Blood consists of cells surrounded by liquid plasma and has important functions like gas exchange. Plasma is 92% water and 8% substances like hormones, proteins, and ions. Venipuncture is usually used for blood tests and involves cleaning the site, inserting a needle at a 30 degree angle, and collecting samples in tubes with additives like sodium citrate or EDTA to prevent clotting. Complications can include fainting, bruising, or allergic reactions. Proper collection and handling is important to avoid errors.

2. Blood: is a type of connective tissue that consists of cells
surrounded by a liquid matrix. Blood have many of
important functions in the body essential for life such as
gases exchange and others.
Plasma: is a pale yellow fluid that consists of about 92%
water and 8% substance such as hormones , proteins,
ions and waste products.
Serum: is represent the plasma minus clotting factors.

3. Blood sample collection ways
1. Venipuncture specimen
This type of blood collection used when we need to make lipids profile
and other serology tests, and the procedure such as shown in lecture no 1.
2. finger stick
Identify the patient, Clean the fingertip, by use sterile lancet stick it, use
suitable capillaries tube to collect the blood , finally put gauze pad and
apply pressure it. This way usually used with tests that need to small
amount of blood such as packed cells volume(PCV), TSB or blood groups
identify.
3. heel stick
As procedure same the procedure of figure stick, but the different, this
way usually used with newborns and when there are extreme difficulties
with aspiration from vein and used with the tests same as in finger stick
way

4. Common Venipuncture Sites
1. Median cubital vein
2. Cephalic vein
3. Basilic vein

5. Venipuncture Procedure
1. Clean your hands with soap and water or gel cleanser and
Wear gloves.
2. Ask the patient to state his/her first and last name; if the
patient is unable to give you this information, ask the
patient's caregiver to confirm the patient's name
3. Determine if the test to be obtained has any special
requirements. For example, should the patient be fasting? Is
this a timed test, or done the operation without use
tourniquet.
4. Attempt to make the patient seem more relax
5. support the arm on a firm surface or handle by your hand
but without any sudden move, the arm should be in a
downward position.

6. 6. Apply tourniquet in appropriate site for venipuncture.
7. Cleanse site with approved disinfectant. Allow the
disinfectant to air-dry to avoid hemolysis of the specimen
and discomfort to the patient.
8. insert needle, bevel-side up, at about a 30° angle, and
collect specimens. Remove needle .
9. Apply direct pressure by use gauze to stop bleeding at
puncture site; do not have patient bend arm as this may cause
a hematoma to form. After about 2 minutes, check the
puncture site to verify that bleeding has stopped. Apply
bandage if appropriate.
10. Label specimen(s) in the presence of the patient including
all the information that is required. Check the labeled tubes a
second time
11. against the patient's wristband to verify labeling accuracy.

7. Types of Collection tubes
Blue-Top Tube - Sodium Citrate (NaCitrate): This tube is primarily used for
coagulation studies (PT and PTT). Complete filling of this tube is essential to
obtain accurate results.

8. Lavender-Top Tube - EDTA:
EDTA is the anticoagulant used for most hematology
procedures. Its primary use is for the complete blood
count(CBC) and individual components of the CBC. The
larger (6ml) tube is used for blood bank procedures.

9. Green-Top Tube - Sodium Heparin or Lithium
Heparin as anticoagulant.

10. Capillaries tubes types
Red tip
supply with anticoagulant to prevent blood clotting
Blue tip
Don’t supply with any material .

11. Complications of venipuncture
1. Fainting during collection of the blood.
Patients feel dizziness and this may happen during or
after the collection of blood. There is a sudden decrease
in the blood pressure and sometimes the patient may
have a temporary loss of consciousness. These results
Caused due to vasovagal syncope.

12. 2-Hematoma.
There is a leak of blood from the site of venipuncture
site. There may be bruise formation., Apply the pressure
bandage to the area

13. 3. Patient on anticoagulant therapy
These patients have more chances of bleeding, In this patient
keep the pressure on the venipuncture site and don't leave
these patients until there is the complete stop of bleeding.
4. Allergies.
There may be reactions to the antiseptic or Band-Aids or
bandages, If it happens to give some anti-allergic medication.
5. Pain
The patient may feel a sharp pain and tingle due to the
involvement of the nerve, It is best to take out the needle.

14. Most common errors in the samples collection
1. Wrong labeling of the sample.
2. Wrong ratio of the blood and the anticoagulant and Not proper mixing
of the blood and there may be micro clots formation.
3. Keeping the sample at extreme (hot) temperature.
4. There may be hemolysis which is not a good sample for electrolytes and
so many other tests.
5. If there is lipemic serum which will interfere with biochemical
reactions.
6. Wrong timing of the sample for some special tests like hormones.
7. Improper centrifugation of the blood which will not give good clear
serum.
8. Some tests are influenced by the light to the blood.
9. The delayed performance of the tests.

15. The cases that must reject the samples.
1.Unlabelled sample.
2.Sample shows hemolysis.
3.Serum shows lipemia.
4.When there are micro-clots in the blood sample.
5.When the sample is too small to perform the test.
6.When need to make Calcium assessment and the
blood collected in class tube, because the calcium will
adsorption with glass wall.
7.If the specimen is contaminated.
8.If the container is leaking.