Phlebotomy Course

Bloodborne pathogen (BBP)

Microorganism that causes disease and is carried in blood

Types of BBPs

Viruses (HIV, HCV, HBV), bacteria, protozoa, fungi

Where BBPs are found

Blood, serum/plasma, semen/vaginal fluids, saliva, organs/tissues, any specimen exposed to blood

Hepatitis C (HCV)

No vaccine; can be acute or chronic; may cause cirrhosis and liver failure; survives on surfaces 2–5 days

HIV

Chronic condition; no vaccine; dies quickly outside the body (~20 minutes)

Hepatitis B (HBV)

Most contagious BBP; has a vaccine; spreads via blood, surfaces, and ingestion

Universal precautions

Treat all patients and fluids as infected using reasonable precautions

Basic PPE

Gloves

Higher-level PPE

Mask, gown, face shield

Risk reality

You are never completely risk-free

Exposure (BBPs)

Pathogen enters body or could enter body

High-risk exposures

Needle sticks; splashes to eyes, mouth, nose; contact with cuts, acne, burns, piercings

Not considered exposure

Contact with intact skin

Immediate actions after exposure

Flush area, wash thoroughly, report immediately

Why report exposure

Legal protection, medical coverage, faster treatment

Treatment timing

Within 48 hours reduces risk by ~50%

Infection control principles

Isolation and containment

Locard’s Principle

“Every contact leaves a trace” (contamination spreads through touch)

Chain of infection

Contamination spreads from one object to others, forming a web

Goal of infection control

Break the chain of infection as soon as possible

Bleach (10%)

Strongest disinfectant; 1:9 ratio; requires 20 minutes contact; corrosive

Ethanol (70%)

Common disinfectant; safe for many surfaces; less powerful than bleach

Hydrogen peroxide

Strong oxidizer; corrosive to metals

Sharps container use

Dispose of needles, glass tubes, and sharp items

Sharps rules

Never recap needles; never reach inside; insert point-first; do not overfill

Biohazard bag use

Dispose of gloves, gauze, and any contaminated items

Regular trash

Only non-sharp and non-contaminated items

Best handwashing method

Soap and water

Why soap is better

Physically removes contaminants; gel only kills some germs

Handwashing rules

Before and after every patient; avoid touching faucet with clean hands

Glove facts

Non-sterile; protect patient and worker; single-use only

Glove rules

Do not touch unnecessary objects; change between patients

Exam tip (gloves)

Gloves do NOT equal sterile technique

Venipuncture

Drawing blood using a needle

Main venipuncture sites

Median cubital vein, hand veins, wrist

Median cubital vein advantages

Large, stable, less painful

Venipuncture risks

Bruising, hematoma, rare complications

Tourniquet purpose

Restricts venous return to make veins easier to find

Tourniquet placement

2–3 inches above site

Tourniquet time limit

Maximum 1 minute

Why time limit matters

Prevents hemoconcentration and false lab results

Blood collection tube basics

Color indicates additive; must fill completely; expired tubes give inaccurate results

Tube additives

Anticoagulants, clot activators, gel separators

Order of draw purpose

Prevents contamination between tubes

Why contamination occurs

Additives from one tube transfer to the next via needle

Syringe parts

Plunger, barrel, tip (Luer-lock or slip), flange

Needle parts

Hub, shaft, lumen, bevel, tip

Gauge system

Higher number = smaller needle; common sizes 20–22 gauge

Bevel rule

Bevel must face up; incorrect position can cause failed draw

Quality control (QC)

Check expiration dates, packaging integrity, tube vacuum, needle condition

Why QC matters

Prevents inaccurate results and ensures patient safety