NHA CPT cheat sheet

Standard precautions apply to all blood, body fluids, secretions, non-intact skin, and mucous membranes regardless of a suspected diagnosis.

Order of PPE removal: gloves first, then goggles or face shield, then gown, then mask or respirator; hand hygiene follows immediately.

Hand hygiene with soap and water is required when hands are visibly soiled or after exposure to spore-formers such as Clostridioides difficile; alcohol rub is otherwise acceptable.

Needlestick or sharps exposure: wash the site with soap and water, do not squeeze or scrub, report immediately, and complete post-exposure evaluation and prophylaxis per protocol.

Gloves are not a substitute for hand hygiene; perform hand hygiene before donning and after removing gloves.

Chemical hazard labels follow the NFPA or GHS system; the SDS must be accessible in the work area for every hazardous chemical.

Biohazard symbol marks containers for regulated medical waste; sharps containers are replaced when three-quarters full and are never recapped by hand.

Chain of custody documentation must accompany forensic or legal specimens and includes collector identity, date, time, and tamper-evident seal.

Positive patient identification requires at least two identifiers, such as full name and date of birth; a room or bed number is never an identifier.

Fasting glucose and lipid panels typically require 8 to 12 hours of fasting; water is permitted and the patient should be asked about fasting status.

Tourniquet application should not exceed one minute; prolonged application causes hemoconcentration, elevated potassium, and falsely elevated protein results.

Order of draw for capillary specimens: discard the first drop, then collect EDTA (lavender) before other additives to limit platelet clumping.

Patients on anticoagulant therapy or with a bleeding disorder require longer pressure application, typically 5 minutes or more, after venipuncture.

Ask about latex allergy, prior fainting, and mastectomy or fistula sites before selecting a venipuncture site.

Basal state specimens are collected early morning after approximately 12 hours of fasting and rest, before exercise or caffeine intake.

Therapeutic drug monitoring timing depends on the drug: trough levels are drawn just before the next dose, peak levels at a specified interval after the dose.

Preferred venipuncture sites are the median cubital, then cephalic, then basilic vein; the basilic vein lies near the brachial artery and nerve.

Order of draw for tubes with additives: blood culture, sodium citrate (light blue), serum tube (red or gold), heparin (green), EDTA (lavender), oxalate/fluoride (gray).

Light blue citrate tubes require a 9:1 blood-to-anticoagulant ratio; underfilled tubes give falsely prolonged coagulation times.

EDTA tubes must be inverted 8 to 10 times; citrate tubes 3 to 4 times; heparin tubes 5 to 10 times; never shake tubes.

Hemolysis is reduced by using a 21-gauge or larger needle, avoiding excessive vacuum, and removing the needle before the tourniquet.

Capillary collection sites: the lateral or medial plantar surface of the heel in infants and the third or fourth finger in adults; never the finger pad center or the earlobe.

Blood cultures are drawn before antimicrobial therapy when possible, with at least two sets from separate sites; each set includes an aerobic and an anaerobic bottle.

Arterial blood gas specimens are collected anaerobically, expel air bubbles, cap the needle, mix by rolling, and transport on ice if a delay is expected.

Serum and plasma should be separated from cells within 2 hours of collection; delayed separation raises potassium, LDH, and glucose artifacts.

Specimens requiring cold transport include arterial blood gases, ammonia, and most coagulation studies; never freeze whole blood for routine chemistry.

Light-sensitive analytes such as bilirubin and vitamin B12 require amber or foil-wrapped tubes.

Specimens for cryoglobulins and cold agglutinins are collected and transported at 37 degrees Celsius.

Centrifugation for routine serum or plasma is typically 10 minutes at approximately 1,000 to 1,200 relative centrifugal force; the brake should be off for gel tubes.

Rejection criteria include unlabeled specimens, mislabeled specimens, hemolysis, insufficient volume, and expired collection devices; rejection must be documented and the result not reported.

Additive tubes should be transported upright and at the temperature specified by the laboratory; EDTA tubes for hematology are kept at room temperature and not refrigerated.

Stat specimens are processed immediately and results are reported within a defined turnaround time; the time of collection, receipt, and result are documented.

Standard precautions apply to all blood, body fluids, secretions, non-intact skin, and mucous membranes regardless of a suspected diagnosis.

Order of PPE removal: gloves first, then goggles or face shield, then gown, then mask or respirator; hand hygiene follows immediately.

Hand hygiene with soap and water is required when hands are visibly soiled or after exposure to spore-formers such as Clostridioides difficile; alcohol rub is otherwise acceptable.

Needlestick or sharps exposure: wash the site with soap and water, do not squeeze or scrub, report immediately, and complete post-exposure evaluation and prophylaxis per protocol.

Gloves are not a substitute for hand hygiene; perform hand hygiene before donning and after removing gloves.

Chemical hazard labels follow the NFPA or GHS system; the SDS must be accessible in the work area for every hazardous chemical.

Biohazard symbol marks containers for regulated medical waste; sharps containers are replaced when three-quarters full and are never recapped by hand.

Chain of custody documentation must accompany forensic or legal specimens and includes collector identity, date, time, and tamper-evident seal.

Positive patient identification requires at least two identifiers, such as full name and date of birth; a room or bed number is never an identifier.

Fasting glucose and lipid panels typically require 8 to 12 hours of fasting; water is permitted and the patient should be asked about fasting status.

Tourniquet application should not exceed one minute; prolonged application causes hemoconcentration, elevated potassium, and falsely elevated protein results.

Order of draw for capillary specimens: discard the first drop, then collect EDTA (lavender) before other additives to limit platelet clumping.

Patients on anticoagulant therapy or with a bleeding disorder require longer pressure application, typically 5 minutes or more, after venipuncture.

Ask about latex allergy, prior fainting, and mastectomy or fistula sites before selecting a venipuncture site.

Basal state specimens are collected early morning after approximately 12 hours of fasting and rest, before exercise or caffeine intake.

Therapeutic drug monitoring timing depends on the drug: trough levels are drawn just before the next dose, peak levels at a specified interval after the dose.

Preferred venipuncture sites are the median cubital, then cephalic, then basilic vein; the basilic vein lies near the brachial artery and nerve.

Order of draw for tubes with additives: blood culture, sodium citrate (light blue), serum tube (red or gold), heparin (green), EDTA (lavender), oxalate/fluoride (gray).

Light blue citrate tubes require a 9:1 blood-to-anticoagulant ratio; underfilled tubes give falsely prolonged coagulation times.

EDTA tubes must be inverted 8 to 10 times; citrate tubes 3 to 4 times; heparin tubes 5 to 10 times; never shake tubes.

Hemolysis is reduced by using a 21-gauge or larger needle, avoiding excessive vacuum, and removing the needle before the tourniquet.

Capillary collection sites: the lateral or medial plantar surface of the heel in infants and the third or fourth finger in adults; never the finger pad center or the earlobe.

Blood cultures are drawn before antimicrobial therapy when possible, with at least two sets from separate sites; each set includes an aerobic and an anaerobic bottle.

Arterial blood gas specimens are collected anaerobically, expel air bubbles, cap the needle, mix by rolling, and transport on ice if a delay is expected.

Serum and plasma should be separated from cells within 2 hours of collection; delayed separation raises potassium, LDH, and glucose artifacts.

Specimens requiring cold transport include arterial blood gases, ammonia, and most coagulation studies; never freeze whole blood for routine chemistry.

Light-sensitive analytes such as bilirubin and vitamin B12 require amber or foil-wrapped tubes.

Specimens for cryoglobulins and cold agglutinins are collected and transported at 37 degrees Celsius.

Centrifugation for routine serum or plasma is typically 10 minutes at approximately 1,000 to 1,200 relative centrifugal force; the brake should be off for gel tubes.

Rejection criteria include unlabeled specimens, mislabeled specimens, hemolysis, insufficient volume, and expired collection devices; rejection must be documented and the result not reported.

Additive tubes should be transported upright and at the temperature specified by the laboratory; EDTA tubes for hematology are kept at room temperature and not refrigerated.

Stat specimens are processed immediately and results are reported within a defined turnaround time; the time of collection, receipt, and result are documented.