PHLEB

• Phlebotomy


  The act of opening a 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
• Temnein


  To cut
• Evolution of Phlebotomy

  1. Stone Age - used crude tools to cut vessels and drain blood from the body

  2. Ancient Egyptians - a form of "Bloodletting" (1400 B.C.)

  3. Hippocrates (460 - 377 BC) - balance of the four humors, removing the excess by bloodletting

  4. Middle Ages – used to treat illness and performed by barber-surgeons

  5. 17th and 18th century – treated as major therapy
• Methods Used for Bloodletting during Ancient Times

  • Cupping
  • Leeching
• Main Goals of Phlebotomy Practice

  • For diagnosis and treatment using blood samples
  • For transfusion, to remove blood from the donor
  • For removal of blood for polycythemia or therapeutic purposes
• Venipuncture


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


  Done by skin puncture
• Credentials of Phlebotomists


  • Certification
  • Licensure
  • Continuing education
• Patient-Client Interaction


  • Reassuring and pleasant
  • Able to communicate well
  • Maintain positive customer relations
  • Understand the diversity of the patients and be able to adjust accordingly
• Qualities of Professionalism


  • Professional appearance
  • Self-confidence
  • Integrity
  • Compassion
  • Self-motivation
  • Dependability
  • Ethical Behavior
• Elements in healthcare communication

  • Empathy
  • Confirmation
  • Control
  • Trust
  • Respect
• Healthcare Setting


  • Inpatient (non-ambulatory)
  • Outpatient
• Hospital


  An institution that has permanent inpatient beds, 24-hour nursing service along with therapeutic and diagnostic services, managed by organized medical team, houses the clinical laboratory services (clinical lab) where tests requested by physicians are performed
• Types of Laboratories


  • Stat Labs
  • Reference Laboratory
• Homebound Service refers to procedures, tests, and services provided to a patient which are done in a patient’s home or in a long-term facility
• Hematology – blood and blood-forming tissues
• Coagulation – ability of blood to form and dissolve clots
• Chemistry – amounts of certain chemicals in a blood sample
• Serology/Immunology – serum and autoimmune reactions in the blood
• Microbiology – microorganisms in body fluids or tissues
• .Urinalysis – tests urine specimen
• Blood bank/Immunohematology – blood for transfusion
• – is used to measure the erythropoietic activity

  Red blood cell (RBC) count
• checks the leukocyte response

  White blood cell (WBC) count
• – usually used to monitor chemotherapy and radiation conditions.

  Platelet Count (Plt. Ct.)
• monitors changes in the appearance or quantity of specific cell type

  Differential White Blood Cell Count (Diff ct.)
• shows the changes in RBC size, weight and Hgb content

  RBC Indices
• shows the size of the cell.

  • Mean Corpuscular Volume
• measures the size differences of the RBC

  Red Blood Cell Distribution Width (RDW)
• gives information on the concentration of the hemoglobin per unit volume of RBCs.

  Mean Corpuscular Hemoglobin Concentration (MCHC)
• reflects the adequacy of heparin therapy

  Activated Partial Thromboplastin Time (APPT)
• measures if the level is high because it results to FDP fragment

  Fibrin Split Products (FSP)
• also called as International Normalized Ratio (INR) evaluates liver diseases or deficiency in Vitamin K

  Prothrombin Time (PT)
• determines level to check obstructions and bone disease.

  Alkaline phosphatase (ALP) –
• enzyme level measured to indicate liver dysfunction

  Aspartate aminotransferase (AST)
• evaluates acid-base balance by measuring the pH, partial pressure of the carbon dioxide and oxygen.

  Arterial Blood Gases (ABG)
• checks elevated levels which leads to impaired renal function.

  Blood Urea Nitrogen (BUN)
• is a cardiac marker for congestive heart failure

  B-type natriuretic peptide (BNP)
• Calcium – is used for monitoring effects of the renal failure. Cholesterol (total) – indicates risk of cardiovascular diseases.

  Cortisol – shows adrenal hypofunction and hyperfunction.

  Creatine Kinase (CK) – used to check muscle damage.

  Creatinine – checks for cases that indicate renal impairment or muscular dystrophy
• Drug Analysis – monitors therapeutic range to avoid toxic levels for drugs. Electrolytes (sodium, potassium, chloride, CO2) – shows the sodium values that determines disorder of the kidney and adrenals. Glucose – is used to check diabetic problems, liver disease, or malnutrition