Venous Blood Collection and Specimen Handling Procedure

Purpose. This procedure describes how collectors identify the patient, check the request, collect venous blood, label and prepare specimens and despatch them to the partner laboratory within the required time and temperature limits.

1.Scope

This procedure applies to all pathology collectors at the Toronto collection centre and to nursing staff who collect blood in the treatment rooms. It follows the partner laboratory's collection manual, which takes precedence for test-specific requirements.

2.Identification and request check

Before any collection the collector must ask the patient to state their full name and date of birth and must match both to the request form and to the labels. Two identifiers must match; if either does not, the collection must not proceed until the discrepancy is resolved. The collector must check the tests requested, fasting status, any special timing and whether the patient has had a recent collection from the same arm.

3.Preparation

Perform hand hygiene, put on gloves, assemble the correct tubes in draw order, and position the patient seated or lying with the arm supported. Ask about fainting history, anticoagulants, allergies to tape or antiseptic and any arm that must not be used. Apply the tourniquet for no more than one minute and clean the site with the antiseptic wipe, allowing it to dry.

4.Collection

Anchor the vein, insert the needle at a shallow angle with the bevel up and fill tubes in the correct order, inverting each tube the required number of times as it is removed. Release the tourniquet before withdrawing the needle. Activate the safety device and dispose of the needle immediately in the sharps container. Apply pressure with gauze until bleeding stops and apply a dressing.

• Blood culture bottles first, then citrate, serum, heparin, EDTA and fluoride tubes
• Invert gently, never shake
• Do not collect above a running intravenous line
• Stop and remove the needle if the patient faints or reports numbness

5.Labelling

Every tube must be labelled at the chair, in the presence of the patient, before the patient leaves, with the patient's full name, date of birth, date and time of collection and the collector's identifier. Unlabelled or pre-labelled tubes must be discarded. The request form must be signed and the collection recorded in the Pathology Specimen Register.

6.Preparation and despatch

Specimens must be stored at the temperature the laboratory manual specifies, centrifuged where required and packed in the biohazard transport bag with the request form in the outer pocket. The courier pick-up time and the specimen identifiers must be recorded in the register. Specimens that exceed the transport time limit must be reported to the supervisor and recollected if the laboratory rejects them.

7.Adverse events

Fainting, haematoma, excessive bleeding, nerve pain or a needlestick injury must be managed immediately, the patient kept until recovered, and the event recorded in the incident register and reported to the supervisor the same day.