Tips for collection and handing of specimen

Diagnostic blood test

General blood test(CBC)

3mL of blood should be collected and the EDTA blood should be gently mixed 8 to 10 times immediately.
If the ratio of anticoagulants (EDTA) and blood volume is not suitable, or if the mix is insufficient, clot and dilution (affecting blood cell and hematocrit levels and cell morphology and dyeing caused by excessive anticoagulants) may result in errors..

Blood test

Diagnose various blood diseases such as anemia and leukemia by blotting peripheral blood and examining the number and form of each blood cell.

Prepare 2 clean slide glass.
Hold one slide glass between the thumb and middle of your left hand and place a drop of blood about 1.5cm from the top right.
Hold the Spreader glass (Slide glass) between the thumb and middle of your right hand.
The blood drop placed on the slide glass touches the back of the Spreader glass, causing the blood to spread uniformly.
Keep the angle between the Spreader slide and the slide glass about 30-40 degrees and push the Spreader slide at a certain speed toward the thumb of the left hand that supports the slide glass. If the pushing speed is slow, the film becomes thin and if it is fast, it becomes thick. If it is too thinly bleed, white blood cells tend to move to the end of the blem, so be careful.
Be careful not to dry and contaminate the air with the bloated Slide.

Bloodclotting test : CITRATE blood

Citrate removes calcium and exhibits anticoagulation action, so it is used for blood coagulation tests such as PT (prothrombin time) and aPT (activated partial thromboplastin time) because it contains coagulation factor.

Blood clotting tests use blood collected in a sodium citrate tube, and samples are taken by venipuncture or from indwelling catheters using 19-21 gauge needles (for children with 23 gauge butterfly needles). If Vacutainer is used, the second container should be used as a coagulation sample.
The anticoagulant uses 3.2% sodium citrate and the ratio of the sample to the anticoagulant is 9:1 (10.9-1.9mMol/L), and the blood sample volume is indicated on the sodium citrate tube. Please keep the blood collection accurately. Test results may vary if the rate is not accurate.
It should be mixed 3~4 times immediately after blood collection. If not mixed quickly and well, clotting occurs in a part of the blood, resulting in microclots, which may reduce the coagulation factor, resulting in errors in the test results.
The sample taken must be tested within 4 hours, otherwise it should be refrigerated (2~6℃), 2,500g centrifugated for 15 minutes, and then the platelet-poor plasma is separated and frozen.

SENSERY COLLECTION FOR BLOOD CATION TEST: BLOOD COLLECTION THROUGH INDWELLING CATHETER

When collecting blood through an Indwelling catheter, take into account contamination by heparin, wash it with 5mL of physiological saline, then discard the first 5mL (or 6 times the line volume) of blood, and then use the blood for coagulation test. Normal saline lock (capped off venous port) should discard twice the dead volume. If unexpected blood clotting test results come out, a new blood collection test or use resin to remove heparin and test again.

Types of tests according to anticoagulant

Anticoagulant	Mechanism of action	Monitor inspection
Waparin(Coumadin)	Inhibition of vitamin K-related factors: Factor II, VII, IX, X 40 hours half-life	PT
The heparin(Unfractionated heparin UFH)	Blocking Factor X Administration of sulfate protamine in case of bleeding merger	aPTT, ACT, TT, Anti-factor Xa
Low molecular weight heparin (Low Molecular Weight Heparin LMWH)	Dalteparin, enxaparin etc. It’s excreted by the kidneys, so be careful when you have kidneys. It has a long half-life, so it is administered 1 to 2 times a day as a subcutaneous injection. It is partially inhibited by sulfate protamine. Xa has better antagonist effect than heparin. Less bleeding side effects. The dose-response relationship is predictable	Anti-factor Xa, aPTT no test required
Aspirin	Inactivating platelet function Stop taking it for a week before surgery Desmopressin (DDAVP) may normalize bleeding time	Platelet drug response assay

Congenital psy

Harvest time

The congenital psy is most suitable for 48 to 72 hours of age.
In the case of a critical child, it is collected and tested immediately, and re-blooded and re-examined after 2 weeks.
If you need a blood transfusion, you need a sample before you get a blood transfusion. If it is not possible, it will be collected at 24 to 48 hours of life and the sample will be retaken on the 14th day after the final transfusion.

How to collect blood

Lancet pokes the outside of the newborn’s heel to make blood flow.
The first drop of blood is wiped with gauze, the blood is made into a large drop, and then dropped into 4 circles in the blood collection area to absorb enough to the back.
If you press the heel too hard to collect blood, you may see abnormal test findings due to tissue fluid, so be careful.
Please note that iodine, alcohol, patronium jelly, feces, urine, and hand lotion on your hands may affect the results of the test.

How to handle blood

After blood collection, completely dry in a flat cold cat for 3 to 4 hours.
Be sure to include specific information such as the newborn’s date of birth, gender, blood collection date, and lactation status.

Avoid direct exposure to heat, moisture, or direct sunlight.
Be careful not to let the blood come into contact with other places because the collected space overlaps.
Be careful because if the drink containing milk or aspartame is contaminated, it may be misjudged as a serious metabolic disease.

Correct blood collection

When collecting blood through an Indwelling catheter, take into account contamination by heparin, wash it with 5mL of physiological saline, then discard the first 5mL (or 6 times the line volume) of blood, and then use the blood for coagulation test. Normal saline lock (capped off venous port) should discard twice the dead volume. If unexpected blood clotting test results come out, a new blood collection test or use resin to remove heparin and test again.

Sample example	Precautions for blood collection
	When a large drop of blood is formed after the puncture, make sure it is buried on the front of the blood collection site and seep well into the back. Complete the 4 circles in the same way.

Unsuitable blood collection

Sample example	Precautions for blood collection
If your blood volume is insufficient	When a large drop of blood is formed after the puncture, make sure it is buried on the front of the blood collection site and seep well into the back. Complete the 4 circles in the same way.
If it is scratched or worn	Please be careful not to use a capillary tube or other apparatus to absorb blood into the blood collection paper.
If it’s not dry enough	Please dry it in the shade for at least 4 hours. Do not stack the blood collection paper before drying. It has a long half-life, so it is administered 1 to 2 times a day as a subcutaneous injection. It is partially inhibited by sulfate protamine. Xa has better antagonist effect than heparin. Less bleeding side effects. The dose-response relationship is predictable
When diluted, discolored, or contaminated	Please do not overpressure the blood collection area. Wear gloves and blood collection. If you apply bare hands, or alcohol, solution, disinfectant, hand lotion, powder, etc. and collect blood, the blood collection support site may be contaminated. Avoid direct sunlight or heat on the blood collection site.
If you show a serum hook	Please do not repeatedly stain blood in the same circle. Please be careful not to contaminate the blood collected paper with foreign substances such as solutions.
If it is solid or layered	Please do not repeatedly bury blood in the same circle of the blood collection site. Please do not stain blood on both sides of the blood collection paper. Please do not use the blood collection equipment to get buried in the blood collection paper.
If it permeates excessively	Please be careful not to use the instrument to put an excessive amount of blood on the blood collection site. Please do not stain blood on both sides of the blood collection paper.