Phlebotomy Explained

Phlebotomy

Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood.[1] The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a phlebotomy is called a phlebotomist, although most doctors, nurses, and other technicians can also carry out a phlebotomy.[2] In contrast, phlebectomy is the removal of a vein.

Phlebotomies that are carried out in the treatment of some blood disorders are known as therapeutic phlebotomies.[3] The average volume of whole blood drawn in a therapeutic phlebotomy to an adult is 1 unit (450–500 ml) weekly to once every several months, as needed.[4]

Etymology

From Greek, Ancient (to 1453);: φλεβοτομία (Greek, Ancient (to 1453);: phlebotomia – Greek, Ancient (to 1453);: phleb 'blood vessel, vein' + Greek, Ancient (to 1453);: tomia 'cutting'), via French, Old (842-ca.1400);: flebothomie (modern French French: phlébotomie).

Phlebotomies

Phlebotomies are carried out by phlebotomists – people trained to draw blood mostly from veins for clinical or medical testing, transfusions, donations, or research. Blood is collected primarily by performing venipunctures, or by using capillary blood sampling with[5] fingersticks or a heel stick in infants for the collection of minute quantities of blood.[6] The duties of a phlebotomist may include interpreting the tests requested, drawing blood into the correct tubes with the proper additives, accurately explaining the procedure to the person and preparing them accordingly, practicing the required forms of asepsis, practicing standard and universal precautions, restoring hemostasis of the puncture site, giving instructions on post-puncture care, affixing tubes with electronically printed labels, and delivering specimens to a laboratory.[7] Some countries, states, or districts require that phlebotomists be licensed or registered.

A therapeutic phlebotomy may be carried out in the treatment of some blood disorders (example: Hemochromatosis, polycythemia vera, porphyria cutanea tarda), and chronic hives (in research).[8] [9]

Australia

In Australia, there are a number of courses in phlebotomy offered by educational institutions, but training is typically provided on the job. The minimum primary qualification for phlebotomists in Australia is a Certificate III in Pathology Collection (HLT37215) from an approved educational institution.[10]

United Kingdom

In the UK there is no requirement for holding a formal qualification or certification prior to becoming a phlebotomist as training is usually provided on the job. The NHS offers training with formal certification upon completion.[11]

United States

See main article: Phlebotomy licensure in the United States. Special state certification in the United States is required only in four states: California, Washington, Nevada, and Louisiana. A phlebotomist can become nationally certified through many different organizations. However, California currently only accepts national certificates from six agencies. These include the American Certification Agency (ACA), American Medical Technologists (AMT), American Society for Clinical Pathology (ASCP), National Center for Competency Testing/Multi-skilled Medical Certification Institute (NCCT/MMCI), National Credentialing Agency (NCA), and National Healthcareer Association (NHA).[12] These and other agencies such as the American Society of Phlebotomy Technicians also certify phlebotomists outside the state of California. To qualify to sit for an examination, candidates must complete a full phlebotomy course and provide documentation of clinical or laboratory experience.

South Africa

In South Africa learnerships to qualify as a Phlebotomy Technician are offered by many public and private educational institutions as well as by private academies owned up by pathology laboratories (such as Ampath Laboratories, Lancet, PathCare) and healthcare service providers (such as Netcare, South African National Blood Service). Some of the larger retail pharmacy chains offering in-store clinical services (such as Clicks, Dis-Chem) also provide training for aspirant phlebotomists. Certification can be obtained from a number of examination and testing institutions. To work as a phlebotomist in South Africa, registration with the Health Professions Council of South Africa (HPCSA) is required.

History

See main article: Bloodletting. Early phlebotomists used techniques such as leeches and incision to extract blood from the body. Bloodletting was used as a therapeutic as well as a prophylactic process, thought to remove toxins from the body and to balance the humors. While physicians did perform bloodletting, it was a specialty of barber surgeons, the primary provider of health care to most people in the medieval and early modern eras.

See also

Notes and References

  1. Book: Betts. J Gordon. Desaix. Peter. Johnson. Eddie. Johnson. Jody E. Korol. Oksana. Kruse. Dean. Poe. Brandon. Wise. James. Womble. Mark D. Young. Kelly A. Anatomy & Physiology. Houston. OpenStax CNX. 978-1-947172-04-3. July 28, 2023. 18.1 An overview of blood.
  2. Web site: FAQ . National Association of Phlebotomists . 28 December 2014 . live . https://web.archive.org/web/20141228205159/http://www.phlebotomy.org/faq . 28 December 2014 .
  3. Kim . KH . Oh . KY . Clinical applications of therapeutic phlebotomy. . Journal of Blood Medicine . 2016 . 7 . 139–44 . 10.2147/JBM.S108479 . 27486346. 4957680 . free .
  4. https://www.aetna.com/cpb/medical/data/600_699/0652.html Retrieved 17 February 2022.
  5. Krleza. Jasna Lenicek. Dorotic. Adrijana. Grzunov. Ana. Maradin. Miljenka. 2015-10-15. Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochemia Medica. 25. 3. 335–358. 10.11613/BM.2015.034. 1330-0962. 4622200. 26524965.
  6. Jeon BR, Seo M, Lee YW, Shin HB, Lee SH, Lee YK . Improving the blood collection process using the active-phlebotomist phlebotomy system . . 57 . 1–2 . 21–7 . 2011 . 21391461 .
  7. Book: WHO Guidelines on Drawing Blood. 2010. World Health Organization. Best practices in phlebotomy.
  8. Cook. Lynda S.. Therapeutic Phlebotomy. Journal of Infusion Nursing. 33. 2. 81–88. 10.1097/nan.0b013e3181d00010. 20228645. 2010.
  9. Yao . Q . Zhang . X . Mu . Y . Liu . Y . An . Y . Zhao . B . Bloodletting Therapy for Patients with Chronic Urticaria: A Systematic Review and Meta-Analysis. . BioMed Research International . 2019 . 2019 . 8650398 . 10.1155/2019/8650398 . 31139656. 6500668 . free .
  10. Web site: Certificate III in Pathology Collection. Australian Government. 14 January 2018. live. https://web.archive.org/web/20180114074101/https://www.myskills.gov.au/courses/details?Code=HLT37215. 14 January 2018.
  11. Web site: Phlebotomist. NHS Careers. 15 September 2014. live. https://web.archive.org/web/20140929061351/http://www.nhscareers.nhs.uk/explore-by-career/wider-healthcare-team/careers-in-the-wider-healthcare-team/clinical-support-staff/phlebotomist. 29 September 2014.
  12. Web site: Archived copy . 2016-03-16 . dead . https://web.archive.org/web/20160323205518/http://www.cdph.ca.gov/programs/lfs/Documents/P-LFS-Approved-CertOrg-Exams.pdf . 2016-03-23 .