Guidelines for the collection of venous blood samples for laboratory testing. How to take a blood test from a vein The procedure for taking blood from a vein

Any pathological process in the body is reflected in the blood counts. Therefore, a blood test from a vein is often one of the first diagnostic procedures that a doctor prescribes when a disease is suspected.

A blood test from a vein is more informative and accurate than a capillary blood test from a finger. When taking blood from a finger, there is always the possibility of distorting the results associated with the blood sampling procedure itself. In addition, the volume of blood obtained from a fingerstick test is often limited, so it can be difficult to cross-check the results.

When is a complete blood count ordered?

A general blood test is prescribed in the following cases:

As part of a scheduled annual medical examination to assess the current state of health.
If necessary, before starting any course of treatment, to monitor its effectiveness.
With an infectious disease to clarify its nature.

Description of the blood sampling procedure

To take blood from a vein, the patient's forearm is slightly pulled with a tourniquet. The patient is then asked to clench and unclench his fist to increase blood flow. The skin in the area of the elbow is wiped with an alcohol wipe, after which a hollow needle is inserted into the vein. Through this needle, blood is taken from a vein and filled with the required number of test tubes.

After that, the needle is pulled out, and a sterile cotton swab is applied to the place of its insertion and fixed on the arm with a bandage. With such a bandage, after taking blood from a vein, you need to walk for no more than 5-7 minutes.

To determine different blood parameters, different methods, various reagents and equipment are used. Therefore, be prepared for the fact that you will need to fill several test tubes, depending on the required number of indicators.

How to prepare for a blood test

A general blood test can be taken at any time of the day, regardless of the meal. A biochemical blood test from a vein is taken on an empty stomach.

Why can't you eat

In some situations, after eating, substances enter the bloodstream that can have an indirect effect on certain indicators if you donate blood from a vein for biochemical analysis.

What not to do before a blood test

The doctor who will prescribe the analysis will tell you about this. Usually, before taking blood from a vein, it is necessary to refrain from eating (if you are taking a biochemical analysis) and to stop taking certain drugs if the patient is taking something.

What can you drink before donating blood

Before taking blood from a vein, you can drink water in unlimited quantities.

The main indicators of a blood test

Hemoglobin is a protein found in red blood cells. Its main function is to provide the body with oxygen. Both elevated and reduced hemoglobin levels can indicate serious disorders: problems with the gastrointestinal tract, iron deficiency anemia, heart failure, etc.

red blood cells- red blood cells. Their excess can lead to thickening of the blood and the appearance of frequent headaches, dizziness, nosebleeds. A low red blood cell count often leads to fatigue and tinnitus.

Reticulocytes are precursors of erythrocytes, which are formed in the bone marrow. If their content is lowered, this may indicate a violation of the process of formation of red blood cells. Elevated levels of reticulocytes may indicate the presence of blood loss.

platelets- blood "plates" responsible for blood clotting. A deviation in the platelet level from the norm may indicate the presence of serious diseases, such as tuberculosis, liver and kidney cancer, bone marrow damage, and leukemia.

ESR- erythrocyte sedimentation rate. It may indirectly indicate the presence of an inflammatory process in the body.

Leukocytes- white blood cells. Their deficiency may indicate, among other things, the presence of an infectious disease.

Neutrophils- one of the varieties of leukocytes. Help the body fight bacteria. Their reduced content may indicate the presence of a severe infection in the body. If the rest of the blood counts are normal, an increase in the level of neutrophils does not indicate the presence of serious problems in the body.

Lymphocytes- Cells of the immune system. An increase in the level of leukocytes can be observed in children during the period of recovery from infectious diseases. A decrease in the content of lymphocytes in the blood is observed at the onset of the disease.

Monocytes- A type of leukocyte. Their function is to cleanse the body and support immunity. An increase in their content may indicate an inflammatory or oncological disease.

Eosinophils- leukocytes responsible for the destruction of foreign protein in the body. They are elevated in allergic diseases.

Basophils- leukocytes, an increase in the content of which may indicate both the presence of an inflammatory process or a foreign body in the body, and inflammation in the digestive organs and disruption of the thyroid gland.

Plasma cells- cells that are part of the immune system and are responsible for the production of immunoglobulins (antibodies). May appear in the blood during infectious diseases such as chicken pox, rubella, measles.

Interpretation of CBC results

Usually, the forms with the results of the analysis indicate whether there is a deviation from the norm. But do not try to interpret the results yourself, draw conclusions and choose a treatment - trust an experienced doctor.

Expert doctor's opinion

A complete blood count will reveal the presence of an acute or current condition, in the case of an infectious disease, it will suggest the nature of the infectious agent, which will allow the doctor to prescribe adequate treatment. A biochemical blood test indicates the state of metabolism, the function of certain organs and systems, and endocrinological diseases.

Introduction

In recent years, thanks to the introduction of modern technologies into clinical practice, the role of laboratory research in the diagnosis and evaluation of the effectiveness of treatment of various diseases has significantly increased. Laboratory tests are more sensitive indicators of the patient's condition than his well-being and the parameters of other diagnostic methods. Important decisions of the physician in the management of the patient are often based on laboratory data. In this regard, the priority task of modern clinical practice is to ensure high quality and reliability of laboratory test results.

Very often, the results of laboratory tests depend on how the patient was prepared for the study, at what time the sample was taken, on compliance with the necessary requirements for taking this sample, etc.

The need to standardize the preanalytical stage of work with venous blood is due to the fact that errors at this stage can be the main reason for incorrect diagnosis and treatment of diseases.

Laboratory diagnostics includes 3 stages:

The preanalytical stage accounts for up to 60% of the time spent on laboratory research. Errors at this stage inevitably lead to a distortion of the results of analysis. In addition to the fact that laboratory errors are fraught with the loss of time and money for repeated studies, their more serious consequences can be misdiagnosis and incorrect treatment.

The results of laboratory tests can be influenced by factors related to the individual characteristics and physiological state of the patient's body, such as: age; race; floor; diet and fasting; smoking and drinking alcoholic beverages; menstrual cycle, pregnancy, menopausal status; physical exercise; emotional state and mental stress; circadian and seasonal rhythms; climatic and meteorological conditions; position of the patient at the time of blood sampling; taking medications, etc.

The accuracy and correctness of the results are also affected by the technique of taking blood, the instruments used (needles, scarifiers, etc.), the tubes into which blood is taken and subsequently stored and transported, as well as the conditions for storing and preparing the sample for analysis.

The traditional and currently widely used needle and/or syringe blood collection methods are the main sources of laboratory errors leading to poor quality of test results. In addition, these methods cannot be standardized and do not ensure the safety of the patient and staff taking blood.

When taking samples of venous blood by gravity using a needle and conventional test tubes, there is a high probability that the patient's blood will get into the hands of medical personnel. In this case, the hands of a nurse can become a source of transmission and spread of pathogens of bloodborne infections to another patient by contamination of the injection wound with blood. The health worker himself can become infected from the source of the infection.

The use of a medical syringe with a needle for blood sampling should also be avoided due to its insufficient safety for medical personnel and the inability to exclude blood hemolysis when transferring a sample under pressure to a test tube.

For sampling venous blood, it is most preferable to use vacuum-containing systems (Fig. 1). This method has a number of advantages, the main of which is that the blood enters directly into a closed tube, which prevents any contact of the medical staff with the patient's blood.

1.1. How the BD Vacutainer® System Works

Under vacuum, blood is drawn through the BD Vacutainer® needle directly from the vein into the tube and immediately mixed with the chemical. A carefully metered vacuum volume ensures an accurate blood/reagent ratio in the tube.

Task for self-control number 1

You are a nurse in a treatment room. You have the opportunity to take a sample of venous blood in several ways: open (through a needle), syringe and using a vacuum system. Which method is the most preferred? Justify the answer.

Answer [show]

For sampling venous blood, it is better to use a vacuum system, because. it allows:

ensure the same conditions for taking blood;
to carry out a minimum of operations for the preparation of a blood sample in the laboratory;
use the test tube into which blood is taken in automatic analyzers (savings in the purchase of secondary plastic test tubes);
simplify and make safe the process of transportation and centrifugation;
clearly identify tubes used for different types of analysis by color-coding caps;
reduce the cost of purchasing centrifuge tubes, washing, disinfection and sterilization of tubes;
reduce the risk of occupational infection;
use vacuum containing systems only once;
save time on the process of taking blood;

Task for self-control number 2

When a test tube is attached to the "needle-holder" system, blood begins to flow into it on its own. Why? Justify the answer.

Answer [show]

A carefully dosed volume of vacuum is created in the test tube at the factory and the required amount of a chemical reagent is added. Under vacuum, blood is drawn through the BD Vacutainer® needle directly from the vein into the tube and immediately mixed with the chemical. This ensures an accurate blood/reagent ratio in the tube.

1.2. Advantages of the BD Vacutainer® Vacuum System

standardization of blood sampling conditions and sample preparation process;
the system is ready for use, the number of operations for preparing a blood sample in the laboratory is reduced;
the possibility of direct use as a primary test tube in a number of automatic analyzers (savings in the purchase of secondary plastic test tubes);
hermetic and unbreakable test tubes simplify and make safe the process of transporting and centrifuging blood samples;
clear identification of tubes used for different types of analysis due to color coding of caps;
reduction of costs for the purchase of centrifuge tubes, for washing, disinfection and sterilization of tubes;
a simple method of staff training;
reducing the risk of occupational infection;
saving time in the process of taking blood;
simplicity of design of vacuum-containing systems and their reliability.

The BD Vacutainer® System consists of three components (Figure 2):

2.1. BD Vacutainer® Sterile Needles

Bilateral needles with a membrane that prevents blood flow when changing tubes are used to collect samples from several tubes in one venipuncture procedure.
They have ultra-thin walls.
Covered with silicone on the outside and inside for less trauma to the patient and improved blood flow.
Due to the unique V-shaped sharpening, they provide a smooth and painless insertion into the vein.
They have different lengths and diameters, which allows the least traumatic puncture of different veins. Color coding allows you to quickly determine the size of the needle.
Needles undergo individual quality control.

Types of BD Vacutainer® Needles and Adapters

Blood collection kits
Luer adapters

a) Precision Glide™

Standard needle for blood sampling into several test tubes (Fig. 4). Available in different sizes.

Equipped with an additional protective cap, which greatly reduces the risk of accidental needle stick injury and transmission of infection. The cap is operated with one hand and does not require retraining of personnel (Fig. 5). These needles are available in different sizes.

c) FBN BD Vacutainer® Blood Flow Imaging Needle

Ideal for difficult cases of blood sampling (weak veins, poor blood flow, etc.), it is recommended for use by young professionals just starting to draw blood (Fig. 6). Available in different sizes.

Specially designed for taking blood from hard-to-reach veins. Kits include needles, latex-free catheters of various lengths, and luer adapters (Fig. 7). The needles have large "wings" for easy fixation when inserted into a vein. The Safety Lok™ and Push Button Safety Lok™ kits (fig. 8) are equipped with safety devices to improve the safety of healthcare workers when handling a needle. The kits differ in the size of the needles and catheters.

f) Luer adapters

Designed for blood sampling through a regular needle or venous catheter. The Luer Lok™ adapter provides a stronger connection to the catheter (Figure 9).

The disposable and reusable holders are compatible with all BD Vacutainer® needles and tubes (Figure 10). Are intended for more convenient introduction of a needle and safe connection of a test tube.

The reusable holder is equipped with a button, when pressed, the needle is released.

BD Vacutainer® Tubes comply with International Standard 15O 6710 for Vacuum Blood Collection Tubes (Figure 11). The test tubes are made from glass and transparent, latex-free polyethylene terephthalate (PET), which is lighter than glass and virtually unbreakable. The BD Vacutainer® System comes ready-to-use and requires no tube preparation or reagent dosing. The tubes are protected by latex-free caps, which are color-coded according to the purpose of the tubes and the type of chemicals they contain (Table 1).

BD Vacutainer® tubes are labeled with reagent information, sample volume, lot number, expiration date, and more. (Fig. 12).

(Source: instruction on compliance with the anti-epidemic regime when taking venous blood by venipuncture in health care institutions of the city of Moscow 2.1.3.007-02).

Table for blood samples. It is possible to use a mobile table that moves silently on any surface.
Supports (supports) for test tubes. Stands should be light, comfortable, with a sufficient number of cells for test tubes.
Chair for venipuncture. A special chair is recommended for venipuncture. The patient during venipuncture should sit with maximum comfort and safety for him and be available to the medical staff of the treatment room. Both armrests of the chair should be positioned so that the optimal venipuncture position for each patient can be found. The armrests serve as a support for the arms and do not allow bending of the elbows, which prevents the collapse of the veins. In addition, the chair must prevent patients from falling in case of fainting.
Couch.
Fridge.
Gloves. Disposable or reusable. Repeated use of gloves is allowed with their disinfection after each patient by wiping them twice with disposable wipes impregnated with antiseptics that have a virucidal effect. When taking blood from the subclavian catheter, gloves should be sterile for single use.
BD Vacutainer® Venous Blood Collection Systems.
Disposable and reusable rubber and latex tourniquets are used, specially designed for this purpose (Fig. 13). If blood or other biological fluids get on a reusable tourniquet, it should be subjected to disinfection. Disposable tourniquets are disposed of together with used consumables.
Gauze napkins. Sterile gauze pads (5.0x5.0 cm or 7.5x7.5 cm) or wipes impregnated with antiseptics in the original packaging should be available. Cotton balls are not recommended.
Antiseptics. To treat the surface of the injection field, it is necessary to have antiseptics allowed in the prescribed manner. Antiseptics are used in the form of solutions that are applied to a sterile gauze napkin, or wipes impregnated with an antiseptic are used in the original packaging.
Robe. In all cases, personnel conducting venipuncture should be dressed in special protective clothing: a gown (trousers and a jacket or overalls; a gown over trousers or overalls), a cap (kerchief), a gauze mask, goggles or a shield, gloves. Bathrobe should be changed as it gets dirty, but at least twice a week. Should be provided for the immediate change of overalls in case of contamination with blood.
Sterile tweezers.
Pillow for leveling the elbow bend (in the absence of a special chair).
- desktop puncture-proof, leak-proof container for needles with a stop for safe removal of the needle (Fig. 14);
- container with an enclosed plastic bag for collecting waste. A strong waste container is needed to contain used needles (in the absence of a first container), syringes with needles and vacuum-containing systems, used dressings.
Ice or ice pack.

A bactericidal adhesive plaster to cover the injection site.

Task for self-control number 3

Answer [show]

For venipuncture, it is recommended to use a special chair, because the patient during venipuncture must sit with maximum comfort and safety for him, and also be accessible to the medical staff of the treatment room. Both armrests of the chair should be positioned so that the optimal venipuncture position for each patient can be found. The armrests serve as a support for the arms and do not allow bending of the elbows, which prevents the collapse of the veins. In addition, the chair prevents patients from falling in case of fainting.

Warming accessories. To enhance the blood flow, you can use warming accessories - a warm (about 40 ° C) wet napkin applied to the puncture site for 5 minutes.
Skin antiseptics for the treatment of hands and gloves.
Disinfectant for decontamination of used material and work surfaces.
A reminder of the ongoing manipulations.
Markers for marking samples.

I. Preparation for the procedure
1. Invite a patient, register a referral for a blood test
- surname, name, patronymic of the patient, age, date and time of blood sampling;
- registration number of the analysis (indicates the laboratory);
- No. of the medical history (outpatient card);
- surname of the attending physician;
- the department or unit that referred the patient;
- other information (home address and phone number of the patient).
Blood collection tubes and referral forms are marked in advance with one registration number.
Perform patient identification

ask the outpatient for his first and last name, home address and/or date of birth;
compare this information with that indicated in the direction;
ask the inpatient for the same data (if the patient is conscious), compare the information with that indicated in the referral;
for unknown patients (patients who are unconscious or twilight conscious) some temporary but clear designation should be assigned in the emergency department until their identity can be clarified.

Explain to the patient the purpose and course of the upcoming procedures to ensure that informed consent is available

Task for self-control number 4

A 52-year-old patient came to the treatment room to take a venous blood sample for cholesterol and triglycerides. At home he had breakfast, drank a cup of strong coffee, and smoked a cigarette on the way to the clinic. The nurse in the treatment room took a blood sample without asking the patient when he last ate, drank coffee, smoked. What test results can be obtained from such a patient? Justify the answer.

Answer [show]

The nurse must check the patient's compliance with dietary restrictions, take into account the intake of prescribed medications for the patient.

Sample collection should be performed 12 hours after the last meal and with reduced physical activity, because. Serum concentrations of some analytes are altered by factors such as food composition, physical activity, smoking, alcohol and coffee consumption.

In a form accessible to the patient, taking into account his psychological characteristics, it is explained what the procedure is, what discomfort and when the patient may experience. Such a conversation helps to relieve emotional stress, create a trusting environment.

When taking blood from a patient who is in a twilight state, special care must be taken to prevent unexpected movements and shudders at the time the needle is inserted or when it is in the lumen of the vein. At the ready should be a gauze napkin.

If the needle falls out or shifts, the tourniquet must be quickly removed. If suddenly the needle is deeply inserted into the arm, it is necessary to warn the doctor about the possibility of damage.

Check the patient's compliance with dietary restrictions, take into account the intake of drugs prescribed to the patient

if possible, samples should be taken between 7 and 9 am;
sampling should be performed 12 hours after the last meal and with reduced physical activity (for example, serum cholesterol and triglyceride concentrations are affected by factors such as food composition, physical activity, smoking, alcohol and coffee consumption);
sampling should be performed prior to any diagnostic or therapeutic procedure likely to influence the results.

The procedure for enforcing dietary restrictions, as well as the procedure for notifying staff of their cancellation after blood collection, depends on the rules of the institution concerned.

Comfortable positioning of the patient

Select and check all devices used for blood collection and conveniently place them in the workplace

Wear goggles, mask, gloves

II. Performance

Select, examine and palpate the site of the proposed venipuncture

Apply tourniquet

It must be remembered that prolonged application of a tourniquet (more than 1 min) can cause changes in the concentration of proteins, blood gases, electrolytes, bilirubin, and coagulation parameters.

Take the needle, remove the white cap to open the needle with the valve (Fig. 20).

Screw the end of the needle closed with a rubber valve into the holder (Fig. 21). If the needle has a protective pink cap, bend it towards the holder

Ask the patient to make a fist

To increase blood flow, you can massage your hand from the wrist to the elbow or use warming accessories - a warm (about 40 ° C) wet towel applied to the puncture site for 5 minutes. If you can't find a vein on this arm, try to find it on the other.

Disinfect the venipuncture site

Wait until the antiseptic is completely dry or dry the venipuncture site with a sterile dry swab

Remove colored protective cap

Fix a vein

Insert a needle into a vein

Insert tube into holder

When taking a sample from one patient in several tubes, follow the correct sequence of filling the tubes (see Rules of Operation below).

Remove (loosen) the tourniquet

Ask the patient to open his fist

Remove tube from holder

Mix the contents of the filled tube

Do not shake the tube violently! This can lead to the destruction of blood cells.

Insert the next tube into the holder and repeat steps 11-15

III. End of procedure

Apply a dry sterile cloth to the venipuncture site

Remove the needle from the vein

Apply a pressure bandage or bactericidal patch to the venipuncture site

Disinfect used equipment. Make sure the patient is well

Mark the taken blood samples, indicating on the label of each tube the full name. patient, case history number (outpatient card), time of blood sampling. Put your signature

Transport labeled test tubes to the appropriate laboratories in special containers with lids subjected to disinfection

I. Tube Filling Sequence

To prevent possible cross-contamination of the sample with reagents from other tubes, it is necessary to follow the correct sequence of filling them (Table 2.)

II. Sample Volume in BD Vacutainer® Tube

Each tube contains a strictly defined amount of reagent for the volume of blood indicated on it;
The tubes must be filled completely, within ±10% of the indicated volume (i.e. a 4.5 ml tube must be filled within 4-5 ml);
Incorrect blood/reagent ratio in the sample leads to erroneous test results.

III. Mixing rules

Immediately after filling and removing the tube from the holder, it must be carefully turned 4-10 times by 180° to mix the sample with the filler. The number of mixings depends on the type of filler in the tube (Table 2). Microclots form in a poorly mixed sample, leading to false analysis results, as well as damage to laboratory analyzers due to clogging of sampling probes. The sample must be mixed gently, do not shake to avoid coagulation and hemolysis.

Task for self-control number 6

When taking a blood sample for the study of coagulation, the nurse chose a tube with a pink cap, and after taking the blood she shook it vigorously 8 times. Did the sister do the right thing? Justify your answer using the BD Vacutainer® Tube Blood Collection Order chart.

Answer [show]

When taking a blood sample for coagulation studies, a tube with a blue cap is required. The contents are mixed by inverting the tube 3-4 times to completely mix the blood and vehicle. Sharp shaking can lead to the destruction of blood cells.

Task for self-control number 7

The patient is scheduled to study several different indicators: glucose, electrolytes, coagulogram and hematological analysis of whole blood. In what order should these samples be taken? Justify your answer using the BD Vacutainer® Tube Blood Collection Order chart.

Answer [show]

Blood samples should be taken in the following sequence:

Coagulogram study
Serum test (plastic tube)
Whole blood hematology
Glucose study
Electrolyte research

6.1. Taking blood from hard-to-reach veins

If venous blood collection uses dorsal hand, temporal, or other hard-to-reach veins, the BD Vacutainer® Safety Lok™ and Push Button Safety Lok™ blood collection kits are best. Kits include butterfly needles, catheter and Luer adapter.

The needle with special "wings" allows better fixation of the needle in the vein, and the flexible catheter ensures the correct position of the tube.

The technique for drawing blood is the same as with a standard Precision Glide™ needle. The needle can be fixed in the vein by the "wings" with a regular plaster (Fig. 28).

6.2. Features of taking blood using venous catheters

Taking blood samples from indwelling catheters can lead to analysis difficulties and erroneous results due to incomplete rinsing of the sampling site. This results in sample contamination with drugs, anticoagulants and/or dilution of the blood sample.

Since catheters are usually flushed with saline to reduce the risk of thrombosis, they should also be flushed with saline before blood samples are taken for diagnostic testing. Sufficient blood must be removed from the catheter prior to sampling to ensure that the sample is not diluted or contaminated. The volume of blood removed depends on the amount of "dead space" of a particular catheter.

For studies other than coagulation analysis, it is recommended to drain blood in the amount of two catheter "dead space" volumes, and for coagulation studies - six catheter "dead space" volumes (or 5 ml).

Thus, if it is necessary to take blood for both biochemical and coagulological studies, then the biochemical test tube is always taken first.

When drawing blood from a catheter using the BD Vacutainer® System, a Luer adapter is used. The technique of taking blood is carried out in the same way as when using needles.

Medical waste is very dangerous for both human health and the environment, and their collection, storage and disposal must be carried out in compliance with the established sanitary and epidemiological rules and norms (SanPiN 2.1.7.728-99 "Rules for the collection, storage and disposal of waste from medical preventive care facilities") and the instructions adopted in your hospital.

Medical devices used for taking venous blood belong to medical waste classes B (hazardous waste) and C (extremely hazardous waste), depending on the research for which the blood is taken.

1. The needle is inserted into the vein, the tube is attached to the needle, but no blood enters the tube
*Reason 1:* You didn't hit the vein with the needle (fig. 30). *Your actions:* Fix the vein, pull the needle out slightly and re-insert the needle into the vein. Make sure the end of the needle stays under the skin.
*Reason 2:* The tip of the needle is pressed against the wall of the vein (Fig. 31). In this case, a few drops of blood enter the test tube, and then it stops filling. *Your actions:* Disconnect the tube from the needle. Due to the elasticity of the rubber stopper, the vacuum in the test tube is completely preserved. Reposition the needle in the vein and reattach the tube.
*Reason 3:* The needle passed through the vein (Fig. 32). A small amount of blood entered the test tube, then the blood flow stopped. *Your actions:* Gradually withdraw the needle until blood flow appears. If the blood flow has not resumed, then remove the tube and remove the needle from the vein. Choose another point and repeat the venipuncture.
2. Tube not filled to labeled volume
*Reason 1:* Vein collapse (Fig. 33). First, there is a slow flow of blood, and then the blood flow stops. *Your actions:* Remove the tube from the holder, wait until the vein is full and reinsert the tube into the holder.

Reason 2: Air got into the test tube (this is possible if the needle with the attached test tube was outside the vein).
Your actions: If blood is drawn into a serum test tube without excipients, and you are satisfied with the amount of blood collected, then the sample can be used further for analysis.

If blood is drawn into an anticoagulant tube, if less blood is taken, the blood/anticoagulant ratio will be disturbed and the blood must be drawn again into a new tube.

Bibliography

Gooder VG, Narayanan S, Visser G, Tsavta B. Samples: from the patient to the laboratory. Gitverlag, 2001.
Instructions on compliance with the anti-epidemic regime when taking venous blood by venipuncture in healthcare institutions in Moscow 2.1.3.007-02.
Kishkun A. A. Modern technologies for improving the quality and efficiency of clinical laboratory diagnostics.- M .: RAMLD, 2005, 528 p.
Kishkun A. A. Evaluation of the economic efficiency of using disposable vacuum-containing systems for taking blood for laboratory tests / Handbook of the head of the CDL. - 2006. - N11 (November). - S. 29-34.
Kozlov A. V. Standardization of the preanalytical stage as a realized necessity.// Laboratory diagnostics/ under. ed. V. V. Dolgova, O. P. Shevchenko.-M.: Reopharm Publishing House, 2005 .- P. 77-78.
Moshkin A. V., Dolgov V. V. Quality assurance in clinical laboratory diagnostics: Prakt. guide. - M .: "Medizdat", 2004. - 216 p.
Ensuring the quality of laboratory research. preanalytical stage. Reference manual (edited by V. V. Menshikov), M., Unimed-press, 2003, 311 pages.
Order of the Ministry of Health of the Russian Federation N 380 of December 25, 1997 "On the state and measures to improve laboratory support for the diagnosis and treatment of patients in healthcare institutions of the Russian Federation".
Order of the Ministry of Health of the Russian Federation N 45 dated February 7, 2000 "On the system of measures to improve the quality of clinical laboratory research in healthcare institutions of the Russian Federation".
Order of the Ministry of Health of the Russian Federation N 220 dated May 26, 2003 "Rules for conducting intralaboratory quality control of quantitative methods of clinical laboratory studies using control materials."
SanPiN 2.1.7.728-99. "Rules for the collection, storage and disposal of waste from medical institutions".
SP 3.1.958-99. "Prevention of viral hepatitis. General requirements for epidemiological surveillance of viral hepatitis".
Procedures for the Collection of Diagnostic Blood Specimens by venipuncture; Approved Standard- Fifth edition, NCCLS H3-A5 Vol.23, No.32.
Procedures for the Handling and Processing of Blood Specimens; Approved Guideline - Third Edition, NCCLS H18-A3 Vol.24, No.38.
Single-use containers for venous blood specimen collection ISO 6710:1995.
Tubes and Additives for Specimen collection; Approved Standard-Fifth edition, NCCLS H1-A5 Vol.23, No.33.
Use of anticoagulants in diagnostic laboratory investigation. WHO/DIL/LAB/99.1/Rev.2 2002.

Taking blood from a vein using a vacuum system is the safest and most effective way to take blood. The use of vacuum tubes, so-called vacutainers, ensures the correct procedure for sample collection, transport and qualitative analysis.

Features and benefits of vacutainers

The three-component system for venous blood sampling consists of:

sterile vacuum tube with a preservative;
bilateral automatic needle for intravenous injection;
automatic needle holder.

The advantages of negative pressure systems are related to their design features:

safety, sterility and sample integrity assurance;
minimization of microclots and hemolysis;
observance of a constant time between the intake and connection with the additive;
exact ratio of sample and additive;
minimizing the effect of the tourniquet.

Algorithm for taking blood using a vacuum system

The technique of taking venous blood with vacuum tubes is similar to using a syringe, while providing greater safety, efficiency and convenience. The sampling is carried out quickly, which is important to guarantee an accurate examination result.

When taking blood from a peripheral vein using a vacuum system, you will need:

vacuum tubes;
tourniquet;
cotton wool (cotton swabs) or napkins;
antiseptic (medical alcohol);
bactericidal plaster;
sterile medical tray;
medical overalls (gown, goggles, mask and gloves).

Before the procedure, it is necessary to issue a referral for the patient, treat the hands with a special solution, and wear protective medical clothing.

Technique for taking blood from a vein

Prepare test tubes that correspond to the declared tests or laboratory tests required by the patient, a needle, a holder, alcohol wipes or a cotton swab, and a band-aid.
Apply a tourniquet to the patient on a shirt or diaper 7-10 cm above the venipuncture site. Ask the patient to make a fist.
Choose a venipuncture site. The most commonly used are the middle cubital and saphenous veins, but smaller and full-blooded veins of the dorsum of the wrist and hand can also be punctured.
Take the needle and remove the cap from the side of the rubber membrane. Insert the needle into the holder and screw until it stops.
Disinfect the venipuncture site with a gauze pad. It is necessary to wait until the antiseptic solution is completely dry.
Remove the protective cap from the other side. Insert the needle-holder vacuum system into the vein in accordance with the algorithm for conventional blood sampling using a syringe. Make sure that the needle is cut up at an angle of 15º relative to the surface of the skin. Since the other end is covered with a membrane, blood does not flow through the needle. With smooth and fast movements, a puncture of the skin and walls of the vein is performed. Deep immersion of the needle should be avoided.
Insert the tube into the holder as far as it will go. As a result, the needle pierces the membrane and the plug, forming a channel between the vacuum tube and the vein. The needle should not be moved when blood begins to flow. The process continues until the vacuum in the tube is compensated.
The tourniquet must be removed or loosened as soon as blood begins to flow into the vacutainer. Make sure the patient opens his fist.
After stopping the flow of blood, the tube is removed from the holder. The membrane comes to its original position, the blood flow through the needle is blocked. If necessary, other tubes can be connected to the holder to collect the required amount of blood. Immediately after filling, the tube must be carefully turned over to mix the sample with the filler: a tube without anticoagulants - 5-6 times; test tube with citrate - 3-4 times; test tube with heparin, EDTA and other additives - 8-10 times.
After filling the last tube, disconnect it from the holder and remove the holder-needle system from the vein. To ensure safety, remove the needle from the holder and place it in a special container for disposal.
A sterile napkin / cotton ball moistened with an antiseptic is applied to the puncture site, or a bactericidal patch is glued.
The tubes are labeled and placed in a special container for transportation to the laboratory.

Possible errors when using vacuum tubes

Problem	Possible reasons	Solution
Blood does not flow into the tube after connecting to the holder	The needle did not enter the vein	In all these cases, it is necessary to carefully adjust the position of the needle. It is not necessary to disconnect the tube from the holder if there is no need to remove the needle and under the skin.
	The tip of the needle rested against the venous wall
	Vein pierced through
Blood in the test tube was received in a smaller amount than necessary for the analysis	Venous vessel collapsed due to low blood pressure	It is necessary to disconnect the tube from the holder and wait for a while until the vein fills up again
	The system needs to be replaced and the procedure repeated.	Air entered the test tube

In the company "Corway" you can order high quality consumables for laboratories. When taking blood with a vacuum system, follow the algorithm. This will ensure the safety of the procedure and the reliability of the study results.

It would seem that it could be easier than donating blood from a finger?! However, errors occur even with such a seemingly simple study. Therefore, you need to donate blood, following all the rules, in order to eventually get the right picture of your health.

When a person comes to see a doctor with any complaint, or during the most common preventive examination, a referral for donating blood from a finger will definitely be issued. What is the technique of taking blood from a finger, how to donate blood correctly will be discussed below.

REASON FOR TESTING

Donating blood from a finger is necessary in order to:

determine a general blood test, by which you can find out about the development in a person of such diseases as anemia, a malignant and inflammatory process, helminthiasis;
determine the level of total cholesterol;
do a quick analysis to find out the indicators of sugar in the blood.

HOW TO PREPARE FOR THE PROCEDURE

In order for the indicators of the given analysis to be correct, the following sampling rules must be followed:

it is necessary to take blood from a finger only in the morning until 10 o’clock;
before taking the test, you can’t eat anything for at least 8 hours, drinking plain water is allowed;
it is necessary to ensure more accurate analyzes a couple of days before the delivery to refuse alcohol and food containing fatty foods;
before passing the analysis, you can not overstrain physically and mentally;
Do not smoke immediately before delivery;
it is not recommended to donate blood from a finger if physiotherapy procedures were performed or an X-ray examination was performed;
blood is taken from the ring finger, earlobe. If the child was just born, then from his heel.

ABOUT INSTRUMENTS USED IN THE ANALYSIS

When taking an analysis, many are worried about what devices are used when blood is taken from a finger. Indeed, in the modern world, such dangerous diseases as AIDS and hepatitis are transmitted through the blood.Currently, only disposable instruments are used for these purposes.They must be packed and opened in the presence of a person.

You can take blood using one of the following tools: a scarifier, a sterile needle, a lancet.

Using the third one is less painful. The new instruments, which are increasingly being used in laboratories, are an automatic instrument in a plastic case that houses a lancet. They have many benefits:

painlessness of the procedure;
ensuring the safety of the person himself and the employee of the medical institution due to the sterile needle and blade inside the device;
reliable starting mechanism;
impossibility of reuse;
penetration depth control.

HOW THE FENCE IS DONE

How to take blood? With a properly organized technique for taking blood from a finger, it is important to properly prepare the desktop and the necessary materials for taking blood from a finger:

if a vacuum system for sampling biological material is used, then a disposable system for sampling blood from a finger is required;
if a vacuum system for sampling biological material is used, then the presence of test tubes is necessary;
instruments for taking blood from a finger;
it is necessary to have a disposable non-puncture container where used scarifiers should be placed;
it is also necessary to have containers in which a disinfectant solution is placed;
tripods, the presence of sterile tweezers and Panchenkov's capillary is mandatory;
it is necessary to prepare a sterile material in the form of cotton or gauze balls;
it is imperative to have a solution with an antiseptic property in order to treat the site of sampling of biological material.

The algorithm, procedure and technique for taking blood are strictly prescribed for specialists in medical institutions and are as follows:

a laboratory worker moistens a cotton swab or gauze in a special solution that has an antiseptic property;
the ring finger of a person before blood sampling should be slightly massaged by a medical professional;
with a free hand, a specialist in a medical institution treats the upper phalanx of a person’s finger with cotton wool or gauze, wet from an antiseptic. Then the finger is wiped with a dry sterile material (gauze or cotton swab);
used cotton wool or gauze is placed in a specially prepared place for consumables;
after the skin is dry, the person taking the blood sample should take one of the instruments provided for this procedure. The puncture in the skin must be done quickly;
the tool used is placed in a special place;
then the first few blood droplets are wiped by a medical worker with dry sterile material (cotton or gauze). Used cotton wool or gauze is placed in a specially prepared place for consumables;
how much biological material is collected by gravity from the finger depends on the method of taking blood from the finger;
after taking blood, a specialist of a medical institution is obliged to apply a cotton swab moistened with an antiseptic solution or a gauze napkin to the punctured place. He should warn the person to hold the sterile moistened material in a pressed state at the puncture site for two to three minutes.

WHY BLOOD IS TAKEN FROM THE FOURTH FINGER

Blood donation is carried out from the ring finger, but you can use the second and third fingers for this purpose. This is due to the fact that the puncture violates the integrity of the skin, which can cause infection. The inner shells of the hand are directly related to the thumb and little finger. When an infection enters, the entire hand is infected in a short time, and the second, third and fourth fingers have their own isolated shell. The ring finger, in addition, is the least busy during physical labor.

ABOUT RESULTS

By receiving the results of the sampling of biological material, you can see for yourself whether it is normal or there are deviations. But you shouldn't do it on your own.

Only a doctor, comparing the parameters of the given analysis with other signs of pathology in a patient, will be able to correctly diagnose.

Normally, the main indicators when passing an analysis from a finger should be as follows:

hemoglobin in a woman should normally be from 120 g / l to 140, in a man - from 130 g / l to 160;
the norm of the color index should be in the range from 0.85% to 1.15;
the rate of erythrocytes is normal in a man from 4 g / l to 5, in a woman - from 3.7 g / l to 4.7;
the rate of erythrocyte sedimentation rate for the strong half of humanity is 15, for women 20 mm / h;
normal level of leukocytes - from 4 to 9x109 / l .;
normal platelet counts - from 180 to 320x109 / l.

When you take a plasma test from a finger, you need to know that if the indicators deviate from the norm, this does not mean that the disease has been confirmed. This may indicate the beginning of the development of pathology. The results may be incorrect if the rules for passing the analysis are violated. Therefore, a second plasma sampling will be scheduled.

The nurse before the blood sampling procedure:

Greets the patient, introduces himself.
Asks the patient to introduce himself, identifies his personality.
Informs the patient about the appointment by the doctor of the procedure, explains its course.
Convinced of the availability of voluntary informed consent to the forthcoming procedure.
Offers and helps the patient to take a comfortable position sitting in a chair (on a chair) or lying on a couch.
Washes hands in a hygienic way, dries them with a towel or napkin.
Treats hands with a skin antiseptic, allows the skin to dry.

Preparation of equipment and workplace

Check that all necessary equipment is available.
Check the expiration date, the integrity of the packages of the vacuum system.
Check the expiration date and tightness of antiseptic wipes.
Take the needle by the long colored cap in one hand, with the other hand remove the short colored cap from the side of the rubber membrane.
Insert the free end of the needle with the rubber membrane into the holder and screw it in until it stops.
Put the needle with the holder on the tray.
Prepare the necessary test tubes in sufficient quantity.
Put on a mask, goggles, oilcloth apron.
Treat your hands with a skin antiseptic.
Put on sterile gloves.

Norm indicators

The formation of indicators in the general analysis is identified by a specialist. With this type of survey, they are often used and give out results in the form of special forms, which have a specific type of indicators. The detection of hemoglobin is the most important indicator in a blood test. This substance is the main component in the respiratory processes, it is a vehicle for supplying oxygen. This form provides the energy necessary for life to each cell, in addition, the substance removes the formation of carbon dioxide. Also during the procedure are revealed:

erythrocytes;
leukocytes;
thrombocrits;
platelets.

Detection of red blood cells: this substance is the most common type of cell in the human body. Types of blood tests for infections: The exact method that is needed in this case is prescribed. It all depends on what complaints and what symptoms the patient has. When the splenic vein reveals a disease during the procedure, a diagnosis of the splenic system is necessary. The functioning of the system of these cells is a function with hemoglobin. Their coincidence occurs in many cases. The presence of a color indicator: this type of parameter binds to erythrocytes and hemoglobin, and this is the main indicator of the saturation of an erythrocyte cell with a hemoglobin cell. The presence of a reticulocyte: this cell is the embryo of an erythrocyte, when they have a young form, then under the influence of special hormones, it turns into adult cells.

In the body system, there are some reserves of this type of cell, when a large number of red blood cells disappear, they are replaced. Presence of platelets: This type of cell is the most important of all elements in the blood system. The main function is the coagulability product. When there is damage to the skin, tissue systems in the organ, the platelet cell produces an instant blockage of the hole, and clots form. Detection of platelets: these indicators mean the ratio of the entire volume in the plasma in relation to the level of the platelet contained in it.

The determination of the erythrocyte sedimentation rate is detected using a special analysis in which the level of the ratio in the protein fraction of the blood is assessed. The presence of leukocytes: this is a white blood cell that protects the body system from infectious processes, the progression of a virus or an allergic process. In addition, this type of cells removes the products of cellular decay from the body. The presence of a leukocyte formula: these parameters indicate the level of quantity and type of leukocyte in the blood system.

Determination of substances in the system during the procedure

In addition to these processes, similar phenomena are observed when there is dehydration in the body, general intoxication, a cold, a violation in the blood flow system. Reduced pigment and red blood cells means a considerable loss of regulation, exhaustion, anemia or leukemia. In addition, a decrease in the degree of hemoglobin and red blood cells means a lack of iron and vitamins. Deviations from generally accepted standards in the color sign of the regulation can help the doctor determine this or another type of anemia.

The level of reticulocytes should be monitored during the period of therapeutic measures of cure, when therapy is taking place, with the help of B vitamins. High and low levels of substances can help the doctor coordinate the dose of medications. If the difference from the generally recognized standards appeared suddenly, then the suspicion of the presence of anemia, malaria, and the formation of metastases in the body system is allowed. As well as a malfunction in the bone marrow. In addition, the autoimmune process, liver failure may be progressing.

Preparation process

Before testing in the laboratory, it is appropriate to consult a doctor in order to find out up-to-date information about what this procedure is and what such an analysis can show. Deciphering the results is the responsibility of a person with the appropriate qualifications.

How to prepare for the test:

On the eve of the test, avoid mental stress and physical exertion.
Do not drastically change the daily routine to which you are already accustomed, and the composition of the diet: the body will be stressed.
Most often, the procedure is carried out in the morning and on an empty stomach. Before taking blood, you can drink clean water, do not smoke.
If for medical reasons you need to take any medications, ask your doctor in advance if they can be taken before the procedure.
In extreme heat, this event is better to postpone.

The concept of a biochemical blood test

Biochemical analysis is a laboratory research method, the results of which make it possible to judge the functioning of human systems and organs. This is an auxiliary diagnostic method that determines protein, fat, carbohydrate metabolism, hormone levels, cholesterol levels, used to clarify the prescribed therapy or correct treatment, as well as to determine the stage of the disease.

Indications: biochemical analysis is carried out at least once a year in order to monitor the state of health and / or after somatic / infectious diseases.

The result of biochemical analysis

Blood biochemistry is one of the important tests in assessing the general condition of the body. The results of the analysis usually look like this:

Often the results show the values of the norm, so you can see for yourself where there are deviations from the norm:

elevated levels occur with the development of diabetes mellitus. With this pathology, the amount of insulin decreases and glucose is not absorbed by the cells;
the decrease, paradoxically, also speaks of diabetes mellitus, only of such a complication as hypoglycemic coma. This occurs when there is an absolute deficiency of insulin. For example, type 1 diabetes.

The total protein includes an indicator of albumins, globulins. Hypoproteinemia develops in violation of the liver. It is when its synthetic function suffers. For example, with cirrhosis or acute hepatitis.

AST and ALT are classified as liver enzymes. As their level increases, the liver is so affected.

Bilirubin is a compound that is formed during the breakdown of red blood cells. Its increase is manifested by jaundice and indicates serious liver damage.

Cholesterol is a factor in the development of myocardial infarction. Therefore, cholesterol should be checked once a year in order to prevent cholesterol plaques.

Uric acid and creatinine are indicators of kidney function. Therefore, their increase directly indicates the pathology of the renal system.

All these indicators are very important in the diagnosis of any pathology. In any clinic, you can donate blood, which will indicate the norm and next to your level.

Deciphering the results

What parameters does the study show? Deciphering the data obtained and making a diagnosis based on them is the business of a qualified specialist.

Along with this, knowing the basic parameters, you can try to deal with the results yourself.

The article provides information on the most important indicators, without knowing which, it makes no sense to try to decipher the results:

The iron-containing protein hemoglobin. Norm: 120-160 g/l. Low hemoglobin indicates anemia, severe blood loss;
Hematocrit is the ratio of certain cells to the total amount of blood. Norm: 36 - 45%. Hematocrit drops sharply in case of intense blood loss, during acute infectious diseases, some autoimmune diseases;
ESR (erythrocyte sedimentation rate). Norm: 1 - 12 mm per hour. The growth of ESR indicates strong inflammatory processes in the body, oncological diseases, blood diseases;
Erythrocytes (red blood cells). Norm: 3.9x1012 - 5.5x1012 cells / liter. A decrease in the number of red blood cells indicates the development of anemia in a patient. A significant excess of the norm can signal the development of a disease such as leukemia. A decrease in the level of red blood cells is possible due to diseases such as myeloma, cancer, bone marrow metastases, measles;
Leukocytes (white blood cells, their types: neutrophils, eosinophils, basophils, monocytes, directly, leukocytes). Norm: 4 - 9x109 / liter. If the number of leukocytes is higher than normal, then an inflammatory process is guaranteed to develop in the body;
Lymphocytes (defenders of immunity, the main types of lymphocytes: T-lymphocytes, B-lymphocytes, NK-lymphocytes). Norm: 1 - 4.8x109 / liter. If the lymphocytes in a person's blood are significantly higher than normal, he may develop a viral disease or acute radiation sickness. The lack of lymphocytes indicates oncological diseases, an immunodeficiency state;
platelets. Norm: 170 - 320x109 / liter. An increased number of platelets is observed in diseases of the cardiovascular system, for example, with thrombosis. So, with thrombosis (especially at its initial stage, during the formation of a thrombus), there is an accumulation of platelets in some difficult places in the vessels. Along with this, with thrombosis, other indicators in the clinical analysis will be deviated from the norm.

A detailed blood test also necessarily includes a leukocyte formula, which indicates how all types of leukocytes in the blood correlate and whether there are any deviations from the norm in this ratio.

Purpose of the technique

A general blood test from a vein - a procedure in the form of a study is a mandatory procedure that is carried out as a routine medical examination, as well as in the form of vaccination against various diseases. What does a blood test from a vein show? Specialists prescribe a procedure before carrying out therapeutic measures in order to eliminate the disease. With the help of this technique, it is found out whether there are contraindications to taking the medication in the system. This is usually when identifying cells that ruin the state of the body (platelets). And they will eventually lead to internal bleeding.

A blood test from a vein decoding: as a rule, biomaterials for this technique are taken from a finger, sometimes a sampling from a vein is necessary. This is usually used when an extended exploration of score sets is required. How to donate blood? Before a fence is made, the finger on the left hand is treated with an alcohol swab. Then an incision is made, which has a depth of 3 mm. The blood that comes out is collected from the pads with a special pipette, and then poured into special thin flasks. Then a small amount is transferred to special laboratory glasses. The portal vein is normal: its indicator is revealed in the course of a thorough study. When venous blood is required for general tests, the forearm is clamped with a special tourniquet.

Then the place where the injection was lubricated with a cotton swab is lubricated. The puncture is done with a hollow needle, and then the blood is drawn into the flask. What are the blood tests? The usual analysis is carried out and general, as well as biochemical. A general blood test is a simple type of procedure that does not require special preparatory measures. As a rule, it is recommended to donate blood in the morning on an empty stomach, as eating can change the result. General analyzes are carried out at least twice in certain periods, since this type of study should be carried out in one condition. It is necessary to donate blood from a vein immediately if this is required during the study of a particular disease.

Taking venous blood with a syringe

If you do not understand the instructions below, then you should not carry out this procedure. Please let someone who has experience with bloodletting supervise your actions, and we also recommend that you undergo a medical examination. courses. And please read the article “Venipuncture” for more details on how to draw blood. The VC administration does not bear any responsibility if you harm your or someone else's health with your inability or inexperience.

It is easier to describe the process using the example of a male vein than a female, since male veins tend to be more visible. We use the forearm or ulnar veins in the crook of the elbow. Step-by-step instruction:

# 1. Make sure syringes and needles are sterile and in the package. Otherwise, DO NOT use them!

# 2. Put on sterile gloves, take an elastic band or other cord, tie around the upper bicep.

#3. Wait about 1 minute and look at the vein. She should swell.

# 4. If you can see the vein well, wipe it with alcohol, let it dry, while you open the syringe package.

# 5. Pull out the plunger of the syringe about a quarter. After removing the cap, return the piston to the opposite position (the cap is easier to take in your teeth)

# 6. The arm should be stable and at a slight angle so that the vein can be accessed.

You may need to move it several times, but do it carefully. Note: Always hold the needle so that it is directed away from the donor's arm and towards his/her body.

# 7. When you have inserted the needle into the vein, do not move or move the syringe, but slowly pull back on the plunger. The syringe fills slowly, but this is normal. If you go too fast, you can damage the vein. If you have inserted the needle more than 1/2 cm, then carefully step back.

#8. Once you have drawn the syringe to its full capacity, gently press the cotton swab over the injection site and pull the needle out. Have the donor stay in place while you remove the needle and pour the blood into a glass to drink. This must be done quickly so that there are no clots. I drank coagulated blood, and it was not a pleasant feeling.

# 9. Pat the puncture site with a cotton swab to prevent bruising. You can also draw blood from a vein in your arm, but this is more painful for donors.
(This applies to those who have taken blood many times. From the tests I have done in my life, I know it hurts. I have been doing intravenous injections for a long time and I hate it! I have asthma and I have to take intravenous solution from time to time Medrol)
To make it easier for the donor:

If he does not have good veins, then first of all you need to practice on muscular men. The needle must be inserted straight into their veins. Almost at a right angle. In addition, it is desirable to distract them at the time of piercing the vein. I say: "Bee venom." But these are relics of the past.

Do not use veins at the wrist or ankle. In these places, the blood tends to clot quickly. If you cannot draw blood professionally, use only the veins in the forearms.

(I can draw blood arteries. But be aware that this is dangerous and difficult if you do not have the appropriate skills.)

In addition, you must control the amount of blood you drink. The body can tolerate up to 420 ml of blood loss every 60 days. Do not exceed this dose. You risk not only the development of anemia in the donor. You also risk that the donor may have heart failure.

Make sure the donor is taking vitamin B12. This will prevent the development of anemia. His diet should contain foods high in iron, such as spinach (good in a cheese casserole) and liver (Ugh! I'd rather die!). Also in the diet should be a lot of meat, as it contains many vitamins.
Anemia symptoms:

- Labored breathing
– Bruising
– Perverted appetite (desire to consume inedible substances)
– Pain in the mouth and tongue (not thrush)
- Fatigue
- Sometimes depression
I hope this helps you.

By the way, it would be interesting for me to selectively examine people who use syringes and measure the amount that they can drink. I would like to know if many people, like me, can drink more than 20 ml. I started on the lowest dose and increased each time. Sometimes I use syringes that are large in volume. I would also like to know if many people vomit blood or black stools after drinking 20 ml. I have no such symptoms. I am developing a medical theory based on iron absorption and RBC. I think granulocytes can be the cause of symptomatic relief. But I don't know for sure yet. Much more needs to be done to refine this idea.

Translation:(own vampirecommunity.ru)Top

Blood test table of the norm in adults decoding of the general and biochemical blood test

In medical practice, a blood test is one of the main and common methods of medical examination that helps to establish an accurate diagnosis. Moreover, there are many varieties of this blood test: general (short - 3 indicators and detailed), biochemical, enzyme immunoassay, serological, for thyroid hormones. Blood is taken for allergens, HIV, pregnancy.

In any case, you see “silent” numbers on the form of research results, understandable only to a specialist, however, after reading this article, you will be able to independently decipher the blood test, at least preliminary, before going to the doctor.

It goes without saying that the most adequate decoding of the analysis is subject to the practitioner who deals daily with the same patients as you.

Deciphering the main indicators of a blood test from a vein

A common laboratory test with which you can assess the condition of the body and identify possible violations is a blood test. The sampling of material can be carried out both from a finger and from a vein.

The procedure for taking venous blood for analysis

The study of venous blood allows you to study the cellular, biochemical, immunological and hormonal composition. Blood is taken from a vein for general and biochemical analysis.

To obtain reliable and informative results, it is necessary to properly prepare for the procedure:

Do not eat or drink before taking blood from a vein.
The day before the study, fried foods, spicy and smoked foods, and alcoholic beverages should be excluded from the diet.
On the eve of physical overload, emotional overstrain should be avoided.
If you are being treated with medicines, you should consult your doctor and, if possible, do not take the medicine or take a break from taking it.
Smoking is prohibited one hour before blood sampling.

It is important to remember that the reliability of the results is influenced by the following factors: the time of blood sampling, instrumental diagnostic methods and physiotherapy performed the day before, as well as some changes in the woman's body (menstruation, menopause). The blood sampling procedure is carried out as follows: the patient is located on a chair near the manipulation table and fixes the hand with the palm up

The blood sampling procedure is carried out as follows: the patient sits on a chair near the manipulation table and fixes his hand with his palm up. An oilcloth roller is placed under the elbow. Next, the laboratory assistant applies a tourniquet just above the elbow bend. At this time, the patient must work with his fist for several seconds to fill the cubital vein with blood.

Useful video - Deciphering the general blood test:

The laboratory assistant processes the puncture area with a cotton swab and inserts a needle with a syringe. After taking the biomaterial, a cotton ball soaked in alcohol is applied to the puncture site and the arm is bent at the elbow. Unpleasant sensations during blood sampling will occur only when the needle is inserted.

The norms of indicators of a general blood test vary depending on the age and gender of the person.

The test results are available on the same day. A detailed transcript will be done by the doctor who sent for laboratory analysis. You can try to independently compare the indicators in the form with the norm.

The main blood parameters and their normal value:

Hemoglobin (Hb). This is a protein that is responsible for delivering oxygen to tissues from the lungs and transporting carbon dioxide back. The norm for men is 120-160 g / l, and for women - 120-140 g / l.
Hematocrit (Ht). This is the ratio of blood cells to the total volume. Normally, the hematocrit for women is 36-42%, and for men it is within the range of 40-45%.
Red blood cells (RBCs). Red blood cells that carry nutrients and oxygen to organs and tissues. The norm for women is 3.8-5.5 × 1012, and for men - 4.3-6.2 × 1012.
Leukocytes (WBC). Represented by white blood cells. They produce antibodies and engulf pathogens. The normal level of leukocytes in the blood is 4-9×1012.
Platelets (PLT). Non-nucleated and colorless blood cells responsible for stopping bleeding. The norm for an adult is 10-320 × 1012.
Neutrophils (NEU). The type of leukocytes and the indicator should not exceed 70% of the total number of white cells.
Eosinophils (EOS). The component of the leukocyte formula and the norm is in the range of 1-5%.
Lymphocytes (LYM). These are cells of the immune system that are part of white blood cells. The concentration of lymphocytes should be 19-30%.
Color Index (CPU). The normal value is in the range of 0.85-1.05.
ESR. The erythrocyte sedimentation rate should be 10 mm/h for men and 15 mm/h for women.
Reticulocytes (RTC). These are young red blood cells. The norm for women is 0.12-2.05%, and for men - 0.24-1.7%.

The deviation of one or another indicator up or down indicates possible changes in the body.

Deviation of blood pressure indicators from the norm may indicate the development of a disease, inflammation, or even a neoplasm.

Decoding should be done exclusively by a doctor, and if the results deviate from the norm, then a comprehensive examination is carried out.

Possible reasons for the deviation of the parameters of the general blood test:

Algorithm for taking blood from a peripheral vein with a syringe

Equipment

manipulation table.
Closed system for blood sampling (in case of obtaining blood using a vacuum system)
Single-use injection syringe from 5 to 20 ml (in case of obtaining blood without using a vacuum system)
Injection needle
Test tube rack
Tubes with or without a cap (in case of obtaining blood without using a vacuum system)
Moisture resistant pad
Venous tourniquet
Waterproof bag/container for Class B waste disposal
Container for transportation of biological fluids
Barcode tape or lab pencil
Depending on the study and methodology
Antiseptic solution for treatment of the injection field.
Hand sanitizer
Disinfectant
Cotton or gauze balls are sterile.
Bactericidal adhesive plaster.
Gloves are non-sterile.

Preparation for the procedure

Identify the patient, introduce yourself, explain the course and purpose of the procedure. Make sure that the patient has informed consent for the upcoming blood sampling procedure. In the absence of such, check with your doctor for further actions.
Offer the patient or help him to take a comfortable position: sitting or lying down
Mark the tubes, indicating the full name of the patient, department "(in order to eliminate errors in the identification of a biomaterial sample).
Treat your hands with an antiseptic. Do not dry, wait for the antiseptic to dry completely.
Wear non-sterile gloves.
Prepare the necessary equipment.
Select, examine and palpate the area of the proposed venipuncture to identify contraindications to avoid possible complications.
When performing venipuncture in the region of the cubital fossa, offer the patient to extend the arm as much as possible in the elbow joint, for which purpose place an oilcloth pad under the patient's elbow.
Apply a tourniquet to a shirt or diaper so that the pulse on the nearest artery is palpated and ask the patient to squeeze the hand several times into a fist and unclench it.
When performing venipuncture in the region of the cubital fossa - apply a tourniquet in the middle third of the shoulder, check the pulse on the radial artery.
When applying a tourniquet to a woman, do not use the hand on the side of the mastectomy.

Performing a procedure

Treat the venipuncture area with at least two napkins or cotton balls with a skin antiseptic, movements in one direction, while determining the most filled vein;
if the patient's hand is heavily contaminated, use as many cotton balls with an antiseptic as necessary;
wait until the antiseptic solution is completely dry (30-60 seconds). You can not wipe and blow the puncture site, so as not to bring microorganisms to it. It is also impossible to palpate a vein after disinfection. If difficulties arose during venipuncture and the vein was palpated repeatedly, this area must be disinfected again;
take the syringe, fixing the cannula of the needle with the index finger. The remaining fingers cover the syringe barrel from above;
stretch the skin in the area of venipuncture, fixing the vein. Hold the needle with the cut up, parallel to the skin, pierce it, then insert the needle into the vein no more than 1/2 of its length. When the needle enters the vein, there is a “hit in the void”;
make sure that the needle is in the vein: holding the syringe with one hand, pull the plunger of the syringe towards you with the other, while blood (dark, venous) should enter the syringe. When blood appears from the cannula of the needle, draw the required amount of blood;
ask the patient to open his fist. Untie the tourniquet;
press a napkin or cotton ball with an antiseptic solution to the injection site. Remove the needle, ask the patient to hold a napkin or cotton ball at the injection site for 5-7 minutes, pressing the thumb of the second hand, or seal it with a bactericidal patch or bandage the injection site;
the time that the patient holds the napkin / cotton ball at the injection site (5-7 minutes), recommended;
the blood in the syringe, carefully and slowly, along the wall, pour into the required number of test tubes;
make sure that the patient does not have external bleeding in the venipuncture area.

End of procedure

Disinfect all consumables. Remove gloves, place in a disinfectant container or waterproof bag/container for Class B waste disposal.
Treat hands in a hygienic way, dry.
Ask the patient how he is feeling.
Make an appropriate record of the results of the service in the medical documentation or issue a referral
Organize the delivery of test tubes with the received laboratory material to the laboratory.

What does a general blood test from a vein show?

A clinical blood test determines the nature of the disease, its stage, shows a general picture of the physiological state. When conducting an examination, it is necessary to take into account age indicators, gender of the patient, psycho-emotional state, lifestyle. For the accuracy of the result, you must first prepare for the analysis.

Don't eat heavy meals the night before. They take the material from a vein in the morning on an empty stomach, so you can not eat later than 6-8 hours before the diagnosis. It is recommended to drink clean water, this will make the blood thinner, which will facilitate the sampling process. Before analysis, physical and emotional overstrain should be avoided. Alcohol should be avoided at least 7 days before the procedure. Some medications can also distort the result. Quantitative indicators differ in men and women, and also differ at different ages and the method of sampling. When taking an analysis from a finger, the platelet count decreases, and the value of leukocytes in venous blood is higher.

Blood is taken by two methods - a syringe and a special vacuum container called a vacutainer. Classic syringe sampling has a number of disadvantages. The material is in contact with the environment, blood clotting in the needle is possible, a long time of taking. When sampling with a vacutainer, the duration of the procedure decreases, the sampling becomes almost painless. The biomaterial does not come into contact with the environment and medical personnel. This method facilitates transportation, as the containers are impact-resistant and airtight.

A clinical blood test provides information about the level of such substances:

hemoglobin;
hematocrit;
erythrocytes;
platelets;
leukocytes;
erythrocyte sedimentation rate.