So let’s get started with the collection. This is an article I found that was on Google. I found it years ago, and I think it’s been updated! I don’t think the 5th edition is the most current but the procedure for the collection blood’s specimens by Venipuncture the approved standard basically for the people in the clinical laboratory or in a hospital! And they set forth all the things that need to be done and you talk about all the questions that they asked, the medical screening question, whether or not they have a shellfish allergy and that’s important because when they don’t use an alcohol prep-pad, they use povidone-iodine and that contains iodine which shellfish allergies can cause severe reaction! Also they have latex injury they shouldn’t be wearing latex gloves or be using the latex tourniquet.
For females who have had a mastectomy they don’t have a mastectomy they need to use the opposite arm if they have a hematoma they need to take it on a different arm! If they have other problems, these are medical screening questions that need to be asked to make sure they’re hemophiliac. There are precautions that need to be take place! Also there are certain things they need to have in that room! If they’re not taking it in at the hospital, if they’re taken in a police station, they need to have ice in case they have a severe problem where they have a rupture of an artery, there are a lot of things that they need to have in place that they don’t have in place in police stations.
So be thinking about these things. You can Google this and you can find it in there. They’ve also created another article for the collection of blood for ethanol, blood ethanol test and out of this very article says,” Major cause of ‘’laboratory error’’ can be related to non-analytical factors such; as specimen collection, handling and transport”. So that’s where, we’re going to focus on now.
So when you’re looking at the blood draw collection, we’re going to breakdown the blood draw down to three areas. You got the Pre-draw, which should be the preparation and those medical screening questions. The Blood draw and then the post blood draw and what do you do with it. First off they start out with the kit and of course the kit looks like this (showing an image on screen) handled with care. This is the Texas department of public safety crime lab kit. You’ve got the box, you’ve got the little foam, you’ve got that little bag, you’ve got the little plastic container where the vial goes in to. Below that is a green seal, below that is some cloth that the vial gets wrapped around. Below that is one single vial with the grey top tube.
The grey top tube is obviously very important. There are two things that are contained in there. And sodium fluoride and potassium oxalate. One is a preservative and other is anti-clotting factor and also to the right of that there’s the submission form which shows the date, who took it, the time and on the back side of that are also these nine steps check list they need to do. And it’s very important that they follow all that. Also these kits have expiration dates on them. We’ll talk about that in a second.
Once the blood is taken, that seals is supposed to be placed around the vial like this, over the top of that stopper, and then also locating the date and the time of the blood draw obviously being vitally important and that needs to be done by the nurse at the time of blood draw not by any police officer. It needs to be done by nurse whoever drew the blood!
Once that’s done you take the vial, you wrap around in this little rack there and then you stick in that little tiny zip lock bag and then it goes all the way in there. And that goes into that plastic tube, into the foam into the box, and then seals the box. Why is that important? It is important for two reasons. Number 1 is; if you don’t properly preserve that specimen, and think about this. What’s contained in that vial? Its blood! What is blood? Human organisms and like milk it’s going to go bad, like eggs like raw eggs it’s going to go bad if it’s not preserved properly.
Secondly, the federal post office has regulations in place when you ship biological specimens that they will allow that to happen so long as you follow this criteria and that’s what has to go in that particular box and that’s why it has little biohazard little sign there. Secondly, if you look at this–going back to this kit, there was only one vial, not two and what else was missing? The butterfly needle, the needle and vacuum container because what is inside that vial is a vacuum in addition to the sodium fluoride, potassium oxalate, the reason why that’s important is because really the contents inside that tube, they don’t expire! It’s the seal and the vacuum inside the vial that’s actually draws the blood out of the vein and into the vial and fills up and it must be filled up all the way.
Because there’s the sodium fluoride and the potassium oxalate there’s a certain amount in there and the ratio is supposed to be all the way up to 10 milliliters and so if you got that full and they’ve only got a half full vial, you’re looking at the vial and the first thing you should be thinking about is either one; There was a problem with that vial, the vacuum was compromised, the seal was compromised meaning outside air bacteria and the contamination is been sucked into there.
Secondly, if it’s not a problem with the vial then it was an improper blood draw. Meaning it was collected not according to the standard! So then that going back, then the sheet gets put in there on the outside and then it get shipped off. It should be shipped off immediately.
Step # 9; protect the specimen from the extreme temperatures. That’s pretty hard to do it in Texas specially this time of year. In the absence of a kit, use medical ‘’gray top’’ tube and the package must comply again with all postal regulations.
We’ve already talked about that in to maintain the integrity of sample, a temper evident seal and proper labeling must be used! So this is the blood test kit and the grey stopper tube, that’s very important! They talk about the number of inversion, once they take the blood; they have to invert it, 8 times, back and forth, 8 times and then in the kits, they talk about 8 to ten times. They can’t shake it vigoursly, will get to that here shortly