CI-CPT key terms

The standardized sequence in which blood collection tubes are filled to prevent additive carryover between tubes. It typically begins with blood culture bottles, then coagulation tubes, serum tubes, heparin tubes, and ends with tubes containing EDTA or glycolytic inhibitors.

Transfer of an additive such as EDTA or heparin from one tube into the next through a needle or holder, potentially altering test results. Proper order of draw and discarding the first drop minimize this contamination risk.

A closed collection set consisting of a double-pointed needle, a plastic holder, and vacuum-sealed tubes that draw a predetermined blood volume. It reduces exposure risk and improves specimen quality compared with open systems.

A double-ended needle with a beveled patient end and a shorter rubber-sheathed end that punctures collection tubes. The sleeve reseals after each tube is removed so multiple tubes can be filled from one venipuncture.

A winged infusion set with flexible tubing attached to a short needle, used for fragile or small veins and for pediatric patients. Its extra dead space makes it unsuitable for collecting coagulation specimens unless a discard tube is drawn first.

Collection of blood from a skin nick, usually on a fingertip or infant heel, used when venipuncture is impractical or a small volume suffices. Warming the site increases arterial flow and improves yield.

The penetration distance of a puncture device into the skin. Depth must be chosen by site and patient age; heel sticks in infants are limited to about 2 mm to avoid striking the calcaneus and causing osteomyelitis.

The interval a constricting band remains applied above the puncture site. It should not exceed about one minute, because prolonged stasis causes hemoconcentration and falsely elevates potassium, protein, and cell counts.

Choosing a vein suitable for puncture by palpation, generally the median cubital or cephalic vein in the antecubital fossa. Areas with scarring, hematoma, intravenous lines, or dialysis fistulas are avoided.

A relative increase in red cells and large molecules caused by fluid shifting out of the vessels, often from prolonged tourniquet application or dehydration. It can falsely raise hemoglobin, potassium, and protein results.

Rupture of red blood cells that releases hemoglobin and intracellular contents into the plasma or serum. It falsely elevates potassium, lactate dehydrogenase, and AST and can interfere with many other assays.

A substance such as silica or thrombin coated on the inner wall of a serum tube to speed and complete coagulation. Complete clotting before centrifugation is essential to avoid fibrin strands in the separated serum.

A collection tube containing clot activator and a thixotropic gel that forms a barrier between serum and cells during centrifugation. Proper clotting time before spinning prevents latent fibrin formation.

The spinning of specimens at a defined relative centrifugal force and time to separate cells from plasma or serum. Correct speed, duration, and balanced loading are required to avoid hemolysis and incomplete separation.

Predefined conditions under which a laboratory refuses to test a sample, such as unlabeled tubes, gross hemolysis, insufficient volume, or improper transport temperature. Rejection protects patient safety and result validity.

Applying patient identifiers to a container at the bedside immediately after collection. Most facilities require two independent identifiers and labeler initials; unlabeled or mislabeled tubes must be recollected, not corrected.

A documented, unbroken record of who handled a specimen and when, required for forensic, employment, and legal drug testing. Each transfer is signed and timed so the sample's integrity can be defended.

Verification of identity using at least two independent identifiers, such as full name and date of birth, plus a verbal confirmation when possible. It is performed before every collection and before any point-of-care test.

A patient's voluntary agreement to a procedure after receiving an explanation of its purpose, risks, and alternatives. Consent may be verbal for routine draws but must be documented for research or special procedures.

An accidental percutaneous injury from a contaminated needle or sharp. Immediate washing, reporting, and post-exposure prophylaxis evaluation are required because of bloodborne pathogen transmission risk.

Infection control practices applied to all patients regardless of diagnosis, including hand hygiene, gloves, and eye protection when splash risk exists. They treat all blood and body fluids as potentially infectious.

A puncture-resistant, leak-proof, labeled receptacle for used needles, lancets, and other contaminated sharps. It is replaced when about three-quarters full and never overfilled or shaken.

A transient loss of consciousness from reduced cerebral blood flow, often triggered by the sight of blood or needle anxiety. Patients should be positioned safely and monitored until fully recovered.

Diagnostic testing performed near the patient rather than in a central laboratory, using devices such as glucose meters or blood gas analyzers. Results are immediate but require operator competency and quality control.

Scheduled testing of control materials with known values to verify that an instrument or test system is performing within acceptable limits. Results are documented before patient samples are reported.

Periodic evaluation in which a laboratory or testing site analyzes unknown specimens supplied by an external program and compares results with peer laboratories. It is a required component of accreditation and regulatory compliance.

A result so far outside the reference range that it may indicate imminent danger to the patient. It must be reported promptly to a responsible caregiver and the notification documented.

Comparison of a current result with the patient's previous result to detect a significant change that may signal specimen error or a true clinical event. It is one safeguard against reporting wrong-patient results.

United States federal law that protects the privacy and security of individually identifiable health information. It limits disclosure of patient data and requires safeguards in both paper and electronic records.

The ethical and legal duty to keep patient information private and share it only with those who need it for care. It applies to conversations, records, and test results in all settings.

The appropriate limits of the relationship between a healthcare worker and a patient, preserving objectivity and avoiding personal or financial entanglement. Boundary crossings should be recognized and reported.

Purposeful verbal and nonverbal techniques, such as open-ended questions, reflection, and active listening, that build rapport and reduce patient anxiety. It avoids jargon, judgment, and false reassurance.

The tasks and responsibilities a healthcare worker is legally and professionally authorized to perform based on training, licensure, and employer policy. Performing outside it creates liability and patient risk.

The required thermal condition for moving a sample from collection site to laboratory, such as ambient, refrigerated, or frozen. Deviation can invalidate analytes like ammonia or blood gases.

Obtaining blood for microbial culture using aseptic skin preparation and bottles drawn before other tubes. Volume and the number of sets strongly influence sensitivity for detecting bacteremia.