INTRODUCTION-TO-PHLEBOTOMY

Introduction to Phlebotomy

• Definition and overview of phlebotomy.

• Importance of safety in phlebotomy.

• Prepared by: Verniece Jean C. Claveria, RMT.

Page 2: Phlebotomy

• Phlebotomy involves the practice of drawing blood for medical purposes.

Page 3: Modern Phlebotomy

• Key functions:

  • Diagnosis and management of disease.

  • Blood removal for transfusions.

  • Therapeutic reasons for blood removal include conditions such as:

    • Polycythemia: A blood disorder characterized by an increase in red blood cells.

    • Hemochromatosis: A condition involving excess iron accumulation in the body.

Page 4: Blood Functions

• 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.

Page 5: Blood Composition

• Blood consists of:

  • Formed Elements (approx. 45%):

    • Red Blood Cells (RBC)

    • White Blood Cells (WBC)

    • Platelets

  • Plasma (approx. 55%):

    • Water (~92%)

    • Proteins (~7%)

Page 6: Coagulation

• 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.

Page 7: Anti-coagulants

• Functions of anti-coagulants:

  • Remove calcium from blood.

  • Neutralize thrombin to avoid clotting.

  • Distinctions between whole blood, plasma, and serum.

Page 8: Blood with Anticoagulant

• Result: Clotting is prevented, and samples must be inverted completely.

  • Components: Plasma containing fibrinogen, WBCs, platelets, and RBCs.

Page 9: Blood without Anticoagulant

• Result: Spontaneous clotting occurs, leading to the formation of fibrin strands that entrap cells.

  • Components: Serum (without fibrinogen) and clot (with blood cells).

Page 10: Appearance of Blood Samples

• Normal: Clear and yellow.

• Abnormal:

  • Hemolyzed: Pink to red (ruptured RBC).

  • Icteric: Dark orange-yellow (bilirubin).

  • Lipemic: Cloudy (due to fats/triglycerides).

Page 11: Blood Collection Tubes

• Utilizes vacuum for collecting blood samples via Vacutainer or syringe systems.

• Stoppers are color-coded to indicate contents and have expiration dates.

Page 12: Tubes without Anticoagulant

• Blood will clot by natural processes when no anticoagulant is present.

Page 13: Red-top Tube

• Glass: No additive, activates clotting.

• Plastic: Contains additive to promote clotting; invert to mix.

  • Used for therapeutic drug monitoring (TDM).

Page 14: Gold or Mottled-red-gray Top Tube

• Contains a clot activator and gel (SST).

• Requires inversion to mix and initiate clotting sequence.

Page 15: Royal Blue-top Tube

• 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).

Page 16-20: Tubes with Anticoagulants

• 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.

Pages 21-36: Blood Collection Equipment

• Various pieces of equipment necessary for blood collection:

  • PPE: Gloves, lab coat, mask.

  • Cleaning agents: Alcohol pads, povidone iodine, soap and water.

  • Sharps containers for safe disposal of needles and lancets.

  • Tourniquets for venous blood flow; must be monitored closely during use.

  • Needles: Must never be reused or recapped; different gauges for different uses.

  • Multi-sample Needle: Used with syringe or vacutainer systems, features a retractable sheath.

  • Butterfly Needles: Used for small, fragile veins; associated with higher risk of needle stick injury.

Pages 37-63: Patient Interaction and Safety Practices

• 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.

Pages 64-72: Ethical Standards and Patients' Rights

• Emphasis on ethical behavior, patient confidentiality, and understanding patients’ rights.

• Overview of the Patient Care Partnership and commitment to high-quality care.

Pages 73-100: Levels of Care and Laboratory Practices

• 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.

Pages 101-122: Clinical Laboratory Personnel

• 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.