Understanding Phlebotomy

Phlebotomy

Phlebotomy is the collection of blood through a puncture or a cut in order to obtain a sample for diagnosis and analysis. 

Phlebotomy can also be referred as part  of patient's treatment done for certain blood disorder

Phlebotomy includes:

• Venipuncture sampling
• Finger stick sampling

Venipuncture Sampling

This is the most common way of blood collection from adult patients. Collection takes place from a super ficial vein in the upper limb, generally the median cubital vein, this vein is close to the skin and doesn't have many large nerves positioned close, this reduces pain and discomfort of the patient.

 MATERIAL REQUIRED

1) Syringe: It is used to collect blood from patient.

2) Tourniquet: This is used to occlude venous and helps the vein to be discovered.

3) Blood Collection Bottle: Used to put and store blood samples for diagnosis

4) Sterilized Cotton Wool: Use for cleansing the skin before puncture and after puncture (with a little pressure applied).

5) Methylated spirit: Used as cleaning agent to avoid contamination of blood sample.

PROCEDURE

1) Collect material needed.

2) Label tube with patient's identification number.

3) Put tourniquet on the patient about 3-4cm above venipuncture site.

4) Have patient to form a fist so veins are more prominent.

5) After palpating the path of the vein clean venipuncture site with alcohol and allow to dry.

6) Assemble the vacuum tube holder and needle.

7) put in the collection tube into the holder till when the tube reaches the needle.

8) Remove the needle cap.

9) Use your fifth finger to slightly drag skin firm about 1-2 below the venipuncture site. Hold skin through step.

10) put in the needle bevel side up, into the patient's vein.

11) Push the vacuum tube completely onto the needle, blood should begin to flow in.

12) Release the tourniquet.

13) When the vacuum is filled, pull out the needle.

14) Put a dry gauze or sterile cotton wool over the venipuncture site.

15) Apply mild pressure to stop bleeding.

16) Dispose properly all contaminated supplies used.

ADVANTAGES OF VENIPUNCTURE

1) Allows more blood collection.

2) Allows to store blood for future and additional test.

3) Though is a bigger needle but it is less painful.

4) Some test requires venous blood so venipuncture is needed.

5) It allows more option with regards to site selection.

6) Venous blood yield more dependable result.

SHORT COMINGS

1) To avoid complication only a skilled phlebotomy is needed.

2) Difficult to perform on obese patients and victims of sever burnt because their veins are invisible and cannot be palpated.

3) Might lead to waste of blood.

4) Difficulty in transferring it into blood collection tube may lead to accident.

 

Finger Stick Sampling

This involves taking a small account of blood from the patient usually from the end of a finger. It is also known as Capillary Sampling , can be carried out on the toe and ear lobe. 

It can be considered as the best way of blood collection sample because of the long-term benefit to the patient which includes the loss of less blood and ability to carry test at home as a phlebotomist is not necessary for this procedure. The method is mainly used on babies.

 

MATERIAL NEEDED

1) Lancet

2) Sterilized Cotton Wool

3) Alcohol (methylated spirit).

PROCEDURE

1) Keep blood collection tube or slide or strip ready.

2) Cleanse pricking site with alcohol and allow to dry.

3) Hold the skin tight below the piercing site.

4) Pierce with lancet.

5) Apply small pressure to bring out blood.

6) Then put sterile cotton wool on the pierced area when done collecting blood samples.

7) Apply mild pressure to stop bleeding.

                                              

 ADVANTAGE

1) No loss of blood.

2) Relatively Painless.

3) Patient can be taught to do capillary blood collection at home.

                                             

DISADVANTAGE

1) Cant be used for all test

2) Blood cells could be ruptured therefore producing inaccurate result

3) Over use of site of collection can cause scars

4) Calcified nodules can develope at site of collection