PMLS L1

• greek word: phleb - vein ; tomia - to cut/cutting
• phlebotomy - to cut into a vein
• phlebotomy - involves invasive procedures usually by cutting or puncture
• invasive - introducing a foreign material into a pre-existing normal environment
• phlebotomy is performed to obtain blood specimen for diagnostic testing either by:

  • venipuncture, arterial puncture, and capillary/dermal puncture
• venipuncture - venous blood collection
• arterial puncture - artery blood collection
• dermal/capillary puncture - capillary blood collection
• phlebotomy - blood collection for blood transfusion (blood banking)
• late stone age - crude tools are used to cut blood vessels and drain blood from the body
• 3500 bc - mesoamerican practice bloodletting for ritual and religious purposes rather than medicinal
• 1400 bc - egypt; papyrus record and tomb paintings depicts bloodletting procedures using leeches.
• 1400 bc - egypt; first to use bloodletting for medical purposes
• Hippocrates of COS (460-377) and his contemporaries: greece
• hippocrates - balanced the four humors
• hippocrates - believed that an imbalance of blood, phlegm, yellow bile and black bile would cause disease.
• hippocrates believed that the imbalance of blood, phlegm, yellow bile and black bile would cause a disease. treatment includes bloodletting, purging, diuresis, and catharsis
• Aelius galenus / galen of pergamum (129-200) A.D.I rome
• aelius galenus/galen of pergamum - believed that blood was the dominant humor and the one in most need of control
• aelius galenius/galen of pergamum - advocated the bleeding of patients with leeches
• leeching persisted in standard treatment
• medieval europe - bloodletting was the best possible treatment for this time
• medieval europe - monks and clergymen performed bloodletting to treat various conditions form plague to smallpox and epilepsy to gout until it was banned in 1163
• medieval europe - barbers began offering wide range of services that included: bloodletting, tooth extrations, cupping, lancing, amputations, and of course trims and shaves - thus calling them barber-surgeons
• 1800's : phlebotomy procedures were performed at its peak. a loss of approximately 10ml (2 teaspoon) was the standard
• 2 methods of bloodletting: generalized method and localized method
• generalized method - done with venesection and arteriotomy
• localized method - done by scarification with cupping and leeches
• venesection - a process by which the median cubital vein is pierced with a sharp object (fleams/lancets) to drain blood
• fleams - a device with multiple, variably sized veins that folded into a case like a pocket knife
• thumb lancet/lancet - small, sharp-pointed, two-edged instrument often with an ivory or tortoise shell case
• leeching/hirudo therapy - use of medicinal leech (hirudo medicinalis) which can injest about 5-10 ml of blood
• scarification - scrapping the skin with a cube shape brass box containing multiple small knives that delivers a uniform set of parellel cuts
• cupping - heated air inside the cup created a vacuum causing blood to flow into the cup
• leech injects local vasodilator, local anesthetic, and hirudin ( an anticoagulant)
• 19th century to present - leech therapy resurfaced and is used in microsurgery
• 19th century to present:

  ➢Phlebotomy profession emerged as an expansion to Medical Technology

  Obtaining blood for diagnostic purposes

  Remove blood for transfusion at donation centers

  Remove blood for therapeutic purposes
• Phlebotomist is applied to any individual who has been trained in various techniques used to obtain blood for laboratory testing and blood donations.
• In the Philippines a phlebotomist must met the following recognition

  to practice phlebotomy:

  Registered Medical Technologist

  Registered Medical Laboratory Technician

  Graduate of Medical Technology or Medical Laboratory Science

  Graduate of other health profession and has undergone intensive

  training for phlebotomy (including blood bank phlebotomy)
• certification - voluntary process by which the agency grants recognition to an individual who has met certain prerequisites in a particular technical area