Advantages and disadvantages of vacuum blood sampling

Advantages and disadvantages of vacuum blood sampling
Core Tips: (This article was obtained from the guidance of Teacher Wu Dexiang. I would like to express my appreciation for the interference factors of platelet count in automatic blood cell analyzer Wang Bijin, Wang Lin (Department of Clinical Laboratory, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China). The use of cell analyzers in hospitals has become quite popular

(This article is guided by Teacher Wu Dexiang, thank you for your initial analysis of the interference factors of platelet count in automatic blood cell analyzer Wang Bijin, Wang Lin (Department of Laboratory Medicine, the Second Affiliated Hospital of NJMU, Nanjing 210011, China) Current automated blood cell analyzer The use in hospitals has become quite popular, whether it is the use of two or three classifications, or the use of even more advanced five-class hematology analyzers, whose results such as white blood cell count and hemoglobin determination are more accurate and reliable, but platelet counts The results are not accurate enough, and the fluctuations are large and the repeatability is poor.

1 blood collection automatic blood cell analyzer requires vein blood sampling, and a shot at the blood. If the blood collection technique is inexperienced, especially a clinical practice nurse or a nurse who has just taken care of the job, it cannot be given a sharp shot, resulting in a long time for blood collection. The components of the interstitial fluid and the blood are retained in the syringe for a long period of time, which may easily lead to the activation and aggregation of platelets, forming a naked eye. Undetectable micro clots result in a false decrease in platelet counts. After blood collection, it is important to remember to remove the blood collection needle first. The collected blood should be injected into the EDTA-K3 anticoagulant tube first, and the mixture should be mixed in time and then injected into other biochemical tubes. The blood collection nurse should pay enough attention. Otherwise, the platelet count results can differ by up to 10 times. Therefore, we must make a good blood collection, which is the main cause of platelet count interference.

2 Anticoagulant Factors It is now generally recommended to use EDTA-K2 as an anticoagulant for blood cell analyzers. However, EDTA-K2 can sometimes cause EDTA-dependent platelet aggregation, causing falsely reduced platelet counts.

After the laboratory receives EDTA-K2 anticoagulation, the specimen must be inverted upside down 8 times in order to fully mix it thoroughly. If the mixing is not complete enough, it will inevitably cause the platelet count to be low or low.

3 disease factors Some diseases, such as diabetes, cardiovascular disease, due to the self-activation of platelets are more prone to aggregation, easy to aggregate, or even in the body has formed a micro-aggregation, which can also lead to falsely reduced platelet count results.

4 Environmental factors Low temperature also easily activates platelets, causing platelet aggregation, resulting in falsely reduced platelet counts. In addition, the surrounding electromagnetic field is too strong, and the disturbance of platelet count is particularly prominent. If there is more indoor dust, interference with platelet count should be taken seriously.

5 The placement time of specimens should not be too long and should be tested within 4 hours. If it is more than 4 h, platelet count results will be significantly reduced.

6 Reagents In principle, original reagents should be used as much as possible so that the reagent quality can be stabilized and guaranteed. At the same time, quality control should be done to reduce the interference factors that affect platelet count to a minimum, so that the count of platelets is accurate and reliable.

Advantages and disadvantages of using vacuum blood collection method Liu Dianzhong (Department of Clinical Laboratory, Second Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan, China) The traditional blood sampling method uses a disposable plastic empty needle to replace the glass blank needle, avoiding the repeated sterilization and repeated use of f glass empty needles. Greatly reduce the chance of reinfection. The extensive use of vacuum blood sampling in clinical venipuncture is another revolution in venipuncture. It compensates for many shortcomings of the traditional blood sampling method. It also has its drawbacks. Summarized as follows: 1 Vacuum blood sampling with a special application - one end of the double-ended blood collection needle (needle A) piercing blood vessels, one end (needle B) through the piercing tube into the human vacuum blood collection tube. A "syringe sleeve" is used between the double-headed blood needle and the vacuum blood collection tube

Connected. The syringe sleeve is tightened in advance with the blood collection needle. After the success of the puncture, the vacuum blood collection tube is pushed along the back end of the syringe sleeve to push the person slightly, so that the needle B pierces the tube cover, and the blood can flow into the tube along with the pressure difference. When multiple blood samples are needed, the fixed needles are not moved, and the prepared vacuum blood collection tubes are sequentially pushed and removed.

2 Comparison of Vacuum Blood Collection Method and Traditional Blood Collection Method 2.1 Automatic measurement, no need to withdraw. Due to artificial vacuum in the blood collection tube, blood pressure can be controlled by the pressure. No manual metering is required during operation.

2-2 aseptic procedures. Inspection interference is small. In order to maintain the vacuum in the tube, the blood collection tube has good tightness, sterility, blood contamination, and little interference with the test results.

2.3 clear classification, easy labeling. Vacuum tube caps have different colors such as red, yellow, purple and blue. In addition, the description of which blood collection tube to use for testing which item is used is clearly categorized. The label is attached outside the blood collection tube, and the department, bed number, name, etc. can be directly indicated on the above, avoiding past temporary adhesion.

2.4 One-time injection of vacuum blood vessels, blood composition changes. The vacuum blood collection method directly injects blood into the blood collection tube, omitting the residence of the blood in the syringe barrel and the transfer from the syringe barrel to the blood collection tube. It also avoids the blood caused by the syringe pumping the blood to the human blood collection tube in the traditional blood collection method. Changes in the number of constituents can be quickly obtained, reducing the repeated compression of the blood and less damage to the blood cells. The test results are more reliable and reliable.

3 drawbacks of the vacuum blood collection method The new technique of vacuum blood sampling in clinical practice also gradually reflects the fly in the ointment. Mainly focused on the probability of successful blood collection.

3.1 When multiple blood collections were performed, the failure rate was low. It takes a little effort (especially the former) to push the blood collection tube so that the needle B pierces the cap and removes the blood collection tube. If a patient needs to collect multiple blood samples, the inevitable push-pull in the replacement of the blood collection tube is unfavorable for fixation, which easily causes the needle to puncture the blood vessel, resulting in failure of blood collection. After the successful puncture, blood collection failed due to improper fixation. Vacuum blood sampling is obviously contrary to traditional blood sampling methods.

3.2 The vacuum disappears in the vacuum vessel tube resulting in failure of blood collection The vacuum blood collection tube is sealed by the manufacturer. Do not loosen the tube cover to prevent the vacuum from disappearing. However, the presence or absence of vacuum cannot be identified with the naked eye. It is also not possible to detect the vacuum inside the tube before use to eliminate the waste tube. Therefore, sometimes the blood sampling is not obtained after the success of the puncture. In addition, the angle formed with the skin during puncture is greatly increased, and the angle of formation of blood vessels with the blood vessels is increased at the same time, which increases the possibility that blood vessels cannot be easily fixed or punctured.

3.3 In patients with older, pediatric, and fat-prone multivein veins that are deep, slippery or have no obvious exposure, vacuum blood sampling is not as convenient and effective as the syringe used in traditional blood sampling methods. The vacuum inside the vacuum tube is limited after all, not in the veins. When the filling is too full or the exposure is not obvious, it is not as good as the syringe can artificially control the pressure of the puncture, especially when the jugular vein or the femoral vein is punctured, at which point it cannot replace the syringe.

TEGF Screening Test with Microplate Reader He Ping (Department of Clinical Laboratory, Shucheng County, Anhui Province, Shucheng 231300, Anhui, China) The tumor-associated substance group (TSGF), which is a number of internationally recognized sugars related to the growth of malignant tumors and The collective name of metabolites. It is a factor that promotes the proliferation of tumors and surrounding capillaries and their release into the peripheral blood when malignant tumors grow. TSGF assay has been used in many hospitals for the early and broad-spectrum diagnosis of malignant tumors. However, the detection reagents are expensive and costly. Our laboratory used a microplate reader instead of a spectrophotometer as a screening test for TSFG, saving Reagents nearly 3/4, greatly reducing the cost, the results are satisfactory, are introduced below.

1 Materials and Methods 1.1 Instrument Aerospace Zs-2 plate reader.

1.2 Reagents The combined test kit for tumor-related substances provided by Fujian Newland Biotechnology Co., Ltd.

1.3 Method Take TSGF reagent 0. 25ml set the reaction tube, add blood 10ml, cover tightly, fully mixed, the reaction tube into the test tube rack, set 1C boiling water bath to heat ISmin, quickly remove and place in cold water cooling 5min to terminate the reaction. The reaction solution was completely transferred to the washed enzyme-labelled plate strips, and 492-wavelength microplate readers were used. The same volume of distilled water was used to adjust the absorbance of each well and the standard curve was used to determine the TSGF units. The standard curve is formulated under the same conditions.

2 Results 152 cases of TSGF were measured specimens, while using this method and the original method to determine the results of the two methods are positive in 45 cases, two methods are suspicious in 6 cases, this method is suspicious the original method is positive in 2 cases, this method is negative The original method was suspicious in 1 case and 97 cases were negative in both methods.

3 Discussion This method uses a microplate reader instead of a spectrophotometer to measure TSGF with a 1/4 amount of the original method reagent, which significantly reduces the cost. Since the Zs-2 plate reader is not equipped with a 470-nm wavelength, we use the 450nm and 492nm wavelengths as the standard curve, and then simultaneously measure 30 serum samples at the two wavelengths and compare them with the original method. The results are determined at a wavelength of 492nm. The result is closer to the original method, so 492nm is used as the measurement wavelength.

From the above results, it can be seen that the coincidence rate between the present method and the original method can reach 97.4%. It is considered that this method can be used as a screening test to ensure complete reliability of the results. For a small number of suspicious individuals and the number of units near the negative and suspicious thresholds Or the number of units near the threshold of doubtful and positive should be confirmed by the original method.

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