Bài giảng Medical Assisting - Chapter 48: Collecting, Processing and Testing Blood Specimens

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 481Objectives48-1 Discuss the composition and function of blood.48-2 Describe the process for collecting a blood specimen.48-3 Explain the importance of confirming patients' identities and correctly identifying blood samples.48-4 Describe how to perform venipuncture and capillary puncture procedures.48-5 Identify the equipment and supplies required for blood drawing procedures.Collecting, Processing andTesting Blood Specimens 248-6 Discuss the correct procedures for disposing of waste generated during blood-drawing procedures.48-7 Discuss common fears and concerns of patients and how to ease these fears.48-9 Identify common blood tests and explain their purposes.48-10 Perform certain blood tests.Objectives (cont.)Collecting, Processing andTesting Blood Specimens3Introduction You will be responsible for collecting blood specimens and doing some testing in the waived category. You will be introduced to venipuncture and capillary collection procedures. You will also learn techniques for dealing with difficult types of patients and how to efficiently and effectively obtain blood samples.4Role of the Medical AssistantExamination of blood can provide extensive information about a patient’s condition.Basic understanding of the anatomy and physiology of the circulatory system will help you perform these tasks.5Functions of BloodHeart pumps 8 to 12 pints of blood through more than 70,000 miles of veins, arteries, and capillaries.Hematology – the study of bloodHematologists – study its function and composition Blood has many functions, all of which are important to overall health of the body.6Functions of Blood (cont.)Blood does all the following:Distributes oxygen, nutrients, and hormones to body cellsEliminates waste productsMaintains acid-base balanceRegulates body temperatureAttacks infecting pathogens7Composition of Blood Plasma – liquid in which other components are suspendedRed blood cells (erythrocytes) – vital role in internal respirationWhite blood cells (leukocytes) – protect the body against infectionPlatelets (thrombocytes) – crucial to clot formation8Apply Your KnowledgeWhat are three functions of blood?9Apply Your Knowledge -AnswerDistributes oxygen, nutrients, and hormones to body cellsEliminates waste productsMaintains acid-base balanceRegulates body temperatureAttacks infecting pathogensWhat are three functions of blood?10Collecting Blood Specimens Reading and interpreting the test orderAssembling the equipment and suppliesPreparing the patientGreeting and identifying the patientConfirming pretest preparationsExplaining the procedure and safety precautionsEstablishing chain of custodyHandling exposure incident11Identifying the PatientAsk patient to state their full name.Be sure you hear both the first and last names correctly.Verify that the name the patient gives is the name on the order.Some places, the phlebotomist may ask for social security, patient ID, or chart number to further identify the patient.12Drawing Blood Some states permit medical assistants to obtain blood samples.Your office will clarify your dutiesVenipuncture – puncture of a veinPhlebotomy – puncturing a vein with a needle to collect blood into a needle or tubeCommon Sites for Venipuncture13Venipuncture EquipmentEvacuation system (VACUTAINER) –special double-pointed needle, needle holder, and collection tubesNeedle and syringe system – use a sterile needle and a syringe to draw blood specimenButterfly system – winged infusion set and syringeCollection tubes – must mix blood with appropriate sample containers14VACUTAINER The VACUTAINER system uses interchangeable collection tubes that allow you to draw several blood specimens from the same venipuncture site.15Capillary PunctureSuperficial puncture of skin with sharp point to draw small amount of blood.Collected in small, calibrated glass tubes, slides, or reagent strips.16Patient NeedsAlleviate patients fears or concerns Provide more information about: PainBruises or scarsSerious diagnosisContracting a disease from procedure17Children:Talk with patient or caregivers before working with childAddress them directlySpeak calmly in soothing voiceExplain the procedure briefly in terms they can understandKeep child informed of status of procedureSpecial Considerations18Special Considerations (cont.)Elderly Patients:Changes in skin conditions make elderly patients prone to bruising Decreased circulation makes it difficult to collect enough bloodSpeak in clear, low-pitched toneGive the patient time to respond to questions19Patients at risk of uncontrolled bleeding such as hemophilia or taking blood-thinning drugs Be careful and alert Hold cotton ball over the puncture site for at least 5 minutesNotify physician if bleeding is uncontrollableSpecial Considerations (cont.)20Special Considerations (cont.)Difficult venipuncture:Try a second time and then give the patient a restFainting patient:Position before venipuncture so no injury will occur21Angry or violent patients:Encourage patient to submit to test and then talk with doctorDo not force the issuePatient has the right to refuseSpecial Considerations (cont.)22Apply Your KnowledgeWhat is one precaution you can take when drawing blood from a patient who had hemophilia?23Apply Your Knowledge -AnswerHold cotton ball over the puncture site for at least 5 minutes Be careful and alert Notify physician if bleeding is uncontrollableWhat is one precaution you can take when drawing blood from a patient who had hemophilia?24Performing Common Blood TestsResults can aid in the diagnosis of specific conditions, disease, and disordersChemicals in lab:AnticoagulantsSerum separatorsStains25Hazardous Waste Hazardous waste products include:Blood and blood productsBody fluids and tissueCultures VaccinesSharpsGlovesSpeculaInoculating loopsPaper product contaminated with body fluids26Hematologic Tests Performed on venous or capillary blood specimensBlood countsRed blood cellsWhite blood cellsPlateletsHematocritHemoglobinCentrifuged Capillary Sample27Erythrocyte sedimentation rate (ESR) –measures rate at which red blood cells settle to the bottom of blood samplePut freshly collected blood into calibrated tube and place in sedimentation rackIn one hour determine how far the red blood cells have fallenRecord in mm/hrHematologic Tests (cont.)28Chemistry Tests Highly detailed tests are not performed in POL labs because of expensive, sophisticated equipment and techniques.Some tests such as blood glucose monitoring are often performed by medical assistant.29Serologic TestsDetect presence of specific substances in blood samples.Refer to the introduction of an antigen or antibody into the specimen and to detect specific reaction to the antigen or antibody.Used to detect disease antibodies, drugs, hormones and vitamins.30ImmunoassaysWestern blot –used to confirm HIV Radio-immunoassay (RIA) – usually performed in reference labs Enzyme-linked immunosorbent assay (ELISA) – used to diagnose HIV infections31Apply Your KnowledgeHow is a serological test different from achemistry test?32Apply Your Knowledge -AnswerSerological tests use the introduction of an antigen or antibody into the specimen to detect specific reactions to the antigen or antibody.How is a serological test different from achemistry test?33Summary Medical Assistant Successful phlebotomy procedures require not only superior technical skills but also excellent interpersonal communication skills. You may be called on to complete certain testing procedures or to explain the purpose of tests to patients.34End of ChapterEnd of Chapter35