Blood and blood components
Blood is a specialized body fluid.
It has four main components:
[Link]
[Link] blood cells
[Link] blood cells
[Link]
• The blood that runs through the
veins, arteries, and capillaries is
known as whole blood, a mixture of
about 55 percent plasma and 45
percent blood cells.
• Blood has many different functions,
including:
• transporting oxygen and nutrients to the
lungs and tissues
• forming blood clots to prevent excess blood
loss
• carrying cells and antibodies that fight
infection
• bringing waste products to the kidneys and
liver, which filter and clean the blood
• regulating body temperature
• Red cells. Transport oxygen from lungs to all
living tissues of the body and carry away carbon
dioxide.
• White blood cells. Gets rid of dead blood cells.
• Platelets. Clots blood.
• Plasma. Carries red cells, white cells, and
platelets and provides nutrients
• Plasma is the yellowish coloured
liquid component of blood, in which
the red blood cells, white blood
cells, and platelets are suspended.
It constitutes more than half of the
blood's volume and consists mostly
of water that contains dissolved
salts (electrolytes) nutrients,
hormones, and proteins.
• Plasma contains fibrinogen and other
clotting factors when separated from
the red blood cells. Evacuated tubes
used to collect plasma specimens
contain anticoagulant and, frequently, a
preservative. The additive in each tube
is specified on the label and tube
stoppers are color coded according to
the additive present.
• Serum is the clear liquid that
remains after blood clots that’s
means that:
• Serum is that part of blood which is
similar in composition with plasma
but exclude clotting factors of
blood.
• Plasma is preferred over serum for
many lab tests requests because using
plasma versus serum eliminates the
step of waiting for a blood tube without
anticoagulant to clot before it can be
centrifuged, and, subsequent testing
performed on the resulting serum.
• Plasma can be processed and tested
immediately following collection.
• Ideally, serum samples should be
allowed to clot in an upright
position
• Serum should be stored at 4–8°C
until the test is done in the same
day.
• When kept for longer periods, serum
samples should be frozen at −20°C
or lower.
Types of Specimen Collection
Containers
• Clot Activator, Plain RED Most chemistry.
• K2EDTA PINK For cross-matching requests only
. K2EDTA (Di-Potassium Ethylene Diamine-Tetra
cetate) PURPL Most hematological tests, HbA1C
. Lithium Heparin GREEN Tests requiring plasma or
whole blood (such as cytogenetics when using blood
DNA) and biochemistry tests such as electrolytes,
renal screen, ammonia test.
• Sodium Citrate BLUE Coagulation
studies.
• Sodium Fluoride / Potassium Oxalate
GREY Glucose tests
Blood Specimen Collection and Processing
Venipuncture Procedure:
• The first step to the collection is to positively identify
the patient by two forms of identification; ask the
patient to state and spell his/her name and give you
his/her birth date.
• Check the requisition form for requested tests.
• Position the patient in a chair, or sitting or lying on a
bed.
• Wash your hands.
• Select a suitable site for venipuncture, by placing the
tourniquet 3 to 4 inches above the selected puncture
site on the patient. Do not put the tourniquet on too
tightly or leave it on the patient longer than 1 minute.
• Next, put on non-latex gloves, and palpate
for a vein.
• When a vein is selected, cleanse the area in
a circular motion, beginning at the site and
working outward. Allow the area to air dry.
After the area is cleansed, it should not be
touched or palpated again. Ask the patient
to make a fist; avoid “pumping the fist”.
Grasp the patient’s arm firmly using your
thumb to draw the skin taut and anchor the
vein. Swiftly insert the needle through the
skin into the lumen of the vein. The needle
should form a 15-30 degree angle with the
arm surface.
• When the tube is filling, remove the
tourniquet.
• Remove the needle from the patient's arm.
• Place gauze immediately on the puncture
site. Apply and hold adequate pressure to
avoid formation of a hematoma. After holding
pressure for 1-2 minutes, tape a fresh piece
of gauze or Band-Aid to the puncture site.
• Dispose of contaminated materials/supplies
in designated containers.
•Note: The larger median cubital
and cephalic veins are the usual
choice, but the basilic vein on
the dorsum of the arm or dorsal
hand veins are also acceptable.
Areas to Avoid When Choosing a Site
for Blood Draw:
• Extensive scars from burns and surgery - it is
difficult to puncture the scar tissue and obtain a
specimen.
• The upper extremity on the side of a previous
mastectomy - test results may be affected because
of lymphedema.
• Hematoma - may cause erroneous test results. If
another site is not available, collect the specimen
distal to the hematoma.
• Intravenous therapy (IV) / blood transfusions
- fluid may dilute the specimen, so collect
from the opposite arm if possible.
• Cannula/fistula/heparin lock - hospitals have
special policies regarding these devices. In
general, blood should not be drawn from an
arm with a fistula or cannula without
consulting the attending physician.
• Edematous extremities - tissue fluid
accumulation alters test results.