PMLS LESSON 3

• 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.
• Derived from two Greek words: phlebos which means vein and temnein which means to cut.
• Phlebotomy is also called venesection.
• Evolution of Phlebotomy

  • 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 barber-surgeons.
  • 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
• Venipuncture 


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


  Done by puncturing the skin.
• Role of the Phlebotomists

  They need to:

  1. Properly label the collected blood samples.

  2. Deliver or transport the collected samples within the appropriate prescribed time limits.

  3. In other institutions, they also process by centrifuging and aliquoting samples ready for laboratory testing.

  4. Assist in collecting other specimen such as urine.
• Good phlebotomists possess the following skills and knowledge:

  • Good manual dexterity
  • Special communication skills
  • Good organizational skills
  • Thorough knowledge of laboratory specimen requirement
  • Trained in phlebotomy skills coupled with standard practice.
• Credentials 


  Phlebotomists need to maintain certain credentials in the continuous practice of their profession. They should have:

  • Certification
  • Licence
  • 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
• Communication in the healthcare setting

  • Verbal Communication
  • Nonverbal Communication
  • Active listening
• Elements in healthcare communication

  • Empathy
  • Control
  • Respect
  • Confirmation
  • Trust
• Inpatient (non-ambulatory)


  Patients require to stay in the hospital for at least one night or two to be serviced by health care providers or tertiary care practitioners.
• Outpatient 


  Patients are served by secondary care specialists on the same day.
• 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: 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.
• 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 offered with little or no charge at all.
• STAT laboratory: this is usually located near the emergency room of some tertiary-care facilities so that procedures and tests can be done immediately when needed.
• Reference laboratory: A reference laboratory is a large and independent laboratory that provides specialized and confirmatory laboratory tests for blood, urine and tissues and offer faster turnaround or processing time.
• Clinical Analysis Areas

  • Hematology
  • Coagulation
  • Chemistry
  • Serology
  • Urinalysis
  • Microbiology
  • Blood bank/immunohematology
• Hematology


  Blood and blood forming tissues.
• Coagulation 


  ability of blood to form and dissolve clots.
• Chemistry 


  performs most lab test for plasma, white blood, urine, etc.
• Serology/Immunology 


  serum and autoimmune reactions
• Urinalysis 


  tests urine specimens
• Microbiology 


  microorganisms in body fluids or tissues
• Blood bank/Immunohematology 


  blood 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 (Plt ct) count


  count usually used to monitor chemotherapy and radiation conditions.
• Differential White Count (Diff)


  monitors changes in the appearance or quantity of specific cell types.
• Indices 


  shows the changes in RBC size, weight, and Hgb content.