PMLS2 Lec lesson 2

• • PHLEBOTOMY or venesection is an 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.
• phlebos which means vein
• temnein which means to cut.
• Evolution of Phlebotomy ▪Stone Age ▪Ancient Egyptians ▪Hippocrates ▪Middle Ages ▪17th and 18th century
• ▪Stone Age - used crude tools to cut vessels and drain blood from the body. ▪Ancient Egyptians - a form of "Bloodletting" (1400 B.C.) ▪Hippocrates (460 - 377 BC) - balance of the four humors, removing the excess by bloodletting. ▪Middle Ages – used to treat illness and performed by barbersurgeons ▪17th and 18th century – treated as major therapy
• Cupping ▪alternative medicine ▪application of special heated suction cups on the patient's skin ▪ incision using a fleam or lancet
• Leeching ▪ known as Hirudotherapy ▪ uses leeches for bloodletting ▪ used for microsurgical replantation
• Methods Used in Phlebotomy: •Venipuncture – method of blood collection using a needle inserted in a vein • Capillary puncture – done by skin puncture
• Phlebotomists • Credentials ✓ Certification ✓ Licensure ✓ Continuing education
• •Communication in the healthcare setting o Verbal Communication o Nonverbal Communication o Active listening
• •Elements in healthcare communication ✓ Empathy ✓ Confirmation ✓ Control ✓ Trust ✓ Respect
• Healthcare Setting • Inpatient (non-ambulatory) – patients are required 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
• Healthcare Services: • Primary level • Secondary level • Tertiary level
• • Primary level – refers to the 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
• Other Health Services: • Ambulatory care • Homebound services • Public health services
• • 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 – refers to procedures, tests, and services provided to a patient which are done in a patient’s home or in 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
• Hospital • Is an institution that has permanent inpatient beds • 24-hour nursing service along with therapeutic and diagnostic services • Managed by organized medical team • It houses the clinical laboratory services (clinical lab) where tests requested by physicians are performed.
• • The laboratory has 2 major divisions: 1) Anatomical and Surgical Pathology Area 2) Clinical Analysis Area
• Clinical Analysis Areas 1. Hematology 2. Coagulation 3. Chemistry 4. Serology/Immunology 5. Urinalysis 6. Microbiology 7. Blood bank/Immunohematology
• 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
• Urinalysis – tests urine specimen
• Microbiology – microorganisms in body fluids or tissues
• Blood bank/Immunohematology – blood for transfusion
• Hematocrit (Hct) – checks the hemoglobin level and the red cell count.
• Hemoglobin (Hgb) – tests the value to rule out anemia.
• Red Blood Cell (RBC) Count – is used to measure the erythropoietic activity
• White Blood Cell (WBC) Count – checks the leukocyte response
• Platelet Count (Plt. Ct.) – usually used to monitor chemotherapy and radiation conditions.
• Differential White Blood Cell Count (Diff ct.) – monitors changes in the appearance or quantity of specific cell types
• RBC Indices – shows the changes in RBC size, weight and Hgb content
• Mean Corpuscular Hemoglobin (MCH) – gives the weight of the hemoglobin in the cell
• Mean Corpuscular Volume (MCV) – shows the size of the cell
• Mean Corpuscular Hemoglobin Concentration (MCHC) – gives information on the concentration of the hemoglobin per unit volume of RBCs.