What is the function of Public Health services? To screen, monitor, and educate about infectious diseases DO NOT provide treatment define kinesics STudy of nonverbal communication (body language) Who developed the Guideline for Isolation Precautions in Hospitals? CDC (center for disease control) and HICPAC (healthcare infection control practices advisory committee) *NOTE - OSHA BBP standard requires gloves during phlebo Right-to-know law? Requirement to provide MSDSs Layers of skin + what's found there Epidermis: avascular Stratum germinativum: layer of epidermis Statum corneum: layer of epidermis Corum (dermis): blood vessels Subcutaneous: blood vessels, adipose tissue Layers of blood vessel (both names) + brief description Tunica adventita (externa): outer layer made of CT thicker in arteries Tunica media: middle layer smooth muscle + elasic fibers much thicker in arteries Tunica intima (interna): inner layer single layer of endothelial cells + basement membrane, CT layer, and elastic membrane Which are the anticubital veins? Acessory cephalic, median basilic, median *NOTE- subclavian is shoulder -> chest What are these things - CK, LD, ALP, ALT, BUN, PT, GTT, ESR CK: creatine kinase - enzyme in cardiac muscle LD: lactate dehydrogenase - enzyme in cardiac muscle (both released during myocardial infarction) ALP: alkaline phosphatase - enzyme that determines liver function ALT: alanine aminotranfersale - enzyme that determines liver function BUN: blood urea nitrogen - kidney function test GTT: glucose tolerance test - glucose metabolism test  ESR: erythrocyte sedimentation rate - nonspecific disease indicator (esp inflammatory conditions) NPO NPO (nil per os): nothing by mouth (not even water) Describe the methods of anticoagulation and their agents binding/chelating or ppt calcium to make it unavailable for the coag process: Sodium citrate, oxalate, EDTA, SPS inhibiting formation of thrombin: lithium and sodium heparin Most common antiglycolytic agents? Purpose? sodium fluoride and lithium iodoacetate prevent glycolysis (metabolism of glucose) When should a discard tube be used? When drawing for a coag test (not PT or PTT) because tissue thromboplastin activates extrinsic coag pathway what is accessioning the specimen? Steps taken to unmistakably connect a specimen and the accompanying paperwork to a specific individual What veins should you use?  Which should you avoid? Use - cephalic or median cephalic Don't use - basilic (too close to brachial artery) Tourniquet should not be left on for more than... 1 minute Release after blood flows into first tube What fluids are contained in a capillary specimen? arterial blood venous bloud tissue fluids (interstitial and intracellular) What reference values shift with capillary draws? increase: Glucose decrease: Calcium, Phosphorous, and total protein What does an ABG req typically include? body temp respiratory rate method of ventilation/delivery patient activity body position normal patient ID info What is the modified Allen test? compression of both the ulnar and radial arteries to stop arterial flow to the hand hand should appear blanched IF collateral circulation is present hand will flush pink when only ulnar artery is released (positive result) Name 4 analytes that need LP bilirubin vitamin C vitamin B12 carotene Name 3 tests that require cooling. Ammonia glucagon lactic acid name a tests that can be damaged/altered by cooling potassium: cold inhibits glycolysis which causes accumulation of K outside the cell (elevated results) Cold also causes hemolysis which elevates results How quickly must an ESR be performed on an EDTA spec at room temp?  When refriged? room: 4 hours ref: 12 hours Maximum time limit for serum/plasma separation? 2 hours from collection (should be ASAP) What departments issue regulations re: off-site transportation of spec? DOT (department of transportation) FAA (federal Aviation administration) OSHA (occupational safety and health administration) What is unique about an ammonia spec? extremely volitile must be transported ASAP and on ice serum vs plasma Serum: does not contain fibrinogen (used during clotting) Plasma: contains fibrinogen (no clotting) What is a C&S? What is it's purpose? Culture and sensitivity diagnosis of UTI what is AFP? alpha-fetoprotein: antigen found in fetus, amniotic fluid, and maternal serum abnormal values can indicate developmental issues What is POCT? Point-of-care testing (performed at/near site of patient care) Interpretations of a TB skin test based on induration (firm, raised area) <5mm: negative 5mm-9mm: doubtful 10mm+: positive What do POCT urine test strips usually detect? gluocse, bilirubin, bacteria, blood, pH, protein, specific gravity, urobilinogen What organizations offer certification to lab professionals? AMT (american medical technologists) ACA (american certification agency) ASCP (american society for clinical pathology) what organizations accredit phlebotomy programs? NAACLS (national accrediting agency for clinical laboratory services) PHS (public health services) what is PHI? Protected health information What is CLIA '88? clinical laboratory improvement amendments of 1988 established standards for regulation of laboratories CLSI standards state that heel puncture depth should not exceed ____ 2 mm What is CLSI? Clinical & Laboratory Standards Institute publishes standards for phlebotomy procedures What are diurnal variations? normal fluxuations that occur throughout the day (think diurnal cycle) Hematomas - where can you collect? Why? Distal to, or below (blood flow least affected) Collecting in the area of a hematoma can cause pain and yield erroneous results