Question

Chapter Preanalytical Considerations 181 Case Studies Case Study 9-1: Proble 9-1: Problem Sites, Complications, and Procedural Errors you've got to get the specimen," so Erica tries again to redirect the needle. Finally, blood spurts into the tube and a hematoma starts to form quickly. At first Erica thinks that she may have hit an artery, but the specimen is normal in color, so Erica dismisses the thought she quickly collects the specimens, covers the site with gauze, and asks the patient to hold pressure while she labels the tubes. When she has finished she thanks the patient and delivers the wat specimens to as the phlebotomist the laboratory is recent phlebotomy program graduate who ind less than a month ago by a major hospital flest job as a phlebotomist. Her first 3 months deployment are a probationary period, and she warmined to do a good job. This morning she en asked to collect a stat CC and electrolytes patient in an intensive care unit. The patient is sive and cooperative but has difficulty breathing The patient's nurse mentions that she will hook up the real's oxygen therapy as soon as the phlebotomis finished with him. He has an IV in his left hand. Prica palpates the right antecubital area. She can feel che median cubital vein, but it is deep. The basilic vein is visible and prominent, so she decides to use it to collect the specimen. When she inserts the needle into be arm, the vein rolls and her needle ends up beside the vein and slightly under it. She redirects the needle and the vein rolls again. The patient winces in pain but thing. Noticing the look of pain on the patient's face, Erica asks him if it hurts. The patient says yes and tells her that the pain is radiating down his arm and his fingers are tingling. Erica asks him if he would like her to remove the needle. The patient replies "No, QUESTIONS 1. What site selection issues were associated with the collection of this specimen? 2. Were the site selection issues handled properly? Explain why or why not 3. What complications and procedural errors were involved? 4. Were complications and procedural errors handled properly? Explain why or why not. Case Study 9-2: Specimen Quality Concerns Ray, a newly hired phlebotomist who has just recently hemolyzed and unsuitable for testing, so that the test finished phlebotomy training, is preparing to draw the will have to be repeated. Ray is completely surprised Last GTT specimen on an outpatient. This is the first by this because there were no problems with the draw. GTT he has performed without supervision, and he is Now Ray has to call the patient and reschedule the test. proud of how well he has done. The patient has good The patient is understandably upset. veins in both arms, so he has been alternating arms for the blood draws. The patient is anxious to go home QUESTIONS and Ray is in a hurry to go on break, so he quickly selects a vein, performs a successful venipuncture, 1. What errors did Ray make that could have caused and collects the required gray-top tube. He finishes the hemolysis of the specimen draw and quickly shakes the tube. Later, as he starts 2. What could Ray have done differently that might to label it, he notices that the tube is only half full. He have prevented the hemolysis? has been allowed to submit other partial tubes without a problem, so he shrugs his shoulders and proceeds to 3. What other error did Ray maket bandage and then dismiss the patient. He submits the 4. What could Ray have done differently to prevent specimen to the laboratory and goes on break. When he the error in number 3 above? returns he is informed that the last GTT specimen was

Answer 1

Answer: The gtt blood test is performed to test the glucose level in the blood. In this case, the withdrawal of the blood from the site of arm vein causes an issue as it in the first time blood withdrawal only the half tube was filled and for the second time, the healthcare professional mistakenly puncture the artery as hematoma got started. So, the choice of the vein site caused an issues.