Which of the following actions is appropriate when transporting a specimen for ABG analysis?

Choice A reason:
The order of citrate, heparin, EDTA, and fluoride is not the correct sequence for blood collection. The correct order is essential to prevent cross-contamination of additives between tubes, which could interfere with test results. Citrate tubes should be drawn first to ensure that the blood does not clot prematurely, but heparin should not follow immediately after citrate.

Choice B reason:
Citrate tubes, which contain sodium citrate, are used for coagulation tests and must be drawn first to ensure the proper blood-to-additive ratio. EDTA tubes are drawn next because EDTA binds calcium and prevents clotting, making it ideal for complete blood counts and other hematology studies. Heparin tubes, which prevent clotting by inhibiting thrombin and thromboplastin, are drawn after EDTA. Lastly, fluoride tubes, which contain a glycolysis inhibitor, are drawn to preserve glucose levels and are typically used for glucose and lactate testing.

Choice C reason:
Starting with fluoride is not recommended as it could lead to contamination of the EDTA and heparin tubes with fluoride, which could affect the results of certain tests, such as calcium determinations in heparin tubes. The order of draw is designed to minimize such risks.

Choice D reason:
This sequence is incorrect because fluoride tubes are not drawn before EDTA and heparin tubes. The presence of fluoride could potentially contaminate the subsequent tubes and alter the results of the tests that require heparin or EDTA as an anticoagulant.

In phlebotomy, following the correct order of draw is crucial. The order is established based on the type of additive in each tube and its potential to interfere with tests conducted in subsequent tubes. The standard order is: blood cultures, citrate tubes, serum tubes with or without clot activator and gel, heparin tubes with or without gel, EDTA tubes, and lastly, fluoride tubes. This sequence helps prevent cross-contamination and ensures the accuracy of laboratory results, which are critical for patient diagnosis and treatment.

Choice A Reason:
Patient's insurance information is not typically included in the follow-up documentation of a stat result. Insurance information is relevant for billing purposes and does not pertain to the immediate clinical care or the communication of test results.

Choice B Reason:
The room number of the patient might be included in the internal documentation for logistical purposes but is not the primary piece of information required following a verbal report of a stat result. The focus should be on the communication details rather than the location.

Choice C Reason:
The name of the provider contacted is essential information in the follow-up documentation after a verbal report. This ensures that there is a record of who received the information, which is crucial for accountability and continuity of care.

Choice D Reason:
The provider's phone number is not necessary in the follow-up documentation if the name of the provider is already included. The phone number would have been used to make the initial contact, and the key information is the confirmation that the provider was reached and informed of the stat result.