The Order of Draw for Blood Tubes - Mobile Phlebotomy and Paramedical Examiner Job Leads
Order of Draw for Blood Tubes
Blood Culture Tube
PT,PTT, APTT - All Coagulation Studies
No Additive (Serum tube)
Electrolyte, Lipid Panel, Hepatic Function, Digoxin, Bilirubin, HCG (pregnancy)
Sodium Heparin or Lithium Heparin
CBC, Hemoglobin, Hematocrit, ESR - Erythrocyte Sedimentation Rate
Potassium Oxalate, Sodium Fluoride
All Glucose Studies - Anticoagulant
Remember the order of draw:
You, Bring, Really, Good, Lollipops, Girl = Yellow, Blue, Red, Green, Lavender, Gray
Evacuated Collection Tubes
The "evacuated collection tubes" are glass or plastic and differs in length from 65mm - 127mm, the outside diameter of 10mm, 13mm, or 16mm. The mechanism of the rubber stopper on the tube has changed because of the increase of blood and body fluid precautions. The traditional rubber stopper popped as the top was removed to access the specimen. This created an aerosol that could be inhaled or ingested.
Expiration Date on Blood Tubes
Health care professionals have to acknowledge that blood tubes have an expiration date, to indicate when the tube should no longer be used. The tubes are good until the end of the month stamped on the tube. After the expiration date, the vacuum will possibly not fill the tube completely and the additives are not guaranteed to perform as it should. Using tubes past the expiration date affects the specimen and can give questionable results.
Upgrades of Blood Tubes
Tubes made from plastic are now used more commonly in health care settings. Different additives are added to the tubes to improve the quality of the specimen. These "additives" are not anticoagulants or preservatives but are used to improve specimen quality or to accelerate specimen processing. These tubes have a red stopper, red/black stopper, or gold stopper (Hemogard tube), depending on the manufacturer. The glass surface of a glass tube for serum testing will activate clot formation in the tube. Some glass serum tubes have a clot activator added to speed the clotting process. A plastic tube will not activate a clot; therefore a clot activator must be added to each tube during manufacture. This clot activator consists of silica particles on the sides of the tubes that initiate the clotting process.
Serum and plasma tubes can also be purchased with a thixotropic separator gel. This gel is and inert material that undergoes a temporary change in viscosity during centrifugation. It has a density that is intermediate to cells/clot and plasma/serum. When centrifuged, the gel moves up the side of the tube and engulfs the cells/clot, and an interface of gel forms that separates the cells/clot from the plasma/serum.
♥ Also, all blood tubes have a draw line on the tube, but the blue tube must be a full draw. ♥
Diabetes mellitus is a complicated disease that may cause more complications for the patient than just an increased blood glucose level. A person with diabetes mellitus often develop blindness (retinopathy), kidney damage (nephropathy), heart disease (cardiovascular disease), and circulatory problems that can result in tissue damage and amputation. Hyperglycemia is the signal that a person might have diabetes mellitus. The American Diabetes Association classifies diabetes as type 1 diabetes, type 2 diabetes, and prediabetes.
- Prediabetes; Prediabetes is when a patient's blood glucose is higher than normal but not high enough to be classified as diabetic.
- Type 1; The patient with type 1 diabetes is deficient in insulin production by the pancreas or in insulin function.
- Type 2; 80 - 90% of diabetes patients have type 2 diabetes. Most patients of this type have a normal insulin concentration but lack relative insulin activity.
The first step most physicians take in diagnosis diabetes is to draw a fasting plasma glucose for the patient. If the FPG level is greater than or equal to 126 milligrams per deciliter (mg/dl), the patient is diabetic.
Glucose Tolerance Test
The oral glucose tolerance test (GTT) detects borderline diabetes by measuring the patient's ability to dispose of a large oral intake of glucose.
A few of the factors can affect glucose tolerance and should be controlled before the test is performed. When a GTT is ordered, the patient should omit medications that are known to affect a glucose tolerance, have three days of unrestricted diet, and have unrestricted activity. The test should then be performed in the morning after an 8 - 16 hour fast. The patient should not be allowed coffee or cigarettes and should try to keep anxiety to a minimum.
List of Paramedical Exam Companies - Job Leads
For Insurance Exams
- Medic Exams, 1888-567-6688 phone
- APPS - American Para Professional Systems, 209-340-8700 phone
- EMSI branch 774-701, 949-678-5866 phone, 951-352-0083 fax
- EMSI # 183, 661-296-5035 phone, 661-296-5564 fax
- ExamOne corporate, 1-866-795-7110 phone, 1-888-419-3926 phone
- IPS National, 503-922-0315 phone, 503-333-5118 phone, 1-877-268-1021 toll free, 1-877-568-3093 fax
- Professional Health Examiners, 818-788-3926, 818-788-0090
- Superior Mobile Medics, 619-814-0101 phone, 1-866-673-5841 phone, 1800-898-3926 toll free, 1-866-761-1143 fax
Once you establish a business relationship with these Paramedical Exam Companies, you would need to set up a filing system. All patients and exam companies' files should be kept in a mini file cabinet. Also most of the Paramedical Exam Companies hire Independent Contractors "nationally," so it wouldn't matter what state you're in. You can work for them doing exams in your local area or farther. Keep the enthusiasm and know that your phlebotomy skill gets better with time.
How to Test for Glucose Blood Levels
My other articles -
- Phlebotomy Renewal Certifications Testing - Fun Phlebotomy Study Quiz
It is a requirement that all phlebotomist take a yearly competency test. Do you want to brush up on your phlebotomy skills? Take a fun "phlebotomy quiz" on this site.
- List of Supplies needed for Paramedical Examiners - Mobile Phlebotomist
This is a list of all the supplies you will need, as a Mobile Phlebotomist/Paramedical Examiner. If you want "Life Insurance Forms," this site has a link to them also. The centrifuge is not taken with you, to your patient's appointments.
© 2011 Brinafr3sh