Physiologic Variables Affecting Blood

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Posted on 13th June 2011 by admin in Uncategorized

There are many variables that can affect blood.  A phlebotomist should be aware of theses variables when collecting and examining blood samples.

Age.  A patient’s age can affect some blood components.  Newborns typically have higer values of red and white blood cells compared to adults.  Because kidney function tends to decrease with age, higher levels of creatinine may be evident in older patients.

Altitude.  Decreased oxygen levels can cause the body to produce more red blood cells to meet the body’s oxygen needs.  The higher the altitude the greater the increase of red blood cells.

Dehydration.  If a patient has lost a lot of fluids due to vomiting and diarrhea, dehydration will result.  Dehydrations can affect the blood causing the blood to become more concentrated.  If a patient is dehydrated it is difficult to obtain a blood sample.

Diet.  What you eat can affect your blood composition.  If you eat a lot of high sugar foods, like carbohydratees or sweets, your blood glucose levels will be high.  It can take several hours before the blood glucose levels return to normal.  Fatty foods can increase the fat content in blood causing the blood plasma to appear cloudy.  This condition of cloudy blood is called lepemia.  It can last for up to 12 hours.

Diurnal/Circadian Variations.  Diurnal variations occur daily and circadian variations occur in a 24 hour cycle.  These variations can affect blood composition.  Diurnal variations are affected by posture, activity, eating, daylight, darkness and sleep patterns.  Blood components that show diurnal variations include bilirubin, hemoglobin, insulin, iron, potassium, testosterone, and red blood cells.

Drug Therapy.  Some drugs can alter the concentrations of certain blood analytes.  this can cause an unwanted side effect. Physicians will monitor patients who are prescribed drugs that can affect specific blood analytes.  Chemotherapy can decrease white blood cells and platelets.  Many drugs are toxic to the liver.  Drugs with steroids or diurtetics can cause pancreatitis and thiazide diuretics can increase calcium and glucose levels and decrease sodium and potassium levels.

Drugs are known to interfere with test results causing false increases or decreases in results or inaccurate results .

Exercise.  The intensity and duration of exercise can affect a patient’s physical condition.  Exercise can directly affect the arterial pH and PCO2 levels.  Glucose, creatinine, insulin, lactic acid, and protein can increase in blood tests due to muscular activity.  Skeletal muscle enzymes increasefor 24 hours or more by exercise and vigorous exercise before blood collection can increase cholesterol levels by 6%.

EMT: Airway Adjuncts

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Posted on 3rd June 2011 by admin in Uncategorized

There are two airway devices that can be used to help open and maintain the airway for patients that are unable to control their airway. These devices can be used by emergency medical technicians out in the field. The oropharyngeal airway is a curved piece of plastic that is inserted into the patient’s mouth. This device is used to lift the tongue out of the oropharynx. This device is also called the oral airway or OP airway. This device should be used whenever a patient is unresponsive and has no gag reflex. The gag reflex will cause the patient to retch if the back of the throat is stimulated. Because inserting the oral airway will trigger the gag reflex, it is not intended to be used unless the patient has no gag reflex. If this device is used on a conscious patient it is very likely that the patient will gag or vomit, which can cause additional problems to the airway. The nasopharyngeal airway is a rubber or plastic tube that is inserted into the patient’s nostril. This flexible tube helps air to pass through the nasopharyngeal passage. This device is commonly caused a nasal airway or NP airway. This airway device dose not usually cause vomiting and is a better choice for patients who are responsive. If a patient is actively seizing, the nasal airway is often the easiest airway to use. When inserting the nasal airway it is important that the device is not forced in. If there is resistance the airway should be removed and relubricated before trying the other nostril. This device can be uncomfortable and painful for patients. The airway should be monitored for mucus, blood or vomit that can clog the tubing. If clogging occurs the airway should be suctioned.

Phlebotomy: Biohazard Exposure Routes

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Posted on 2nd June 2011 by admin in Uncategorized

Health care workers must be aware of the many ways that they can be exposed to biohazards.  The most common and easily recognizable route is by ingestion.  Other routes besides ingestion are called parenteral routes.  Here is some information about some of the most common routes for biohazard exposure.

Airborne
Aerosols and splashes can allow biohazard materials to become airborne and easy inhaled.  This can happen when biohazard specimens are centrifuged and the stoppers are removed.  It can also occur when preparing specimen aliquots.  If chemicals are not properly stored, mixed or handled dangerous fumes can result and become inhaled.

Ingestion
Sanitization is important to prevent ingesting biohazards.  The simplest and most effect means of preventing ingestions is to wash your hands frequently before having contact with food, gum, candy, drinks or anything that will come into contact with your mouth, like cigarettes.  Covering your mouth with your hands instead of using a tissue when coughing and sneezing can also allow for the transmission and ingestion of biohazards.  Biting your nails, chewing on pens, licking your fingers after meals or to turn the pages of books increases your chances of biohazard ingestion.

Precutaneous
The term percutaneous means through the skin.  Biohazard materials can enter the body if they come into contact with unbroken skin.  This can occur in a health care environment if the skin becomes punctured by needlesticks and broken glass.  Percutaneous exposure can be reduced by using needle safety devices, wearing appropriate gloves to handle broken glass, and never handling glass barehanded.

Permucosal
If the mucous membranes are exposed to biohazards they can quickly and easily enter the body. Mucous membranes are located in the mouth, nose and eyes.  Sneezing, coughing, and rubbing or touching your eyes, nose or mouth with contaminated hands increases your chance of infection.

Washing your hands regularly is a simple and effective way of preventing exposure to microorganisms and other biohazards that can enter your body.