Module 1 Introduction to Phlebotomy

• 17th and 18th Century


  this was when phlebotomy was treated as a major therapy
• Two Main Methods of Phlebotomy

  - venipuncture

  - capillary puncture
• Venipucture


  method of blood collection using a needle inserted in a vein
• Capillary puncture


  done by puncturing the skin
• Main role of the Phlebotomist

  to collect blood samples for laboratory testing or for transfusion
• Characteristics of a Good Phlebotomist

  - skills and knowledge

  - good manual dexterity (flexible)

  - special communication skills

  - good organizational skills

  - thorough knowledge of lab specimen reqs

  - training in phleb skills coupled with standard practice
• Traits that form the professional image of phlebotomist

  - credentials

  - patient client interaction

  - qualities of professionalism
• Credentials

  A phlebotomist needs to maintain certain credentials in the continunous practice of the profession
• Patient Client interaction

  the phlebotomist should be pleasant and reassuring when dealing with patients
• Qualities of Professionalism

  phlebotomist is expected to practice professionalism at all times by exhibiting the following qualities

  
  

  1. professional appearance

  2. self confidence

  3. integrity

  4. compassion

  5. self motivation

  6. dependability

  7. ethical behavior
• Components of good communication

  - verbal

  - non verbal

  - active listening
• Inpatient


  - non ambulatory

  - requires patients to stay in the hospital for at least one night to be serviced by tertiary care. practitioners
• Outpatient


  patients are served by secondary care specialists on the same day
• Primary level hospital


  health units in rural areas including sub units
• Secondary level hospitals


  non departmentalized hospitals that attends the patients during the symptomatic stages of ailment
• Tertiary level hospitals

  - big hospitals

  - medical centers

  - services are sophisticated
• Ambulatory Care


  patients requiring care or follow up check ups after their discharge from the hospital
• Homebound Services


  refers to procedures, tests, and services provided to a patient which are done at patient's home or at a long-term facility.
• Public Health Services


  - belong to the unit at the local level but are still under the jurisdiction of the health department of the government

  
  

  - Services are offered with little or no charge at all
• Two major divisions of clinical laboratory

  - clinical analysis area

  - anatomical and surgical pathology area
• Anatomical and Surgical Pathology Area


  division of clinical lab that handles tests related to histology (microscopic structure of tissues), cytology (structure of cells), and cytogenetics (chromosomal deficiencies & genetic disease)
• Clinical Analysis Areas


  division of clinical lab that is divided into seven areas
• Stat Labs


  This laboratory facility is established in the emergency room of some tertiary care facilities so procedures and test can be done immediately when needed
• Reference Laboratory


  a laboratory that is large and independent that provides routine and specialized analysis of blood, urine and tissue and offer fast turnaround or processing time
• Cupping


  Alternative medicine that helps ease pain, inflammation, or other health related concerns.
• Leeching


  - hirudotheraphy

  - uses leeches for bloodletting and is currently used for microsurgical replantation
• Medicinal Leech

  - Hirudo medicinalis

  - injects vasodilator, anesthetic, hirudin
• Verbal Communication


  communication that uses written or spoken words
• Non-verbal communication


  phlebotomist should be keen in observing the patient's facial expressions and other non verbal cues
• Kinesics


  body motion and language
• Proxemics


  use of space
• Appearance


  attire
• Touch


  thoughtful expression
• Active Listening


  - paying close attention to what someone is saying and communicating

  - ensure that the phlebotomist interpreted the message correctly by giving feedback
• 7 Clinical Analysis Areas

  - hematology

  - chemistry

  - coagulation

  - urinalysis

  - microbiology

  - serology/immunology

  - bloodbank/ immunohematology
• Hematology Tests

  Lavender-top tubes are most commonly used to collect

  
  

  - Hematocrit

  - Hemoglobin

  - RBC count

  - WBC Count

  - Platelet Count

  - Complete Blood Count

  - Differential White Blood Cell Count

  - Indices

  - Mean Corpuscular Hemoglobin

  - Mean Corpuscular Volume

  - Mean Corpuscular Hemoglobin Concentration

  - RBC Distribution Width
• Coagulation Test

  - Activated Partial Thromboplastin Time

  - D-dimer

  - Fibrin Split Products

  - Fibrinogen Test

  - Prothrombin Time
• Chemistry Tests

  - Alanine Aminotransferase Test

  - Alpha feto protein

  - Alkaline Phosphatase Test

  - Ammonia

  - Amylase

  - Aspartate aminotransferase test

  - Bilirubin Test

  - Arterial Blood Gases

  - Blood Urea Nitrogen

  - B-type Natriuretic Peptide

  - C-reactive protein high sensitivity

  - Carcinoembryonic Antigen Test

  - Blood Calcium

  - Total Cholesterol

  - Cortisol

  - Creatine kinase

  - Creatinine

  - Drug analysis

  - Electrolytes

  - Glucose

  - Gamma Glutamyl Transferase

  - Hemoglobin A1C

  - Lactate dehydrogenase

  - Lipase

  - Prostate Specific Antigen

  - Total Protein

  - Triglycerides

  - Troponin I

  - Uric Acid Test

  - Vitamin B12 and Folate Test
• Serology/Immunology

  1. Bacterial Studies

  - Antinuclear Antibody

  - Antistreptolysin O

  - Cold Agglutinins

  - Febrile Agglutination Test

  - FTA ABS

  - Rapid Plasma Reagin

  - Rheumatoid Factor

  2. Viral Studies

  - Anti HIV

  - Cytomegalovirus Antibody

  - Epstein Barr Virus

  - Hepatitis B Surface Antigen

  3. General Studies

  - C reactive Protein

  - Human Chorionic Gonadotropin Test

  ​
• Urinalysis Test

  1. Physical Evaluation

  - color indicates presence of blood melanin bilirubin or urobilin in specimen

  - clarity shows presence of fat, chyle, or bacteria which affect turbidity

  - specific gravity suggests renal tubular involvement or ADH deficiency

  2. Chemical Evaluation

  - Blood

  - Bilirubin

  - Glucose

  - Ketones

  - Leukocyte

  - pH

  - Protein

  - Nitrite

  - Urobilinogen

  3. Microscope Evaluation

  - shows status of urinary tract, hematuria etc