AMT CMLA flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Venipuncture order of draw

Sequence: blood culture, light blue citrate, serum or gold, green heparin, lavender EDTA, gray fluoride. Following this order prevents additive carryover from one tube to the next.

Light blue tube additive

Sodium citrate 3.2 percent binds calcium to prevent clotting. Used for PT/INR and aPTT, and it must be filled to the line to keep the 9 to 1 blood-to-additive ratio.

Lavender EDTA tube

EDTA chelates calcium and stops clotting. Used for CBC and HbA1c; invert eight to ten times and never shake, since shaking causes hemolysis and platelet clumping.

Tourniquet application limit

The tourniquet stays on no longer than one minute. Longer application causes hemoconcentration and falsely raises potassium, total protein, and lipid values.

Infant heel puncture depth

Puncture the medial or lateral plantar surface of the heel no deeper than 2.0 mm. Avoid the center and posterior curve of the heel to prevent bone damage.

Specimen rejection criteria

Specimens are rejected if unlabeled or mislabeled, collected in the wrong tube, underfilled, grossly hemolyzed, clotted when anticoagulated, or received past the stability limit.

Blood culture collection timing

Collect two sets from separate sites before antibiotics begin. Blood cultures are drawn first in order of draw, and the site antiseptic must dry before puncture.

Cold transport specimens

Blood gas, ammonia, and lactic acid samples are transported on ice and delivered immediately. Warm or delayed transport falsely changes these results.

Centrifuge balancing rule

Load tubes opposite one another with equal weight and equal count. An unbalanced rotor causes vibration, poor separation, tube breakage, and release of aerosols.

Serum clotting before spin

Allow blood in serum tubes to clot about 30 minutes at room temperature before centrifugation. Incomplete clotting leaves fibrin strands that clog analyzers and cause erroneous results.

Hemolysis effect on results

Ruptured red cells release potassium, LDH, and AST, falsely raising these values. Free hemoglobin also interferes with spectrophotometric measurement of many analytes.

Refrigerated storage range

Refrigerated specimens are held at 2-8 degrees Celsius, frozen aliquots at minus 20 degrees or lower, and ultracold storage at minus 70 degrees for unstable analytes.

Aliquot labeling requirements

Each secondary container carries two patient identifiers, specimen type, date and time of aliquoting, and storage conditions. Unlabeled aliquots must be discarded.

HIL interference index

Analyzers report hemolysis, icterus, and lipemia indices. A value above the manufacturer's threshold signals interference, and the result is reviewed before it is reported.

CLIA waived test definition

Tests cleared by FDA as simple with low risk of an erroneous result. The site needs a CLIA Certificate of Waiver but must still follow manufacturer instructions and perform quality control.

Point-of-care glucose QC

Run manufacturer-specified control materials, commonly two levels, on each day that patient testing occurs. Record results and stop testing when controls fall outside acceptable limits.

Urine dipstick reading time

Read each reagent pad within the manufacturer's stated window, usually 30 to 120 seconds. Reading too early or too late produces falsely low or falsely high results.

Rapid strep test limits

Antigen tests give results within minutes but are less sensitive than culture. A negative result in a child may require culture confirmation according to facility policy.

PT/INR point-of-care testing

Fingerstick whole blood is applied to a test strip to measure INR for warfarin monitoring. Results outside the expected range are confirmed with laboratory plasma testing.

Urine hCG detection limit

Standard urine pregnancy tests detect hCG at about 25 mIU/mL. First-morning urine is most concentrated, and very early pregnancy can produce a false negative.

Critical value reporting

A result posing immediate danger to life requires prompt notification of the responsible caregiver, with read-back and documentation of date, time, and the person notified.

OSHA Bloodborne Pathogens Standard

29 CFR 1910.1030 requires an exposure control plan, hepatitis B vaccination offered at no cost, personal protective equipment, engineering controls, and post-exposure evaluation.

SDS sixteen sections

Safety Data Sheets use a 16-section format covering identification, hazards, composition, first aid, firefighting, accidental release, handling, exposure controls, physical properties, stability, toxicology, and disposal.

Sharps container disposal limit

Replace sharps containers when three-quarters full. Overfilling leads to needlestick injuries, and containers must be closed and handled as regulated medical waste.

Eyewash flush duration

Flush the eyes at an emergency eyewash for at least 15 minutes after a chemical splash, holding the lids open, then seek medical evaluation and report the exposure.

Class B fire extinguisher

Class B extinguishers are used on flammable liquid fires such as solvents and reagents. Class A is ordinary combustibles, Class C electrical, and Class K cooking oil.

Hepatitis B vaccine offer

Employers must offer hepatitis B vaccination at no cost within 10 working days of initial assignment to staff with blood exposure risk, unless the worker is already immune.

Two patient identifiers

Verify identity using full name plus date of birth or medical record number. Never use a room or bed number, and compare the label with the patient and armband.

Teach-back communication

Ask the patient to repeat instructions in their own words to confirm understanding. This reveals gaps that yes-or-no questioning fails to detect.

HIPAA minimum necessary

Disclose only the protected health information needed for the purpose at hand. Avoid discussing patients in public areas and share results only with authorized recipients.

Managing a fainting patient

Stop the draw, lower the patient to a supine position, apply a cold compress, and monitor breathing and pulse. Do not allow a rapid return to standing.

Interpreter use

Use a qualified medical interpreter for patients with limited English proficiency. Family members, especially children, should not be relied on to interpret medical information.