phlebotomy module 1

• Health care system

  Made up of several health care professionals, each performing their roles with the aim of providing the patient with quality care
• Laboratory

  Serves a vital role in the healthcare system, where several different types of tests are done on tissues of the body to provide doctors with a diagnosis
• Laboratory medicine

  1. Pre-analytical

  2. Analytical

  3. Post-analytical
• Pre-analytical skills

  Fall under the responsibility of the phlebotomist, and error in this phase can affect the quality of the specimen and in turn affect the validity of the test results
• Phlebotomist

  Key player in the pre-analysis phase
• Phlebotomy is not a modern-day concept, but the purpose of the skill has changed over the years
• The term 'phlebotomy' was not used in the past
• Phlebotomy

  The act of drawing or removing blood from the circulatory system through a cut (incision) or puncture in order to obtain a sample for analysis and diagnosis
• Phlebotomy

  Also done as part of the patient's treatment for certain blood disorders
• Bloodletting

  The process of releasing blood from the body to cure various diseases, such as the plague and acne, or to cast out evil spirits
• Bloodletting was used by the ancient Egyptians

  Around 1000 BC
• Some authorities believe phlebotomy dates back to the last period of the Stone Age, when crude tools were used to puncture vessels and allow excess blood to drain out of the body
• A painting in a tomb showing the application of a leech to a patient evidences bloodletting in Egypt in about 1400 B
• Hippocrates

  A Greek physician who believed that disease was the result of excess substances in the body
• Galen

  A Greek physician, surgeon and philosopher who added to Hippocrates' work by connecting a person's temperament and personality to imbalances in their humors
• Humorism

  The belief that the body is influenced by four fluids produced by organs in the body: blood, phlegm, black bile, and yellow bile
• Venesection

  Cutting a vein to release evil spirits, cleanse the body of impurities, or bring the body into balance
• Bloodletting became a trade, and barbers were the ones who took up the trade in addition to the physicians
• By 1210, the Guild of Barber–Surgeons had been formed, dividing the surgeons into Surgeons of the Long Robe and Surgeons of the Short Robe
• The Short Robe surgeons were forbidden by law to do any surgery except bloodletting, wound surgery, cupping, leeching, shaving, tooth extraction, and enema administration
• Barber pole

  Represented the rod squeezed by the patient to promote bleeding, and the white stripe on the pole corresponded to the bandages, which were also used as tourniquets
• The red stripe associated with a barber pole originated from the time when barbers performed bloodletting
• By the 1800s, bloodletting became more sophisticated, with physicians performing the procedure by making an incision into the arteries or veins
• Lancet

  A tool used for cutting the vein during venesection, perhaps the most prevalent medical instrument of the times
• Excessive phlebotomy was common, with the usual amount of blood withdrawn being approximately 10 mL
• Fleam

  A wooden stick that drove a blade into the vein
• Scarificator

  A more humane way of bloodletting, using a 12 spring-driven blade that could make shallow cuts all at once
• Cupping

  A method involving the application of a heated suction apparatus to the skin to draw the blood to the surface, blistering the skin so that the blood could then be released via the blisters
• Leeches

  Used for more localized bloodletting, by enticing the leech called Hirudo medicinalis to the area needing bloodletting with a drop of milk or blood on the patient's skin
• Bloodletting provided relief for those who suffered with high blood pressure, and for people with high iron levels
• The death of President George Washington was thought to be a result of too much bloodletting, as the physician drained over eight pints of blood to treat a throat infection
• The role of a Phlebotomist includes

  • Collect blood samples from patients by venepuncture or micro-techniques, for diagnostic purposes and to monitor prescribed treatment
  • Prepare patients for collection procedures
  • Prepare specimens for transport to ensure stability
  • Maintain patient confidentiality
  • Perform quality-control checks
  • Comply with procedures
  • Promote good relations with patients and hospital personnel
  • Assist in collecting and documenting monthly workload and recording data
  • Maintain safe working conditions
  • Perform appropriate laboratory computer operation
  • Participate in continuing education programs
  • Collect and perform point-of-care testing
  • Perform electrocardiography
  • Interpret the best method for drawing blood depending on the specific patient
  • Evaluate a patient's ability to withstand procedures
  • Explain various blood-drawing procedures to patients and answer any questions
  • Perform basic care testing, such as blood glucose levels
  • Prepare urine, blood, and other specimens for testing
  • Maintain medical equipment such as test tubes, needles, and blood vials
  • Label and store blood containers for processing
• Certification

  The process of publicly attesting that a specified quality or standard has been achieved or exceeded
• Professional certification

  A voluntary process that uses a formal process to identify and acknowledge individuals who have met a recognized standard, including education, experience, and an exam of knowledge, skills, and abilities needed to perform the job
• Licensing

  A non-voluntary process by which an agency of government regulates a profession, granting permission to an individual to engage in an occupation if it finds that the applicant has attained the degree of competency required to ensure the public health, safety, and welfare will be reasonably protected
• Certification and/or Licensing Agencies

  • American Society for Clinical Pathology (ASCP)
  • National Phlebotomy Association (NPA)
  • Association of Phlebotomy Technicians (ASPT)
  • American Association of Bioanalysts (ABOR)
  • American Certification Agency for Healthcare Professionals (ACA)
  • American Medical Technologists (AMT)
  • American Medical Certification Association (AMCA)
  • American Allied Health (AAH)
• Phlebotomist

  Responsible, patient and gentle with patients, accurate with attention to details, able to follow procedures and instructions accurately, good communication and people skills, good hygiene, organizational skills
• Blood Banking Phlebotomist

  A more specialized practice connected to the area of Transfusion Medicine and certified by a Blood Banking Hematologist. Qualifications include a university degree in a health-related discipline/diploma or Certification in Medical Laboratory Technology, and at least three (3) years post graduate training/ Phlebotomy Certification