血液凝固采检注意事项-cgmhorgtw.PDF

血液凝固採檢注意事項 檢驗醫學科 採檢順序 • 真空採檢試管使用順序原則為： – 無菌採檢試管→不含抗凝固劑採檢試管→含促凝劑 採檢試管(頇溫和上下混合8次)→含抗凝固劑採檢試管 (且頇溫和上下混合5~8次) – 採檢試管建議使用順序如下：1). 血液培養瓶2). 血液凝 固(藍蓋)3). 血清生化(黃蓋塑膠)4). 快速血清生化(迷彩 蓋)5). 血漿生化(綠蓋)6). 血液一般(紫蓋)7). 生化血糖(灰 蓋)8). 血液ESR(黑蓋) • 空針採檢試管分注順序為：血液培養瓶→含抗凝 固劑採檢試管(且頇溫和上下混合5~8次)→ 不含抗 凝固劑採檢試管 血液凝固採檢前注意事項 • 1.洗腎病人於洗腎後需超過8hrs才能採檢。 • 2.若採血困難或小兒科病患，可依比例減少 採血量(試管內抗凝固劑與血量比例必頇要 正確的為1:9) ，並於檢驗單上註明已照比例 抽血。建議小兒科病患使用幼兒專用2.0 mL 藍頭小採血管。採檢試管使用順序請參照 檢驗手冊，採檢後1小時內立即送檢 。 如果必頇透過VAD採血，儘量避免heparin污染或檢體被沖洗管 路的液體稀釋 CLSI guideline 非血液凝固項目，丟棄兩倍管路密閉空間體積的血量; 若是血液 凝固項目，則丟棄5mL或六倍管路密閉空間體積的血量 避免從IV同一隻手抽血 若是採Indwelling venous catheter的血液，應先以5 mL saline 沖洗indwelling line ，並抽取前5 mL血液或是導管的密閉空間 (dead space)的六倍血量丟棄，才再以藍蓋頭真空採血。若使 用Normal Saline lock導管採檢頇丟棄兩倍密閉空間全血，再 抽藍蓋頭試管。 Specimen Collection - Intravenous Lines • HEM.22707 • Specimen Collection - Intravenous Lines • • There is a documented procedure regarding clearing (flushing) of the volume of intravenous lines before drawing samples for hemostasis testing. • NOTE: Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible. If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution should be considered. When obtaining specimens from indwelling lines that may contain heparin, the line should be flushed with 5 mL of saline, and the first 5 mL of blood or 6 -times the line volume (dead space volume of the catheter) be drawn off and discarded before the coagulation tube is filled. For those samples collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.