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Diagnostic Tests and Clinical Procedures

Since quality of the diagnostic process largely determines quality of care, overcoming deficiencies in standards, methodology, and funding deserves high priority. This category summarises objectives of diagnostic testing and research, methodological challenges, and options for design of studies.

CVC Site Care Procedure

Equipment:
* Mask
* Alcohol or Sani-Cloth™ - to clean work surface
* 1 pair non-sterile gloves
* CVC dressing tray (CHG included)
* 1 pair sterile gloves (included)
* Appropriate size transparent dressing (small included)
* Sterile normal saline or alcohol swab (optional)
* For securing the CVC, use tape, clamp, Coflex™, or X-Span™ dressing, or
appropriate securement device as indicated.

Read more: CVC Site Care Procedure

Capillary Blood Gas Sampling for Neonatal and Pediatric Patients

By Dr. Ramaz Mitaishvili
1. PROCEDURE:
Capillary sampling for blood gas analysis
2. DESCRIPTION:
Capillary blood gas (CBG) samples may be used in place of
samples from arterial punctures or indwelling arterial catheters to estimate
acid-base balance (pH) and adequacy of ventilation (PaCO2). Capillary PO2 measurements are of little value in estimating arterial oxygenation.

Read more: Capillary Blood Gas Sampling for Neonatal and Pediatric Patients

Peripheral Intravenous Access

By Ramaz Mitaishvili
Introduction
The ability to obtain intravenous (IV) access is an essential skill in medicine and is performed in a variety of settings by paramedics, nurses and physicians. Although the procedure can appear deceptively simple when performed by an expert, it is in fact a difficult skill which requires considerable practice to perfect.

Read more: Peripheral Intravenous Access

Intravenous Push Drug Administration

By  Ramaz Mitaishvili
Purpose
To define the professionals authorized to administer medications by direct intravenous push (IVP).
Definition: IVP is defined as the administration of any medication, diagnostic agent or intravenous fluid
infused over less than 5 minutes without the use of an infusion device.

Read more: Intravenous Push Drug Administration

Guidlines for atraumatic skin/vessel punctures

By Dr. Ramaz Mitaishvili
To reduce the pain associated with heel, finger, venous, or arterial punctures: Apply EMLA topically over site if time permits (at least 60 minutes). To remove the Tegaderm dressing atraumatically, grasp opposite sides of the film and pull sides away from each other to stretch and loosen the film.

Read more: Guidlines for atraumatic skin/vessel punctures

Clinical Practice Guidelines/ABG sampling

Alternative names: Arterial Blood Gas Analysis; ABG Sampling; Arterial Blood Gas Test Definition Blood is drawn anaerobically from a peripheral artery (radial, brachial, femoral, or dorsalis pedis) via a single percutaneous needle puncture, or from an indwelling arterial cannula or catheter for multiple samples. Either method provides a blood specimen for direct measurement of partial pressures of carbon dioxide (PaCO2) and oxygen (PaO2), hydrogen ion activity (pH), total hemoglobin (Hbtotal), oxyhemoglobin saturation (HbO2), and the dyshemoglobins carboxyhemoglobin (COHb) and methemoglobin (MetHb).

Read more: Clinical Practice Guidelines/ABG sampling

Pre-analytical source of errors

by Dr. Ramaz Mitaishvili
Pre - analytical - involves all issues from test request to processing sample
Patient Identification and labeling
"zero tolerance" for patient misidentification (positive patient identification is the No. 1 step in the entire phlebotomy practice)
identification bracelet and room number
when the patient is comatose or cannot communicate

Read more: Pre-analytical source of errors

Complications in Blood Collection

by Dr. Ramaz Mitaishvili
Brief Lecture Plan for Medical School Instructor
•    Excessive Bleeding
•    Petechiae
•    Neurological Complications
•    Mastectomy
•    Edema
•    Obesity
•    Intravenous Therapy
•    Damaged, Sclerosed, or Occluded  veins
•    Burned or Scarred Areas
•    Infections

Read more: Complications in Blood Collection

Errors in specimen collection

By Ramaz Mitaishvili, MD

45 to 55 % of all errors that can affect a specimen are made during the collecting, processing, and transportation phase-not during testing. Therefore, most errors are buried in the collector’s technique and the negative outcomes usually leave physicians scratching their heads.

Read more: Errors in specimen collection

Quality Assurance and Proficiency Testing for Newborn Screening

For almost 30 years, CDC's Environmental Health Laboratory has been the only comprehensive source in the world for quality assurance and proficiency testing involving the testing of newborns for preventable diseases. If these diseases are not accurately diagnosed and treated, they cause mental retardation, severe illness, and premature death in newborns.

Read more: Quality Assurance and Proficiency Testing for Newborn Screening

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