Which of the following pairs of blood tests is appropriate for a fasting specimen?

Choice A Reason:
Inverting the tube 5 to 7 times may not be sufficient to mix the blood thoroughly with the EDTA. This could lead to partial clotting and potentially inaccurate test results. The EDTA anticoagulant works by binding calcium ions, which are necessary for blood clotting. Without adequate mixing, the EDTA may not be evenly distributed, leaving some areas of the blood sample able to clot.

Choice B Reason:
Inverting the tube only 2 to 4 times is inadequate for proper mixing. This minimal agitation would likely result in clot formation because the anticoagulant would not be sufficiently mixed with the blood. Clots can interfere with the accuracy of hematological tests by trapping cells and altering the specimen's composition.

Choice C Reason:
Inverting the tube 1 to 3 times is clearly insufficient and would almost certainly lead to clotting. The purpose of inverting the tube is to ensure that the EDTA coats all the blood cells, preventing coagulation. Such a low number of inversions would not allow for the anticoagulant to perform its function effectively.

Choice D Reason:
Inverting the tube 8 to 10 times is the recommended practice. This number of inversions ensures that the blood is fully mixed with the EDTA, preventing clot formation and preserving the integrity of the sample for accurate laboratory analysis. It is important to perform these inversions gently to avoid hemolysis, which can also affect test results. Hemolysis occurs when red blood cells are damaged and their contents leak out, which can happen if the blood is shaken too vigorously.

Choice A Reason:
CLIA, or the Clinical Laboratory Improvement Amendments, sets standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results. While CLIA provides a framework for laboratory operation, it does not offer specific guidelines for chemical spill cleanup.

Choice B Reason:
OSHA, or the Occupational Safety and Health Administration, provides regulations to ensure worker safety, including protocols for handling hazardous materials. However, OSHA itself does not provide the specific cleanup procedures; instead, it requires workplaces to follow certain safety practices.

Choice C Reason:
SDS, or Safety Data Sheets, provide detailed information on chemicals, including their properties, health hazards, protective measures, and safety precautions, including spill response and cleanup procedures. In the event of a chemical spill, the SDS contains the most direct instructions for safe and effective cleanup, making it the primary reference for a phlebotomist in this situation.

Choice D Reason:
The CDC, or Centers for Disease Control and Prevention, focuses on public health and disease prevention. While the CDC provides guidelines for infection control and laboratory safety, it is not the primary resource for chemical spill cleanup procedures.