Understanding Phlebotomy

Phlebotomy, the practice of drawing blood for diagnostic and therapeutic purposes, is an integral part of healthcare. Whether you’re a healthcare professional, training to become a phlebotomist, or are simply preparing for a future blood draw, understanding common phlebotomy terms is essential. Below are some commonly used terms that you may encounter in your next phlebotomy appointment.

Venipuncture

Venipuncture is the primary technique used in phlebotomy, involving the puncture of a vein with a needle to collect blood. The most common venipuncture site is in the antecubital fossa (inner bend of the elbow), where major veins are easily accessible. If the phlebotomist, or person performing the collection, cannot draw the blood from the inner arm, they may opt for a different collection site (i.e., the top of the hand).

Anticoagulant

Anticoagulants are substances or medications that prevent blood from clotting. In phlebotomy, small amounts of anticoagulants are often added to blood collection tubes to maintain the blood’s liquid state and prevent clot formation during laboratory analysis.

Hemolysis

Hemolysis refers to the breakdown of red blood cells, leading to the release of hemoglobin into the surrounding fluid. This can occur if blood samples are mishandled, causing inaccurate test results. Phlebotomists strive to avoid hemolysis by using proper techniques and equipment.

Tourniquet

A tourniquet is a band or strap applied around the arm to temporarily block blood flow, making veins more visible and accessible. Phlebotomists use tourniquets to facilitate the venipuncture process.

Butterfly Needle

Also known as winged infusion set, a butterfly needle is a smaller, more delicate needle connected to a flexible tubing and collection tube. It is often used for difficult draws or when working with fragile veins, such as those in pediatric or elderly patients.

Vacutainer

A vacutainer is a brand of blood collection tube that simplifies the blood drawing process. These tubes come prefilled with a specific amount of anticoagulant or clot activator, allowing for efficient and standardized blood collection.

Hematoma

A hematoma is a localized swelling filled with blood, resulting from a break in a blood vessel. It can occur if there is bleeding under the skin during or after a venipuncture. Proper technique and post-phlebotomy care help minimize the risk of hematoma formation.

Order of Draw

The order of draw is a critical concept in phlebotomy, referring to the sequence in which blood collection tubes are filled during a venipuncture procedure. Following the correct order helps prevent cross-contamination between tubes and ensures accurate test results.

Who Can Perform Phlebotomy?

Phlebotomy is a specialized medical procedure, and individuals who are trained and certified in the practice can perform it. Examples include:

  • Phlebotomists: This term refers to anyone certified in performing phlebotomy. Their primary responsibility is to draw blood from patients for various medical purposes, including diagnostic tests, blood donations, and research. To become certified, one must undergo formal education and training programs, which may include classroom instruction, hands-on practice, and clinical experience. Upon completion of training, a certification from a recognized organization is given.
  • Nurses: Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) often receive training in phlebotomy as part of their nursing education. Nurses may perform phlebotomy as part of their broader scope of practice, particularly in healthcare settings where multitasking and diverse skills are required.
  • Medical Assistants: Some medical assistants (MAs) receive training in phlebotomy as part of their education. Depending on state regulations and the employer’s policies, MAs may be permitted to perform phlebotomy duties.
  • Lab Technicians and Technologists: Laboratory professionals, including medical laboratory technicians and medical laboratory technologists, are trained to handle various aspects of laboratory work, including phlebotomy. In some settings, especially larger laboratories, these professionals may be involved in blood collections as part of their broader responsibilities.

It is important to note that the regulations regarding who can perform phlebotomy can vary. Specific training and certification requirements may be mandated by healthcare facilities or employers. Regardless of the profession, individuals performing phlebotomy should have a strong understanding of infection control, patient safety, and proper blood collection techniques to ensure accurate and reliable results. Ongoing education and adherence to industry standards are crucial for maintaining the quality of phlebotomy services.

All MAPs: Medical Access Points/Providers™ have the skilled labor trained in phlebotomy on hand to perform the required specimen collections. MAPs are required to be insured, licensed and not part of the Office of the Inspector General (OIG) exclusion list in order to be part of the MAP network.

**Medically approved by Dr. Sona Kirpekar, MD

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