Introduction to Phlebotomy

REGINA COELI I. NALDO, RMT

WHAT IS PHLEBOTOMY?

Defined: “an incision into a vein”

One of the oldest medical procedures

Bloodletting

• Suction cups

• Leeches

• Barber’s Razor: bleeding bowls

The procedure is known as a venipuncture

A person who performs phlebotomy is called a

phlebotomist, doctors, nurses and medical laboratory
scientist can collect blood.
3 PURPOSES FOR COLLECTION AND ANALYSIS OF LABORATORY SAMPLES

1 Diagnostic testing

2 Therapeutic assessment

3 Monitoring patient’s condition

OVERVIEW
• Good phlebotomy begins with
finding an appropriate draw site.
• Knowledge of the anatomy of the
draw site is vital.
• A good phlebotomist is familiar
with many different potential sites
on the arm and hand.
• Veins grown in response to
pressure and follow NO exact
pattern.
• The basic idea is to look for a draw
site TWICE as long as you actually
perform the venipuncture.
Blood specimen collection and processing
The first step in acquiring a quality lab test result for any patient is the specimen collection procedure.

Blood specimen are obtained through capillary skin puncture (finger, toe, heel), arterial or venous
sampling

1 Capillary/ dermal/ skin puncture, earlobe

stick, finger stick heel stick (infants)

2 Venous puncture (direct puncture of vein by

venipuncture)

3 Artillary puncture (direct

puncture of arteries)
VENIPUNCTURE
Venipuncture is
the process of To obtain blood samples in order to
obtaining blood
samples from perform dagnostics.
veins for
laboratory testing.
It is probably the
most common To collect blood for later use of the patients
procedure in the
medical field
conditions that requires blood transfusion.
usually performed
for the following
reasons: To remove blood that was found with
excessive levels of erythrocytes or iron.
Venipuncture procedure

1. Explain the procedure and purpose to the patient.

2. Assess the patient’s physical disposition.

3. Position the patient- sitting or lying (NEVER allow the patient to sit upright on a high stool or standing due to the possibility of fainting.

4. Check the requisition form for requested tests, patient information, and any special requirements.

5. Select the suitable site for venipuncture.

6. Prepare the equipment, the patient and the puncture site and perform the venipuncture.

7. Collect the sample in the appropriate container.

8. While the tube fills, remove the tourniquet.

9. Label the collection tubes at the drawing area.

10.Immediately send the specimens with requisition form to the laboratory.

 ORDER OF DRAW
Blood collection tubes must be drawn in a
specific order to avoid cross contamination of
additives between tubes.

A vacutainer blood collection tube is a sterile

glass or plastic tube with a closure that
evacuated to create a vacuum inside the tube
facilitating the draw of a predetermined
volume of liquid.

The recommended order of draw is:

 SPECIMENS MAY BE REJECTED FOR THE
NOTES:
FOLLOWING REASONS: UNACCEPTABLE
SPECIMENS
Additives preserve the specimen, prevent
deterioration and coagulation or block action of
1. There is a patient name or ID number discrepancy
certain enzymes in blood cells.
between specimen label and request form.
After the tube has been filled with blood,
immediately invert the tube several times to prevent 2. There is no patient name or other unique
coagulation.
identifier on specimen.

Tubes with anticoagulants should be gently and

completely inverted after collection. This process 3. Specimen is too old when received.
ensure complete mixing of anticoagulants with the
blood sample and prevents clot formation. 4. There is apparently no specimen in container.

Complete filling the tubes to obtain accurate results. 5. The expiration date of the transport medium has
Some evacuate tubes contains mark line, you must fill
been exceeded.
the tube into this mark line.
Avoid performing a venipuncture on

1 Arm on site of mastectomy. 2 Scarred or burned areas. 3 Arm in which blood is being
If drawn here, the test results Performing a venipuncture at transfused / IV cannula. The
could be inaccurate because these sites is more difficult due fluid in the IV could dilute the
of the lymph edema. to the scar tissue. specimen.
4 A hematoma. ( a 5 Edematous. (edema is
hematoma is an abnormal swelling caused by fluid
collection of blood outside retention. It should be avoided
of a blood vessel. It occurs because the accumulated fluid
because the wall of a blood could alter test results.
vessel wall, artery, vein, or
capillary, has been
damaged and blood has
leaked into tissues.) if
drawn here, could cause