INTRODUCTION-TO-PHLEBOTOMY

Introduction to Phlebotomy

Blood plays several critical roles in the body:
1. Supplies nutrients to tissues (O₂, hormones, glucose).
2. Removes metabolic end-products such as CO₂, urea, creatinine.
3. Provides a defense mechanism through white blood cells (WBC) and antibodies.
4. Prevents blood loss, assisted by platelets and coagulation proteins.

Coagulation can occur:
- In vivo: Blood is fluid; clots form spontaneously to protect injured vessels.
- In vitro: Clotting can be triggered by factors such as glass surfaces or poor drawing techniques.

Functions of anti-coagulants:
- Remove calcium from blood.
- Neutralize thrombin to avoid clotting.
- Distinctions between whole blood, plasma, and serum.

Result: Clotting is prevented, and samples must be inverted completely.
- Components: Plasma containing fibrinogen, WBCs, platelets, and RBCs.

Result: Spontaneous clotting occurs, leading to the formation of fibrin strands that entrap cells.
- Components: Serum (without fibrinogen) and clot (with blood cells).

Normal: Clear and yellow.
Abnormal:
- Hemolyzed: Pink to red (ruptured RBC).
- Icteric: Dark orange-yellow (bilirubin).
- Lipemic: Cloudy (due to fats/triglycerides).

Glass: No additive, activates clotting.
Plastic: Contains additive to promote clotting; invert to mix.
- Used for therapeutic drug monitoring (TDM).

Trace metal-free tube used for tests that require minimal contamination.
Color-coded labels indicate specific contents (e.g., no additive, EDTA for whole blood/plasma).

Light Blue Top Tube: Contains sodium citrate (binds calcium).
- Must be filled and maintained at a specific blood-anticoagulant ratio for coagulation studies.
Green Top Tube: Contains heparin; three formulations: lithium, ammonium, sodium.
Purple Top Tube: Contains EDTA (binds calcium); used for hematology studies, such as CBC.
Grey Top Tube: Contains potassium oxalate, binds calcium, includes sodium fluoride to maintain glucose levels.

Importance of communication, empathy, and professionalism in patient interactions.
Guidelines for labeling blood collection tubes efficiently and legally.
Safety measures including handwashing, PPE, and proper disposal protocols.
Importance of recognizing diversity in patient care and maintaining high-quality customer service.

Emphasis on ethical behavior, patient confidentiality, and understanding patients’ rights.
Overview of the Patient Care Partnership and commitment to high-quality care.

Levels of Care:
- Primary care: First point of contact for patients.
- Secondary care: Specialized care typically upon referral.
- Tertiary care: Highly specialized consultative care.
Overview of clinical laboratory sections, including serology, microbiology, and blood bank practices.
Importance of accurate and timely laboratory tests for effective medical care.

Role and qualifications of various laboratory personnel:
- Laboratory Director: Oversees laboratory services.
- Medical Technologist: Performs tests and ensures quality.
- Phlebotomist: Specialized in blood collection procedures; certification and potential licensing requirements.