Basingstoke and north hampshire hospital pathology user handbook

Note the preferred order of tube use is ...

Citrate samples BLUE

Plain Gel Samples YELLOW/GOLD

Heparinised samples GREEN

EDTA samples LAVENDER

EDTA samples PINK

Oxalate samples GREY

If you are not familiar with the system, or wish to have instruction, our phlebotomists will be happy to help you.

Important things to remember when taking blood

1. 
   Those taking blood must have received appropriate training as defined by the National Patient Safety Agency guidelines.
   

2. 
   Identify patient correctly before taking blood. Ask patient to state their name and date of birth, check their identity bracelet if present. Ensure that all details match the request card.
   

3. 
   Use the correct blood tube for the test required. Mix the bottle gently after collection to ensure activation of any additive. Do not shake.
   

4. 
   The sequence of blood vacuum tube collection should be:
   

BLUE, GOLD, GREEN, LAVENDER, PINK, GREY.

5. 
   Do not remove tops to manually fill bottles. Vacuum tubes are not designed for use in this way and will leak.
   

6. 
   Gross errors occur when samples have been collected from an area that is receiving an intravenous infusion. Do not take samples from in-dwelling access devices unless specific training has been received.
   

7. 
   Needles and holders are for single use only and must be disposed of immediately into an adjacent sharps container. Needles must not be re-sheathed or removed from the holder.
   

8. 
   Take care to prevent needle stick injuries. If you do have a needle stick injury contact occupational health or the emergency department immediately.
   

9. 
   Under-filled/over filled coagulation (citrate) bottles will be rejected as results will be unreliable.
   

10. 
    Ensure complete identification is clearly written on the bottle immediately after taking samples. Do not pre-label tubes. If labels are used on cards ensure that they are on all layers of multi–part cards.
    

11. 
    High-risk patients. Both samples and cards must be identified with a ‘high risk’ label and each sample should be sealed in a separate plastic bag.
    

High-risk groups can include patients suffering from, or thought to be suffering from, Hepatitis, CJD, HIV, TB, E coli 0157 and other notifiable diseases. Intra-venous drug users and patients who have travelled abroad recently and present with unexplained high pyrexia should also be treated as high risk.

12. 
    All blood spillages must be cleaned up immediately. Gloves must be worn and special care taken with any broken plastic/glass. The contaminated area must be decontaminated with ViruSolve+ or a locally agreed disinfectant.
    

13. 
    Blood cannot be accepted by the laboratory without a request card/electronic request, which must be completed and signed by the requesting practitioner. Black ball point pen and clear printing must be used to ensure legibility. Blood Sciences cards are scanned, print one digit or letter within each entry box.
    

14. 
    Samples sent to the laboratory must arrive in a leak-proof container. Blood tubes should be placed in the plastic bag attached to the request card. We are unable to guarantee the processing of leaking samples. If not processed, these will be disposed of immediately and the requesting doctor informed. Patients will be contacted directly if the samples were taken by the laboratory.
    

15. 
    Samples should be delivered to the laboratory as soon as possible after collection. For some tests it is essential that the sample be received and processed within 30 minutes (See Test index). Coagulation assays must be performed within six hours of taking blood.
    

16. 
    Requests for urgent tests must be notified directly to the department concerned (see phone numbers on pages 5 - 6). Samples must be collected or organised by the requesting doctor who must also arrange their delivery to the laboratory; within the hospital this can be done by bleeping the charge-hand porter on 1201. Pathology phlebotomists will NOT collect urgent samples nor deliver them to the laboratory.
    

17. 
    It is the responsibility of the requesting doctor to ensure that all these requirements are met. The laboratory cannot accept the responsibility of changing any request card or sample identification. Incomplete request cards and incorrectly labelled samples will be brought to the attention of requesting doctors and discarded where appropriate.