Lecture Notes on Phlebotomy Basics

Objectives

• Learn about the history of phlebotomy
• Understand the role of a phlebotomist
• Discuss healthcare settings and the healthcare team
• Organization of the laboratory
• Regulatory agencies in phlebotomy
• Qualities and characteristics of a good phlebotomist

Definition of Phlebotomy

• Phlebotomy: Procedure of making an incision into a vein (venipuncture).
• Dermal puncture: Collecting blood by puncturing the skin (capillary).

Credentialing

• NHA requires 30 successful venipunctures and 10 dermal procedures for phlebotomy students.

Importance of Phlebotomy

• Critical for accurate medical decisions – over 70% based on lab results.

History of Phlebotomy

• Dates back to 1400 BC.
• Bloodletting: Ancient practice to remove impurities or balance bodily fluids.
• Hippocrates: Father of medicine, Hippocratic Oath.
• Barbers: Performed bloodletting in the 1800s.
• Barber Pole: Originated from red/white bandages.

Bloodletting Methods

1. Leeches: Used in bloodletting, still used in modern medicine for specific treatments.
2. Cupping: Vacuum effect to draw blood to skin surface.
3. Venisection: Using a lancet to pierce the skin.

Historical Notes

• George Washington’s death possibly due to excessive bloodletting.

Roles and Responsibilities of Phlebotomists

• Emerged in the 1980s/1990s, regulated by CLSI.
• Collection, processing, and transportation of blood specimens.
• Well-being of patients during procedures.
• May collect other specimens (urine, feces) depending on the setting.
• Involved in quality control and point of care testing.

Healthcare Settings

• Inpatient: Hospitals, nursing homes, rehab centers.
• Outpatient: Doctor’s offices, ambulatory care centers, blood collection centers, home healthcare.

Testing

• Point of Care Testing: Performed at bedside or specific area with portable instruments.
• CLIA Waived Tests: Simple tests with low risk of error.

Healthcare Team

• Includes phlebotomists, doctors, nurses, therapists, etc.
• Importance of understanding various healthcare specialties.

Medical Laboratory Organization

• Clinical Pathology: Analysis of body fluids/tissues.
• Anatomical Pathology: Examination of surgical specimens.

Laboratory Specialties

1. Cytology: Investigates cells for cancer.
2. Histology: Study of body tissues.
3. Clinical Chemistry: Chemical evaluation of body constituents.
4. Hematology: Study of blood and tissues.
5. Immunohematology: Blood bank operations.
6. Immunology/Serology: Body’s disease resistance.
7. Medical Microbiology: Study of microscopic organisms.
8. Molecular Diagnostics: DNA-based disease testing.
9. Toxicology: Study of adverse effects of chemicals.
10. Urinalysis: Examination of urine.

Regulatory Agencies

• CLIA: Ensures laboratory standards.
• The Joint Commission: Accredits healthcare organizations.
• CDC: Categorizes lab tests.
• OSHA: Regulates workplace safety.
• EPA: Sets standards for medical waste.
• FDA: Regulates blood banks and medical products.

Other Agencies

• Department of Health and Human Services: Oversees CMS.
• COLA: Accredits physician office labs.

Medical Laboratory Personnel

• Medical office staff, transcriptionists, lab assistants, technicians, scientists.
• Pathologists (clinical and anatomical).

Qualities of a Good Phlebotomist

• Professionalism and neat appearance.
• Good hygiene (short, clean nails, no perfumes).
• Importance of first impressions in healthcare.
• Effective communication (verbal and non-verbal).
• Active listening and empathy.
• Adapt communication style to patient understanding.
• Avoid false reassurance.

Communication Styles

1. Analytical: Focus on numbers and facts.
2. Intuitive: Big picture approach.
3. Functional: Detailed and organized.
4. Personal: Emotional language and connections.

Study Tips

• Review chapter, write down questions.
• Participate in collaboration sessions and skills labs for clarifications.