Item
B03 Examiner: Does the subject agree to the taking of blood samples?
integer
Code List
B03 Examiner: Does the subject agree to the taking of blood samples?
CL Item
Yes, but without storage of blood for follow-up projects (Do not take tubes 5-9!) (2)
B03 Reason
Item
B03 If not, please specify reason:
text
Item
B04 Do you suffer from haemophilia?
integer
Code List
B04 Do you suffer from haemophilia?
Item
B05 Have you been administered an anticoagulant?
integer
Code List
B05 Have you been administered an anticoagulant?
Item
B06 Have you already eaten today?
integer
Code List
B06 Have you already eaten today?
CL Item
No (Skip question B07) (2)
B07 Time of food intake
Item
B07 When was the last time you ate something today?
time
Item
B08 Are you allergic to latex?
integer
Code List
B08 Are you allergic to latex?
CL Item
Yes (Please use latex-free gloves when taking the blood sample!) (1)
1. Serum-Gel-Monovette (9 ml)
Item
1. Serum-Gel-Monovette (9 ml)
float
2. EDTA-Monovette (2.7 ml)
Item
2. EDTA-Monovette (2.7 ml)
float
3. EDTA-Monovette (9 ml)
Item
3. EDTA-Monovette (9 ml)
float
4. Citrate-Monovette (coagulation tube, 5 ml)
Item
4. Citrate-Monovette (coagulation tube, 5 ml)
float
5. Serum-Gel-Monovette (9 ml)
Item
5. Serum-Gel-Monovette (9 ml)
float
6. EDTA-Monovette (2.7 ml)
Item
6. EDTA-Monovette (2.7 ml)
float
7. Serum-Gel-Monovette (9 ml)
Item
7. Serum-Gel-Monovette (9 ml)
float
8. EDTA-Monovette (9 ml)
Item
8. EDTA-Monovette (9 ml)
float
9. Serum-Gel-Monovette (9 ml)
Item
9. Serum-Gel-Monovette (9 ml)
float
10. Li-Heparin-Monovette (9 ml)
Item
10. Li-Heparin-Monovette (9 ml)
float
11. EDTA-Monovette (4.9 ml)
Item
11. EDTA-Monovette (4.9 ml)
float
12. EDTA-Monovette (9 ml)
Item
12. EDTA-Monovette (9 ml)
float
13. Li-Heparin-Monovette (4.9 ml)
Item
13. Li-Heparin-Monovette (4.9 ml)
float
Item
B10 Examiner: Has the subject stated to suffer from hepatitis?
integer
Code List
B10 Examiner: Has the subject stated to suffer from hepatitis?
Item
B11 Examiner: Has the subject stated to suffer from an HIV-infection?
integer
Code List
B11 Examiner: Has the subject stated to suffer from an HIV-infection?
Item
B12 Could the blood samples be taken?
integer
Code List
B12 Could the blood samples be taken?
B12 Reason
Item
B12 If not, please specify reason:
text
B13 End of blood taking (exact time)
Item
B13 End of blood taking (exact time)
time
B14 Comments
Item
B14 Comments
text
1st data entry: DNo.
Item
1st data entry: DNo.
text
1st data entry: Date
Item
1st data entry: Date
date
2nd data entry: DNo.
Item
2nd data entry: DNo.
text
2nd data entry: Date
Item
2nd data entry: Date
date