7.5 Special Transport, Delivery & Corrective Action

AMCA PTC Phlebotomy Technician Exam

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1 Chapter 1: Introduction & Exam Overview

1.1 Current Exam Facts & Logistics 1.2 Exam Blueprint & Study Strategy

2 Chapter 2: Professionalism & Regulatory Compliance

2.1 Professional Conduct, Diversity & Communication 2.2 Scope of Practice & AMCA Code of Ethics 2.3 Patient Rights, Consent & Documentation Basics 2.4 Patient Privacy & HIPAA Compliance 2.5 CLIA, OSHA Oversight & Incident Reporting 2.6 Continuing Education & Recertification

3 Chapter 3: Infection Control & Safety

3.1 OSHA Bloodborne Pathogens Standard & Exposure Control 3.2 Hand Hygiene & Respiratory Etiquette 3.3 Personal Protective Equipment & Standard Precautions 3.4 Transmission-Based Isolation Precautions 3.5 Cleaning, Disinfection & Sharps Disposal 3.6 Emergency Care, First Aid & CPR Response 3.7 Workplace Safety: CDC, OSHA & NFPA

4 Chapter 4: Patient Identification, Assessment & Site Preparation

4.1 Requisition Review & Professional Introduction 4.2 Two-Identifier Rule & Misidentification Protocol 4.3 Collection Compliance & Patient History Assessment 4.4 Patient Positioning for Safe Collection 4.5 Venipuncture Site Selection & Anatomy 4.6 Aseptic Site Preparation 4.7 Tourniquet Use & CLSI Guidelines

5 Chapter 5: Equipment Selection & Maintenance

5.1 Tube Additives & Color Selection 5.2 Analytical Interference Factors 5.3 Antiseptic Agent Selection 5.4 Venipuncture Equipment Selection 5.5 Capillary & Non-Blood Collection Equipment 5.6 Equipment Quality Control & Inspection

6 Chapter 6: Collection of Blood & Non-Blood Specimens

6.1 Venipuncture Procedure & Needle Technique 6.2 CLSI Order of Draw 6.3 Prioritizing Timed, STAT & Fasting Specimens 6.4 Chain of Custody Collections 6.5 Capillary Puncture Methods 6.6 Collection Complications & Response 6.7 Special Patient Circumstances 6.8 Blood Culture Collection 6.9 Special Collections: GTT, TDM & Blood Bank 6.10 Point-of-Care Testing 6.11 Blood Volume & Tube Fill Requirements 6.12 Non-Blood Specimen Collection 6.13 Post-Puncture Patient Care 6.14 Recording Collection Details 6.15 Measuring & Recording Vital Signs

7 Chapter 7: Specimen Processing & Transportation

7.1 Specimen Labeling & Inversion 7.2 Specimen Quality Assessment & Rejection 7.3 Centrifugation & Aliquoting 7.4 Preparing Non-Blood Specimens for the Lab 7.5 Special Transport, Delivery & Corrective Action

7.5 Special Transport, Delivery & Corrective Action

Key Takeaways Explain This Topic AI

Protect light-sensitive bilirubin, vitamin B12, and folate with amber tubes or foil; chill ammonia, lactic acid, and delayed ABGs in a wet ice slurry; keep cold agglutinins and cryoglobulin at ~37°C.

Deliver specimens to the correct laboratory unit—chemistry, hematology, coagulation, blood bank, microbiology, or blood gas—according to the test, not convenience.

When transport or processing fails, stop use of the compromised specimen, recollect when criteria are met, notify the ordering provider and lab, and complete an incident report.

Never place chilled tubes directly on solid ice alone; use crushed ice and water to avoid freezing hemolysis.

Misdelivery (e.g., blood bank samples left in chemistry) requires immediate correction plus occurrence documentation.

Last updated: July 2026

7.5 Special Transport, Delivery & Corrective Action

Tasks 6.05–6.07 connect three skills that exam items often weave together: keeping special analytes at the correct temperature or light condition, delivering each specimen to the correct laboratory unit , and taking corrective action when processing or transport fails. A perfectly drawn ammonia tube is still a failure if it warms on a counter, lands in blood bank instead of chemistry, or sits rejected without provider notification.

Special Storage and Transport Conditions (Common Analytes)

Condition How to Maintain High-Yield Analytes

Protect from light Amber tube, aluminum foil wrap, or light-blocking bag Bilirubin , vitamin B12 , folate , vitamin A/B6, beta-carotene, porphyrins

Chill (wet ice slurry ~1°C–5°C) Crushed ice + water; do not place tubes on solid ice only (hemolysis risk) Ammonia , lactic acid/lactate , delayed ABGs , gastrin, PTH, renin

Keep warm (~37°C) Pre-warmed tube + heat block/heel warmer during transport Cold agglutinins , cryoglobulin , cryofibrinogen

Routine timed processing Transport/separate within ~2 hours when required Glucose/potassium stability concerns in unseparated blood

Light-sensitive bilirubin can fall dramatically with unprotected light exposure; B12 and folate are likewise protected in amber/foil workflows in many labs. Chilled ammonia and lactate must move in an ice slurry promptly—room-temperature delays falsely elevate results. Cold agglutinin and cryoglobulin specimens must not cool in a pneumatic tube or on a cold dock; maintain body temperature until separation. +-------------------------------------------------------------------------+

• | LIGHT: foil/amber | COLD: ice SLURRY | WARM: 37°C block/warmer |
• | Bilirubin, B12, | Ammonia, lactate, | Cold agglutinins, |
• | folate (+ others) | ABGs (if delayed) | cryoglobulin |
• +-------------------------------------------------------------------------+
• Deliver to the Correct Laboratory Unit

Special handling is wasted if the specimen is handed to the wrong bench.

Specimen / Test Type Typical Destination Why Misdelivery Matters

Routine chemistry (metabolic panels, bilirubin, ammonia, lactate, B12/folate) Chemistry / core lab receiving Wrong unit may refrigerate a warm cryoglobulin or leave ammonia unchilled

• Hematology (CBC, differential) Hematology Delays affect platelet clumping/EDTA stability narratives
• Coagulation Coag bench Citrate tubes have strict fill and time rules

Blood bank / transfusion Blood bank Special ID banding and type-and-screen protocols; never treat as routine chemistry

Microbiology (cultures, AFB sputum, viral swabs) Microbiology Temperature and media needs differ; AFB may have separate receipt rules

ABGs Blood gas lab / designated analyzer location Time-critical; chilling rules depend on delay and syringe type

Use LIS routing labels, colored bags, or courier manifests exactly as designed. When carrying multiple specimens, physically separate blood-bank tubes from chemistry ice-slurry bags so a busy drop-off cannot mix them. Hand-deliver fragile specials when pneumatic tube policy prohibits them (often cold agglutinins, some large containers, or known hemolysis-risk spins in PTS).

Corrective Action When Processing or Transport Fails

Failures include: broken tubes, thawed ice slurry, foil removed from bilirubin, cryoglobulin cooled, wrong-unit delivery, unlabeled aliquot, QNS after spill, or centrifuge imbalance with leakage.

Stepwise Corrective Pattern

Stop further misuse of the compromised specimen (do not run “anyway” if rejection criteria are met).

Preserve evidence for quality review when safe (photo/log per policy); contain spills with PPE.

Apply recollection criteria : If the analyte is unstable or the specimen is hemolyzed, mislabeled, QNS, clotted inappropriately, or held under wrong temperature/light, recollect when clinically appropriate and safe for the patient.

Notify the ordering provider and the laboratory (or charge nurse/provider pathway) that results will be delayed or cannot be reported from the failed specimen.

Complete an incident / occurrence report per facility policy for transport breaks, misdeliveries, labeling errors, and exposure events.

Document what failed, time discovered, who was notified, and whether recollection occurred.

Failure Example Likely Corrective Action

Bilirubin tube left in bright light unwrapped for an extended period Reject/recollect; notify lab/provider; incident if process breach

• Ammonia not placed on ice slurry Recollect with proper chill; do not report delayed warm ammonia as valid
• Cold agglutinin specimen cooled in PTS Recollect with 37°C maintenance; notify hematology/lab

Type-and-screen dropped at chemistry receiving Immediate retrieval to blood bank; occurrence report; verify ID integrity

• Lactic acid spilled in courier bag Biohazard cleanup; recollect; notify provider of delay
• ABG delayed far beyond analyzer window without proper handling Recollect; do not “guess-correct” gas values
• Recollection Judgment

Recollect when integrity is lost and the test remains clinically needed. Coordinate timing (e.g., peak drug levels, fasting labs) with nursing/provider so the new draw still answers the clinical question. Never silently substitute a different patient’s leftover sample.

Putting It Together: Exam-Style Workflow

Identify special analytes on the requisition ( bilirubin/B12/folate → light protection; ammonia/lactate/ABG → chill; cold agglutinin/cryoglobulin → warm).

Package accordingly and route to the correct unit (micro vs chemistry vs blood bank, etc.).

If anything breaks down in transit or processing, contain, report, recollect when indicated, and notify ordering provider/lab with an incident report as required.

Special transport, correct delivery, and honest corrective action are one continuous chain—Task 6.05 through 6.07 test whether you can keep that chain intact under time pressure.