Phlebotomy

• Phlebos means veins and Temnein means to cut or venesection
• The ancient Egyptians practiced phlebotomy as form of bloodletting as early as 1400 BC
• Hippocrates believes person has four humors; Earth - blood and brain, Air - phlegm and lungs, Fire- black bile and spleen, Water - yellow bile and gall bladder.
• Cupping is an alternative medicine that helps ease pain, inflammation, or other health related concerns. Involves the application of special heated cups on patient's skin and incision that is made using fleam (lancet) which is wiped with a rag.
• Leeching (hirudotherapy) - the use of leeches for bloodletting and used for microsurgical replantation. It involves placing a drop of milk or blood on patient's skin and introducing Hirudo medicinalis (medicinal leech)
• Main goals for phlebotomy practice:

  1. for diagnosis and treatment using blood samples
  2. for transfusion, to remove blood from the donor
  3. for removal of blood for polycythemia or therapeutic purposes
• Two main methods of phlebotomy which are venipuncture and capillary puncture.
• Traits of Professional image of Phlebotomist are good manual dexterity, special communication skills, good organizational skills, thorough knowledge of laboratory specimen requirement, and training in phlebotomy skills.
• Credential - a phlebotomist should have certification or license and continuing education.
• Patient-client interaction - reassuring and pleasant when dealing with patients. Also should maintain positive customer relations.
• Qualities of a Phlebotomist

  1. Phlebotomist should wear conservative clothing and observe proper personal hygiene.
  2. Phlebotomist must have self-confidence
  3. Persons of integrity, exhibiting honesty and consistency
  4. Show compassion, sensitivity to the need of others and ability to stay calm
  5. Phlebotomist are self-motivated, having positive attitude and initiative to follow tasks
  6. Dependable, observe proper work ethic, and take personal responsibility for action
  7. Display good ethical behavior
• Basic concepts of communication in Healthcare setting:

  Verbal communication - expressing ideas through words and important to accurately change ideas by using feedback to clarify hampered by vagueness.
• Basic concepts of communication in Healthcare setting:

  Active listening - major part of communication. Phlebotomist build rapport by listening to the patients.
• Healthcare Setting

  Inpatient (non-ambulatory) - requires patient to stay in hospital for at least one night to be serviced by tertiary care practitioners.
• • Primary level - health units in the rural areas and sub-units operated by DOH.
  • Secondary level - non-departmentalized hospital that attend to patients during the symptomatic stages of an ailment.
  • Tertiary level - medical centers and large hospitals where services are sophisticated coupled with highly technical facilities.
• Type of Healthcare services

  • Ambulatory care - medical services given to outpatient or patients requiring follow up check-ups after their discharge from hospital, it can be on free standing medical care setting, hospital owned clinics, and outpatient departments
• Hospital - institution that has permanent inpatient beds with 24-hour nursing service along with therapeutic and diagnostic services managed by organized medical staff or personnel. It houses a clinical laboratory services (clinical laboratory) where test requested by physician.
• Two major division of hospital

  1. The anatomical and surgical pathology is the area that handles tests related to histology (microscopic structure of tissues), cytology (structure of cells), and cytogenetics (chromosomal deficiencies and genetic disease)
  2. Clinical analysis are is divided into 7 areas, which are (1) hematology, (2) coagulation, (3) chemistry, (4) serology/immunology, (5) urinalysis, (6) microbiology,(7) blood bank/immunohematology.
• Non-verbal communication - observing the patient's facial expressions. It has dimensions includes kinesics (body motion & language), proxemics (individual concept and use of space), appearance (attire), and touch (thoughtful expression)
• Type of Healthcare services

  Homebound services - procedures, tests, and services provided to a patient which are done in patient's home or in a long term facility
• Type of Healthcare services

  Public health services - belong to the unit at local level but are still under the jurisdiction of health department of the government. Service are offered with little or no charge at all.
• Outpatient - served by secondary care specialists on the same day.