L1: Understanding Phlebotomy

• Phlebotomy is the process of collecting blood through the vein by using incision or puncture methods to draw blood for analysis or as part of therapeutic or diagnostic measures under the physician's request
• Phlebotomy is derived from 2 Greek words: phlebos which means vein, and temnein which means to cut
• Phlebotomy is also called venesection
• The practice of phlebotomy can be traced back to the Stone Age
• During Stone Age, humans used crude tools to cut vessels and drain blood from the body
• The ancient Egyptians also practiced phlebotomy as a form of "bloodletting" as early as 1400 BC
• Hippocrates, a Greek physician, believed that a person's health was dependent on the balance of the 4 humors
• 4 Humors:

  • Earth - blood and brain
  • Air - phlegm and lungs
  • Fire - black bile and spleen
  • Water - yellow bile and gall bladder
• During the Middle Ages, barber-surgeons performed bloodletting as part of the treatment for some illnesses
• It was only during the 17th and 18th centuries when phlebotomy was treated as a major therapy
• Cupping and leeching were performed by phlebotomists using lancets and fleams
• Cupping is an alternative medicine that halps ease pain, inflammation, or other health-related concerns
• Cupping involves the application of special heated suction cups on the patient's skin and the incision that is made using a fleam (lancet) which is previously wiped with a rag
• Leeching is also known as hirudotherapy
• Leeching is a method that uses leeches for bloodlettiing nd is currently used for microsurgical replantation
• Leeching involves placing a drop of milk or blood on the patien't skin and introducing Hirudo medicinalis (medicinal leech) to the site, allowing it to engorge and fall off
• It is believed that the leeches inject local vasodilator, anesthetic, and hirudin, which is an anticoagulant
• The main goals of the 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
• 2 main methods used in phlebotomy:

  1. venipuncture
  2. capillary puncture
• Venipuncture is a method of blood collection using a needle inserted in a vein
• Capillary puncture is done by puncturing the skin
• Good phlebotomits possess the following skills and knowledge

  1. good manual dexterity
  2. special communication skills
  3. good organizational skills
  4. thorough knowledge of laboratory specimen requirements
  5. training in phlebotomy skills coupled with standard practice
• Phlebotoists should have the ff. in credentials:

  • certification or license
  • continuing education
• Qualities of Professionalism of Phlebotomists:

  • professional aperance
  • self-confidence
  • integrity, honesty, and consistency
  • compassion, sensitivity, stay calm, helpful demeanor
  • self-motivated, positive attitude, initiative
  • dependable, proper work ethic, personal responsibility
  • good ethical behavior
• 3 Components of good communication

  1. verbal communication
  2. non-verbal communication
  3. active listening
• verbal communication involves expressing ideas through words
• non-verbal communication has many dimensions and elements:

  • kinesics
  • proxemics
  • appearance
  • touch
• kinesics - body motion and langauage
• proxemics - individual's concept and use of space
• appearance - attire
• touch - thoughtful expression
• Categories of healthcare facilities:

  1. inpatient
  2. outpatient
• Inpatient requires patients to stay in the hospital for at least on night to be serviced by tertiary care practitioners
• outpatient in which patients are served by secondary care specialists on the same day
• 6 Healthcare setting services:

  1. Primary level
  2. Secondary level
  3. Tertiary level
  4. Ambulatory care
  5. Homebound services
  6. Public health services
• Primary level refers to health units in the rural areas and sub-units which are operated by the DOH
• Secondary level refers to non-departmentalized hospitals that attend to patients during the symptomatic stages of an ailment
• Tertiary level refers to medical centers and large hospitals where services are sophisticated coupled with highly technical facilities that can address serious diseases
• Ambulatory care is medical care given to outpatients or patients requiring care or follow-up check-ups after their discharge from the hospital
• Homebound services refer to procedures, tests, and services, provided to a patient which are done in a patient's home or in a long-term facility