PowerPoint® to accompany
Medical Assisting
Chapter 48
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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Collecting, Processing and
Testing Blood Specimens
Objectives
48-1 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.
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Collecting, Processing and
Testing Blood Specimens
Objectives (cont.)
48-6 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.
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Introduction
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.
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Role of the Medical Assistant
 Examination 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.
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Functions of Blood
 Heart pumps 8 to 12
pints of blood
through more than
70,000 miles of veins,
arteries, and
capillaries.
 Hematology – the
study of blood
 Hematologists – study
its function and
composition
Blood has many functions, all of which are
important to overall health of the body.
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Functions of Blood (cont.)
 Blood does all the following:
 Distributes oxygen, nutrients, and
hormones to body cells
 Eliminates waste products
 Maintains acid-base balance
 Regulates body temperature
 Attacks infecting pathogens
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Composition of Blood
 Plasma – liquid in which other components
are suspended
 Red blood cells (erythrocytes) – vital role in
internal respiration
 White blood cells (leukocytes) – protect the
body against infection
 Platelets (thrombocytes) – crucial to clot
formation
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Apply Your Knowledge
What are three functions of blood?
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Apply Your Knowledge -Answer
What are three functions of blood?
1.
2.
3.
4.
5.
Distributes oxygen, nutrients, and hormones to
body cells
Eliminates waste products
Maintains acid-base balance
Regulates body temperature
Attacks infecting pathogens
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Collecting Blood Specimens

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

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
Reading and interpreting the test order
Assembling the equipment and supplies
Preparing the patient
Greeting and identifying the patient
Confirming pretest preparations
Explaining the procedure and safety precautions
Establishing chain of custody
Handling exposure incident
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Identifying the Patient
 Ask 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.
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Drawing Blood
 Some states permit
medical assistants to
obtain blood samples.
 Your office will clarify
your duties
 Venipuncture – puncture
of a vein
 Phlebotomy – puncturing
a vein with a needle to
collect blood into a needle
or tube
Common Sites for
Venipuncture
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Venipuncture Equipment
 Evacuation system (VACUTAINER) –special
double-pointed needle, needle holder, and collection
tubes
 Needle and syringe system – use a sterile needle
and a syringe to draw blood specimen
 Butterfly system – winged infusion set and syringe
 Collection tubes – must mix blood with appropriate
sample containers
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VACUTAINER
 The VACUTAINER
system uses
interchangeable
collection tubes that
allow you to draw
several blood
specimens from the
same venipuncture site.
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Capillary Puncture
 Superficial puncture
of skin with sharp
point to draw small
amount of blood.
 Collected in small,
calibrated glass
tubes, slides, or
reagent strips.
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Patient Needs
 Alleviate patients fears or concerns
 Provide more information about:
 Pain
 Bruises or scars
 Serious diagnosis
 Contracting a disease from procedure
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Special Considerations
 Children:
 Talk with patient or caregivers before
working with child
 Address them directly
 Speak calmly in soothing voice
 Explain the procedure briefly in terms they
can understand
 Keep child informed of status of procedure
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Special Considerations (cont.)
Elderly Patients:
 Changes in skin conditions make
elderly patients prone to bruising
 Decreased circulation makes it
difficult to collect enough blood
 Speak in clear, low-pitched tone
 Give the patient time to respond to
questions
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Special Considerations (cont.)
 Patients at risk of uncontrolled bleeding
such as hemophilia or taking bloodthinning drugs
 Be careful and alert
 Hold cotton ball over the puncture site for
at least 5 minutes
 Notify physician if bleeding is
uncontrollable
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Special Considerations (cont.)
 Difficult
venipuncture:
 Try a second
time and then
give the patient
a rest
 Fainting patient:
 Position before
venipuncture so
no injury will
occur
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Special Considerations (cont.)
Angry or violent
patients:
 Encourage patient to
submit to test and then talk
with doctor
 Do not force the issue
 Patient has the right to
refuse
22
Apply Your Knowledge
What is one precaution you can take
when drawing blood from a patient who
had hemophilia?
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Apply Your Knowledge -Answer
What is one precaution you can take
when drawing blood from a patient who
had hemophilia?
Hold cotton ball over the puncture site for at least
5 minutes
Be careful and alert
Notify physician if bleeding is uncontrollable
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Performing Common
Blood Tests
 Results can aid in the
diagnosis of specific
conditions, disease,
and disorders
 Chemicals in lab:
 Anticoagulants
 Serum separators
 Stains
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Hazardous Waste
 Hazardous waste products include:

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Blood and blood products
Body fluids and tissue
Cultures
Vaccines
Sharps
Gloves
Specula
Inoculating loops
Paper product contaminated with body fluids
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Hematologic Tests
 Performed on venous or capillary blood
specimens
 Blood counts
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
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

Red blood cells
White blood cells
Platelets
Hematocrit
Hemoglobin
Centrifuged Capillary Sample
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Hematologic Tests (cont.)
 Erythrocyte sedimentation rate (ESR) –
measures rate at which red blood cells settle
to the bottom of blood sample
 Put freshly collected blood into calibrated tube
and place in sedimentation rack
 In one hour determine how far the red blood cells
have fallen
 Record in mm/hr
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Chemistry 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.
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Serologic Tests
 Detect 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.
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Immunoassays
 Western blot –
used to confirm
HIV
 Radioimmunoassay
(RIA) – usually
performed in
reference labs
 Enzyme-linked
immunosorbent
assay (ELISA) –
used to diagnose
HIV infections
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Apply Your Knowledge
How is a serological test different from a
chemistry test?
32
Apply Your Knowledge -Answer
How is a serological test different from a
chemistry test?
Serological tests use the introduction of an
antigen or antibody into the specimen to detect
specific reactions to the antigen or antibody.
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Summary
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.
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End of Chapter
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