The BD Vacutainer® Eclipse blood collection system is composed of a multi-sample vacuum collection needle and a disposable tube holder. The product can be purchased as individual components or preassembled, as it appears in the third picture. Note the needle safety device is directly attached to the needle. When the phlebotomy procedure is complete, the safety device is activated with the thumb.

The pictures below illustrate the performance of the bleeding time test which is used in conjunction with other coagulation tests, such as the prothrombin time, in the evaluation of a patient suspected of having a bleeding disorder. A patient’s bleeding time is a measure of the number of platelets, how well they function, and the ability of the capillary blood vessel wall to constrict (sometimes referred to as capillary integrity). The procedure requires a blood pressure cuff inflated to 40 mm/Hg, and using a bleeding time lancet to make a standardized incision. A filter paper is used to pull the blood away from the incision allowing the technician to view the wound. A stop watch is used to record the amount of time required for the bleeding to stop.

Blood culture bottles are used to collect blood from patients suspected of having septicemia or bacteremia. Proper preparation of the venipuncture site is crucial in preventing contamination with skin bacteria (causing a false positive). The blood collection site must be aseptically cleansed to produce a sterile site with a product such as a Chlorascrub. To aid in preventing false positives, the phlebotomist cannot repalpate or touch the venipuncture site after it has been prepared. Not putting a sufficient amount of blood into the bottle(s) and/or not drawing the blood at the correct time could result in a false negative.

BACTEC blood culture bottles (BMS Diagnostics)

BacT/ALERT® Culture Media

Chlorascrub Swabstick contains 2% chlorhexidine gluconate and 70% isopropyl alcohol.

• Samples that are icteric, lipemic, or hemolyzed often produce erronous laboratory results.
• Left: The Icteric sample. A patient whose blood sample is icteric will have a greatly increased bilirubin which is most often an indication of liver disease or damage. The increased bilirubin causes the patient to be “jaundiced”. Icteric samples are bright golden yellow to orange brown in color depending on the bilirubin level. An icteric sample is very likely to produce erroneous lab results, however, it is not possible for the phlebotomist to avoid or prevent drawing an icteric sample.
• Center: The Lipemic sample. Lipemia (fats in the blood) usually indicates the patient was not fasting when the specimen was drawn. The phlebotomist should re-collect the specimen when the patient is fasting. In very rare cases, the patient may have a hereditary lipidemia (hyperlipidemia), and recollection of the sample will not improve the sample’s quality.
• Right: The Hemolyzed sample. The picture on the right indicates significant hemolysis of the specimen. Hemolysis is most commonly due to the red blood cells rupturing due to a traumatic draw, such as pulling too hard on the plunger of the syringe, drawing blood through a needle that is too small, or blood being forcefully pulled into a tube.

Butterfly (Winged Collection Set) needles are used to draw blood from patients with small or fragile veins.

The fecal occult blood test is primarily used to screen for colorectal cancer by detecting “occult” or hidden blood in the stool sample. The cards in the test pack contain a special guiac paper which reacts with the heme portion of blood to cause a blue color to appear when the developer is added. The product shown below is Hemoccult II®.

Hemoglobin and Hematocrit point of care instrument provides fast, easy and accurate results for both hemoglobin and hematocrit on blood obtained from a capillary puncture.

Lancets are used for capillary blood sampling and come in a wide variety of shapes and sizes. Modern blood lancets are safety engineered, self-contained, single use automated puncture devices designed to produce a uniform puncture of a specified depth. Punctures are routinely made on the side and near the tip of the 3rd or 4th finger of adult and pediatric patients. Capillary blood is collected from the sides of the heel of non-walking infants. It is critically important the heel stick is performed in the correct area of the heel to prevent nerve or bone damage.

Owen Mumford Unistik 3

Microcapillary tubes are used to collect small volumes of blood. The tubes have a ring / tip color to indicate any additive. Color coding is as follows: red tip = sodium heparin, green tip = ammonium heparin, and blue tip = plain/no additive. The most common test using the microcapillary tube is the hematocrit (a part of the CBC) which is routinely collected in the red tipped tube.

Microtainer® microcollecion tubes are used to collect blood from a skin puncture (heel or finger). Collecting this type of sample should be considered for patients who are difficult draws such as elderly patients with fragile veins, infants, small children and other patients with difficult veins. This can only be done for tests which can be performed on small quantities of blood. List 3 tests which cannot be performed on blood from a capillary puncture.

This device has two needles. The needle is screwed into the holder. One needle is inserted into the vein, the vacuum blood collection tube is inserted into the holder and is punctured by a needle on the opposite end. The rubber sheath allows multiple tubes of blood to be collected and covers the needle in between tube changes so blood does not collect in the holder.

The Portex Needle-Pro (Jelco® Venipuncture Needle-Pro® Safety Device) is a needle safety device used with the vacuum tube blood collection system. Note, this blood collection device uses a standard multi-sample collection needle, as seen in the first photo. The needle safety device is activated by pressing it against a hard surface to permanently cover the needle.

A syringe with a syringe needle is sometimes used to collect blood from patients with difficult, small or fragile veins. Collecting with a syringe and needle is especially useful when the phlebotomist needs to control the amount of vacuum being applied to prevent or reduce the chance of the vein collapsing.

Tourniquets are used to stop the flow of venous blood and make the veins more prominent. A latex free tourniquet must be used on patients who have latex allergy.

Transfer pipets are used to transfer serum or plasma into other tubes for testing. The transfer tube must be properly labeled using information from the original sample tube before placing the sample in it.

Urine dipsticks are used for the chemical examination of urine. The product shown below is the Multistix® 10 SG reagent strip.

Vacutainer® blood transfer devices are used to protect the phlebotomist from an accidental needle stick when transferring blood from a syringe to the vacuum tubes. The syringe is attached to the top of the device, the tubes are then inserted into the holder until the stopper is punctured by the needle inside the holder. The vacuum in the tube causes blood to be drawn into the tube.