5-TUBE- Additives - PMLS LEC PDF

Preview

Summary

PMLS LEC...

Description

TUBE ADDITIVES PMLS 2 MIDTERMS LECTURE 5 OBJECTIVES: After studying this chapter, each PMLS 2 Student should be able to: × State the manner in which the following anticoagulants prevent coagulation: fluoride, oxalate, citrates, EDTA, and heparin × Name the anticoagulant associated with the following color-coded tubes: blue, gray, green, and lavender × State the anticoagulant that requires a 1:9 ratio of anticoagulant to blood × State the purpose of the following additive: silicon and thixotropic gel TUBE ADDITIVES × Anticoagulant × Clot activators × Antiglycolytic agent × Thixotropic gel

ANTICOAGULANTS × Substances that prevent blood from ____________ (coagulating) × TWO METHODS: × by chelating (binding) or precipitating ____________ so it is unavailable to the coagulation process × by inhibiting the formation of ____________ needed to convert fibrinogen to fibrin in the coagulation process NOTE: × Always check first the volume of blood needed for each tube × Fill tube with only the designated volume indicated × Do not overfill or underfill tube × Do not shake or invert vigorously

BASIC ANTICOAGULANTS AND THEIR ACTIONS HEPARIN

Inactivates thrombin by accelerating anti-thrombin III and prevent formation of fibrin clot

CITRATE

Forms calcium salts, in a non-ionized form or soluble complex

EDTA

Traps/ binds calcium preventing coagulation or participation in coagulation cascade

OXALATE

Form a weakly dissociated Ca++ component

HEPARIN



GREEN TOP o ADDITIVE:  ____________ heparin  ____________ heparin o NUMBER OF INVERSIONS: 8 to 10 X inversions o LABORATORY USES:  lithium level (use sodium heparin)  ammonia level (use sodium/lithium heparin)  _______________ to check oxygenation level and blood pH (Henry)



SPECIAL CONSIDERATIONS WHEN USING HEPARIN: o Very expensive o NOT ideal for blood smears o changes in WBC & platelets o bluish background



o o o

If test be done in ____________, SPECIMEN must be refrigerated RBC swells w/in ____________ at RT NOT used for coagulation studies

LIGHT GREEN TOP o ADDITIVE: _________ and Lithium heparin o NUMBER OF INVERSIONS: 8 to 10 X inversions o LABORATORY USES: Plasma chemistries o MODE OF ACTION: Plasma is separated with gel at the bottom of the tube and lithium heparin inhibits coagulation

CITRATE  LIGHT BLUE TOP o ADDITIVE:  3.2% (0.105 M) or 3.8% (0.129 M) buffered sodium citrate (Henry)  Buffered sodium citrate (BD)  0.105 M (≈3.2%) ____________  0.109 M (3.2%) ____________ o LABORATORY USES:  Coagulation tests (PT and PTT)  Uses ________ ratio of blood to anticoagulant o NUMBER OF INVERSIONS: 3 – 4 X inversions



BLACK TOP o ADDITIVE: Same as light blue top o LABORATORY USES:  Westergren erythrocyte sedimentation rate  Uses ______ ratio of blood to anticoagulant o NUMBER OF INVERSIONS: 3 – 4 X inversions



CLEAR WITH LIGHT BLUE STOPPER o ADDITIVE: Citrate, Theophylline, Adenosine and Dipyridamole o LABORATORY USES: Selected platelet function assays and Routine coagulation determination o NUMBER OF INVERSIONS: 3 – 4 X inversions

EDTA (ETHYLENEDIAMINETETRAACETIC ACID)



LAVENDER TOP o ADDITIVE:  Spray-dried dipotassium EDTA (plastic)  Liquid tripotassium EDTA (glass) o LABORATORY USES:  Hematology (CBC)  Blood bank (Crossmatching) o NUMBER OF INVERSIONS: 8 – 10 X inversions o SOURCES:  Disodium salt of EDTA (powder): ____________ or versenate

o







 Dipotassium salt of EDTA (liquid): ____________ SPECIAL CONSIDERATIONS:  Blood smear should be performed not more than 4 hours as it may cause red cell shrinkage

PINK TOP o ADDITIVE: Spray-coated/ dried dipotassium K2 EDTA (plastic) o NUMBER OF INVERSIONS: 8 – 10 X inversions o LABORATORY USES: Whole blood hematology determinations, Molecular diagnostics and Blood bank (crossmatching) WHITE TOP OR PEARL TOP o ADDITIVE: Dipotassium EDTA and gel for plasma separation o NUMBER OF INVERSIONS: 8 – 10 X inversions o LABORATORY USES:  Helpful in working with HIV positive patients  Molecular diagnostic tests such as PCR and DNA amplification techniques TAN TOP o ADDITIVE: Dipotassium EDTA (plastic) o NUMBER OF INVERSIONS: 8 – 10 X inversions o LABORATORY USES: _________ determinations (tube contains less than 0.1ug/mL of lead)

OXALATE ANTIGLYCOLYTIC AGENTS: × Substance that prevents ____________ × If glycolysis is not prevented, glucose concentration in a blood specimen decreases at a rate of ____________ per hour × SODIUM FLUORIDE × Most common antiglycolytic agent × Preserves glucose up to ____________ × Also inhibits growth of bacteria × In combination with potassium oxalate to provide plasma specimens × 5 – 10 inversions 

GRAY TOP o ADDITIVE:  Sodium fluoride/ Potassium oxalate  Sodium fluoride/ Sodium EDTA  Sodium fluoride o LABORATORY USE: ____________ measurements o MODE OF ACTION:  Potassium oxalate or Sodium EDTA (anticoagulant)  Sodium fluoride (antiglycolytic agent and not an anticoagulant which preserves glucose up to 3 days) o NUMBER OF INVERSIONS: 5 – 10 X inversions

SPECIAL USE ANTICOAGULANTS  YELLOW TOP o ADDITIVE:  Sodium polyanethol sulfonate (SPS)  Stabilize ____________ growth  Acid citrate dextrose (ACD)  ____________ activation o Number of inversions: 8 – 10 x inversion o LABORATORY USES:  SPS: Blood culture (microbiology)  ACD...