Common reasons a lab rejects a blood specimen and quality assurance steps that prevent them, tested on phlebotomy certification exams.
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- What causes hemolysis in a blood specimen?
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Improper technique (excessive tourniquet time, difficult draw), rough handling, temperature extremes, or prolonged storage at room temperature.- Name the correct order of blood tube collection.
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Culture bottles, serum (red), coagulation (light blue), EDTA (purple), glycolysis inhibitor (gray).- What is hemolysis?
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Rupture of red blood cells that releases hemoglobin into serum or plasma, contaminating the specimen.- What happens when an EDTA tube is not inverted after collection?
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The anticoagulant does not mix properly, allowing blood to clot and the specimen to be rejected.- What is the ideal storage temperature for most serum specimens?
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2 to 8 degrees Celsius (refrigerated).- What rejection criterion applies to a specimen without proper labeling?
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Patient identification missing or incorrect, the specimen cannot be accepted.- How long should a tourniquet be applied during collection?
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No more than 1 minute to prevent hemoconcentration and hemolysis.- Why is blood collection from a running IV line problematic?
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Risk of specimen dilution with IV fluid and contamination of results.- What causes lipemia in a specimen?
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High fat content in blood, usually from a non-fasting state or recent fatty meal.- What is the standard needle gauge for adult venipuncture?
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20 or 21 gauge.- What happens if an anticoagulant tube is under-filled?
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The blood-to-anticoagulant ratio is incorrect and the specimen must be rejected.- Why must blood be collected in a specific tube order?
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To prevent cross-contamination of additives that would interfere with test results.- What does clotting in an EDTA tube indicate?
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Improper mixing, tube expiration, or loss of anticoagulant effectiveness.- At what angle should capillary tubes be held during collection?
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45 to 50 degrees to maintain steady flow and prevent air bubbles.- What rejection reason applies if blood is collected from an IV line without clearing it first?
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Contamination, unless 5 mL of waste was drawn first to clear the line.
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