I got the last batch from clinic today and the new girl filled the purple top tube first and all the way (3mL of blood) and then got a pedi-green top and gave me about 200 microLiters of whole blood for a large panel and another test. If she had done things the other way around everything would have been fine and I could have gotten the work done.
Part of the problem is that the anticoagulant in the purple top tube affects alot of the chemistry tests and has potassium in it so I cant use it for electrolytes (Na, Cl, and K) because of this. The purple tops are most often used for complete blood counts (CBC)
The green top tubes have lithium-heperin as the anticoagulant and are used for most chemistries and all the ones we do here. The next problem comes when you have to spin the blood down. There is alot of cellular material in blood and we use the plasma that is ontop of that, once spun to run our tests. So with this tiny amount of blood she gave me I couldnt run one test.
So I got to call the doctor and tell him I couldnt run the tests he wants cause I didnt get enough blood to do the tests. Then I left a message for the other phlebotomist to call back the patient to redraw the sample so that we can run the tests.
For my first day back it has been quite stressfull, I so wish I was back in Waco listening to people talk about interesting topics
Daily Kitten Chat Forum » General Chat
I love having phlebotomists but.....
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Posted 2 years ago by TheKnittingNinja #
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ugh.. the pt will need to be redrawn , that wouldn't go over big with me if i were that patient.. yep thats a stressful day !! i guess mistakes are a part of learning ,, but the pt had to pay the price... i do alot of blooddraws from central lines ( actually that's all i draw blood from) and i ask the lab which color tube i use before i draw it up.. i always ask the lab how much they need ( how many cc's ) for that tube before i draw it.... hopefully things will get better for you !! hugs your way !!
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that is how most nurses do it Beth, but this is a new phlebotomist that is part time and a high schooler (I think that is what I was told not to sure on that one)
The Doc wasnt too happy either when I told him about that.
Its scary how important it is to draw the tubes in the correct order. If you contaminate some of the other tubes you can do serrious damage to a person with treatments being given incorrectly because of faulty lab results.
The other thing is patients HATE being redrawn because of mistakesPosted 2 years ago by TheKnittingNinja #
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When I first started in the lab in the late 70's(yeah I'm old) we only collected in plain tubes, then we moved into the coloured top tubes. Back then we needed heaps of blood to do and iron test, 4 tubes just for the iron test if I remember correctly. My job was the labelling of the tubes with patient name & number then the centrifuge and separating off the plasma into other tubes. Also doing the testing along with other staff members. I loved my centrifuge, especially when it was whizzing around at 3500rpm, but what a noise. Possibly why I'm a bit hard of hearing now. I worked in a private lab where all the GP's sent their patients, not attached to a hospital. Not that easy to recall a patient.
Head up Ale, you'll get back into the swing of things.Posted 2 years ago by Moonshadow_NZ #
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well you know I can do quite a few tests with a little bit of plasma, but there is a limit.
Cheri you sound like all the patients I have had this year :-D
Though I usually get everyone on the first stick. After the 3rd I generally say that I am not getting it by now and give up and have someone else tryPosted 2 years ago by TheKnittingNinja #
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oh i didn't know the tubes had to be drawn in a certain order... that is interesting .. i hope i didn't ruin anything when i put them in the tubes... do tiger tops have a chemical? i do alot with red , purple, light blue and tiger tops.... how do i know which order to draw them in? can i draw from a PICC line( or any central line) and just put the blood in the tiger top then purple and red or blue?,,,,, i take the blood from the PICC or central line or whatever , flush with normal sline then i draw waste 5 cc i then redraw and put them in the tubes.. i usually do the tiger top first then the little tubes.... i hope i do it right...
i bet the doc wasn't happy , but what can you do.. your working with a teenager and doing the best you can ( you must have patience of a saint) ... you deserve kudos just for that.... you did your best... at least the teenager knows now the correct way to do it ... hoepfully... hugs to you
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the order of draw is that you do blood cultures first, then blue tops (which always have to be full for coags), then you do red (non additives) then green and tiger tops, then purple and then grey or other colors (which are nto used as much)
tiger tops have a clotting activator. EDTA in the purple tops has potassium in it so it can affect the levels on a BMP or CMP.
She will find out tomorrow when she gets to work and is presented with the order of draw documentI dont do central line draws that is done exclusively by the nurses here and I am very glad for that because once you start doing flushes and stuff it becomes giving medicine especially with the heparin flushes
Posted 2 years ago by TheKnittingNinja #
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ooh thank you for letting me know how to draw them up... i never knew that... i am going to make a color coded picture for me so i can be sure i do it right... thank you !! oh yes i do alot of heparin flushes.. i flush alot on the central lines or keep a TKO bag going then i do a heparin flush each port every shift ... don't want those ports clotting off.. then it's a huge mess ... and more work ...ugh
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you're welcome, I try and work with people to educate them, but some people just "know" the correct way to do stuff and you cant correct them no matter how much evidence to the contrary you have
Posted 2 years ago by TheKnittingNinja #
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Oh me too, I just got back from a conference and I had so much fun with all the seminars and learning new things. I do know that I am very greatful to work in a place with a steady supply of electricity and clean water.
One of the presenters had gone to tanzania last march to help set up medical labs there through the Abbott fund. She said that they had lots of problems with electricity and no available supply of DI water (which we use almost nonstop here)Posted 2 years ago by TheKnittingNinja #
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When I was in the Peace Corps in Thailand in the early 80s I was a med tech, and we had lots of electicity problems even tho we were in the provincial capital... I did a lot of bacti protocal development and training, and got the blood bank started in the process of screening units for syph, malaria and hep B... to which they added HIV in a couple more years. I used microscopes with mirrors to reflect sunlight into the field, none had electricity!
Posted 2 years ago by nawlins catmom #
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and here I am complaining about the microscop we have here that randomly goes out of focus and doesnt move the slides well at times.
Posted 2 years ago by TheKnittingNinja #
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