Phlebotomy Procedures Described

The practice of phlebotomy includes much more than simply drawing blood. One must be highly skilled in the different techniques, and knowledgeable in the proper way to process samples. Phlebotomists may also be responsible for monitoring patients’ vital signs and for taking down answers to medical interview questions. Before one makes the decision to enroll in phlebotomist certification training, they should gain a greater understanding of the procedures they will perform on a daily basis.

Preparing for Venipuncture

Prior to sticking any needles in any veins, the proper steps must be taken to ensure sterility and accuracy. A tourniquet must be placed around the patient’s arm if that is to be the site of the puncture. The area should be cleansed with antibiotic and/or antiseptic swabs and the phlebotomists hands should be gloved at all times. Gauze, cotton, and medical tape or a band-aid should be close at hand for use when the procedure is finished.

Performing Venipunctures

There are several techniques for performing a venipuncture, and phlebotomists must be familiar and comfortable with each of them. Most of the hand-on phlebotomy certification training offered will focus on perfecting these techniques. They are:

• Evacuated or Vacuum Tube Venipuncture
  • Most common method for standard procedures
  • Facilitates the collection of multiple samples with only one puncture site
  • Blood is collected directly in the tubes that will be sent to the lab
  • Least traumatic method for patients
  • Phlebotomists must ensure all stoppers are the correct code for each test ordered
  • Vials must be labeled immediately with patient information
  • Butterfly Needle Venipuncture
    • Small gauged, flexible needle for specialized procedures such as those for pediatric patients
    • Needle features two plastic wings that allow phlebotomists greater control
    • Blood runs from the needle, through thin tubing, and into the collection vial
    • Flexibility of the needle reduces trauma to patients who tend to move or resist the procedure
    • Syringe Venipuncture
      • Oldest venipuncture technique, very rarely used today
      • Requires needle, tube, and plunger syringe
      • Results in multiple puncture sites if more than one vial is needed
      • Must be transferred to a vacuum tube prior to sending off to the lab
      • Should be reserved for those situations in which the phlebotomist feels the modern options are not well suited

Other Phlebotomy Procedures

Sometimes a physician will order tests for which only a small sample of blood is required. Performing venipunctures in these circumstances is wasteful and unnecessarily painful for the patient. Fingersticks and heelsticks are best for testing insulin levels or iron levels. Heelsticks are often used for newborn testing and screening as it is minimally painful and highly controllable area. Fingerpads should never be lanced and pricks should be made perpendicular to fingerprint and heel lines.

Therapeutic phlebotomy, once referred to as bloodletting, is used in some circumstances to relieve a patient’s body of imbalances in pressure and chemicals. Finally, a bleeding time test is a simple procedure that measures for any clotting abnormalities. Phlebotomist certification training will cover all of these techniques in greater detail and prepare the student for performing them.