Question

Chapter 11: Special Collections and Point-of-Care Testing 225 Case Studies dy 11-1: Prothrombin Test Collection tube, followed by a lavender-top tube for the CBC. Later that day the coagulation department rejected the specimen and he was sent to re-collect it. Case Study 11-7. During clinical na found that the times were not the His clinical coordi 10 follow facility practicum. There CBC and prothrom clinical practicum, a phlebotomy student hat the requirements for drawing prothrombin re not the same as he was taught in class. cal coordinator made it very clear that he was v facility protocol while he was in his clinical m. Therefore, when he was asked to collect a d prothrombin time from a patient, he knew the order of draw at this facility was citrate first, discard tube. As he started to draw the specimen the patient, he immediately ran into trouble when vein rolled. He was certain that the needle had dinned beside the vein, so he tried to redirect it into the vein. After two unsuccessful redirects, the needle siccessfully entered the vein. He collected the citrate QUESTIONS 1. Why would the laboratory reject the sample? 2. What had the student done to cause the sample to be rejected? 3. How could the problem have been corrected while the needle was still in the arm?

Answer 1

1.One of the major reason for the laboratory to reject a sample is when the blood sample is hemolysed

2.While collecting sample for prothrombin time the venipuncture should not cause trauma to the veins or repeated redirection can lead to touching the interstitial fluid and breaking the blood cells called as hemolysis .The student has redirected the venipuncture site twice on a recoiled vein(recoiling occurs in thrombosed vein) hence making the sample not appropriate for a test.

3.When the vein recoiled the student could have removed the needle and selected a new site for venipuncture with a new tube for sample collection. When the needle is in vein allow the blood to flow easily without any great pressure.Along with this tauting the skin and holding the vein from slipping can prevent hemolysis when needle is in arm.Probbing should be avoided.