• not suited for small veins.

25. 3) With Butterfly Needle
Disadvantages.
• The risk of hemolysis
• It is difficult to collect large quantity of blood as well as in multiple
vacuette
Advantages:
• Useful in infants & children

26. 4. Lancet
• Finger-stick blood samplers (lancet devices) are used to obtain blood
for testing blood sugar (glucose).

27. Preanalytic Interference in Sample
• Haemolysis
• Reddish discoloration of serum/plasma due to rupture of RBCs.
• Factor causing haemolysis
• Sampling = Inject forcefully in vacutte
• Store = Frozen = Due to high or low temp,
• Vigorously shaking of blood - trasnporatation
Icteric
• Yellowish discoloration of Serum due to high bilirubin.
Lipemic
• Milky or Turbid appearance of Serum due to high Triglyceride

28. Blood Collection Tubes:
• Serum separating tubes (SST)
• Plasma separating tubes (PST)

29. Top Color Additives Principle Uses
Lavender EDTA
Dose= 1to2g/l
of blood
-The strongest anti-coagulant
-Ca+2 chelating agent
- Hematology
- Blood bank
Light Blue Sodium
Citrate
2g/l
Ca+2 chelating agent - PT
- APTT:
Green Sodium
Heparin or
Lithium
Heparin
Heparin binds to Thrombin and
inhibits the second step in the
coagulation cascade
(Prothrombin Thrombin)
Fibrinogen Fibrin
Enzymes
Hormones
Electrolytes (Na+,
K+, Mg+, Cl)
Heparin
Plasma Separating Tubes (PST)

30. Top Color Additives Principle Uses
Gray -Sodium Fluoride
2g/l
-Potassium
Oxalate
Glycolysis
inhibitor
Anti-
Coagulant
Glucose tests
Top Tubes Additives Principle Uses
Red ------
Sometimes it has gel
or silicon at the
bottom of tube to
reduce hemolysis
Enhancing the
formation of
blood clot
Serology
-Antibodies
-Hormones
-Drugs
Virology
Chemistry
Blood cross matching
before blood
transfusion
Serum Separating Tubes (SST)

41. Preservation of Blood
• For many purposes blood may be safely persevered at 4ºC in
Refrigerator.
• EDTA is best preservative for Hemogram.
• Tri-sodium citrate best for coagulation study.
• Before procedure, the blood should be first allowed to warm up to
room temperature, then mixed, preferably by rotation, for at least 2
min.