Which of the following tests is performed to identify bacteremia?

Choice A Reason:
Hemostasis is the process of blood clotting and the cessation of bleeding. While it is a desired outcome following any puncture, squeezing the puncture site would not typically cause hemostasis as a complication. It is the body's natural response to injury to prevent excessive blood loss.

Choice B Reason:
Hemolysis refers to the rupture of red blood cells, which can occur when excessive pressure is applied to a puncture site during a capillary blood collection. This pressure can cause the cells to burst, releasing their contents into the plasma, which can interfere with various laboratory tests and lead to inaccurate results.

Choice C Reason:
Homeostasis is the body's ability to maintain a stable internal environment despite changes in external conditions. It is not a complication but rather a regulatory process. Squeezing a puncture site does not directly relate to homeostasis as a complication.

Choice D Reason:
Hypobilirubinemia is a condition where there is less than the normal amount of bilirubin in the blood. It is not a complication associated with squeezing a puncture site. Bilirubin levels are typically affected by liver function and red blood cell breakdown, not by the mechanical action of squeezing a site.

Choice A Reason:
The red top tube is typically used for serum determinations in chemistry, serology, and blood bank. It contains no additive or may contain a clot activator. The red top tube is not the first choice for capillary puncture order of draw because it is designed for tests that require serum and not whole blood.

Choice B Reason:
The lavender top tube is used for whole blood hematology determinations, as it contains EDTA as an anticoagulant. According to the order of draw for capillary punctures, the EDTA tube should be collected first to ensure adequate volume and accurate hematology test results. This makes the lavender top tube the correct choice for the first collection in this scenario.

Choice C Reason:
The light blue top tube contains sodium citrate and is used for coagulation tests. In venipuncture, it is drawn after the blood culture bottle and before other tubes to prevent contamination with additives from other tubes. However, for capillary punctures, it is not the first choice as hematology tests take precedence.

Choice D Reason:
The royal blue top tube is used for trace element, toxicology, and nutrient determinations². While it may be used for lead and toxicology screens mentioned in the question, it is not the first tube to be drawn in a capillary puncture sequence. The EDTA tube (lavender top) is drawn first to prevent clotting and ensure accurate CBC results.