Phlebotomy Techniques: Drawing Blood

Phlebotomy Steps

• Discuss with the patient what you will be doing and why, confirming patient name and tests being drawn.
• Identify the vein to be used, commonly the antecubital fossa, median cephalic, or median basilic veins.
• Gather needed supplies, perform proper hand washing techniques, and put on gloves.
• Place a tourniquet and clean the area for 30 seconds with an alcohol wipe.
• Insert the beveled needle at a 30-degree angle into the vessel, connecting vacutainers or using a syringe to drawback.
• Properly label the tubes and send them to the laboratory for analysis.
• Clean up space, ensuring all sharps are placed in a properly labeled sharps container.

Career Profiles

• Clinical Laboratory Technician: conducts laboratory tests, prepares specimens, analyzes results, and reports findings to medical staff.
• Pharmacist: dispenses medications, provides patient education, and reviews prescriptions for accuracy and potential drug interactions.
• Pharmacy Technician: assists pharmacists, processes prescriptions, labels medication, and handles customer inquiries.
• Phlebotomist: collects blood samples, ensures proper labeling and handling of specimens, and adheres to safety protocols.
• Radiologist: interprets medical images, provides diagnostic reports, and requires extensive medical training and expertise in diagnostic imaging.
• Radiographer: operates imaging equipment, positions patients correctly, and ensures image quality.

Urinary System

• Kidneys: filter waste from blood, regulate electrolyte balance and blood pressure.
• Ureters: transport urine from kidneys to the bladder.
• Bladder: stores urine.
• Urethra: tube through which urine exits the body.
• Conditions:
  • Urinary Tract Infection (UTI): bacterial infection in the urinary tract.
  • Kidney Stones: hard deposits formed in the kidneys from minerals and salts.
  • Renal Failure: decreased kidney function leading to waste buildup in the body.

Circulation and Body Defense

• Anatomy of the Heart:
  • Atria: upper chambers of the heart receiving blood.
  • Ventricles: lower chambers pumping blood out of the heart.
• Blood Vessels:
  • Arteries: carry oxygen-rich blood away from the heart.
  • Veins: return oxygen-depleted blood to the heart.
  • Capillaries: tiny blood vessels where gas exchange occurs.
• Blood:
  • Plasma: liquid portion of blood containing water, proteins, and other solutes.
  • Cells: red blood cells (RBCs), white blood cells (WBCs), and platelets.
• Conditions:
  • Anemia: decreased red blood cell count or hemoglobin levels.
  • Leukemia: cancer of the blood-forming tissues, including bone marrow.
  • Hemophilia: genetic disorder impairing blood clotting.
  • Sickle Cell Anemia: inherited disorder causing abnormal hemoglobin production.
  • Atherosclerosis: buildup of plaque in the arteries, narrowing blood flow.

Diagnostic Factors

• Ketones: high levels of blood acids, indicating increased fat metabolism, potentially due to diabetes or fasting.
• Proteins: presence in urine may indicate kidney damage or disease, dehydration, infection, or certain medications.
• Glucose: presence in urine may indicate high blood sugar levels, often seen in uncontrolled diabetes.
• hCG (Human Chorionic Gonadotropin): presence indicates pregnancy, used in pregnancy tests to detect early signs of pregnancy.
• Patient History: provides insights into past medical conditions, medications, lifestyle habits, and family history.
• Vital Signs: blood pressure, heart rate, respiratory rate, and temperature, which may indicate systemic issues or organ dysfunction.
• Color and Odor: changes in urine can provide clues about hydration levels, dietary habits, and certain medical conditions.

Blood

• Composition: 45% blood to 55% plasma.
• Erythrocyte (Red Blood Cell): biconcave shape.
• Leukocyte (White Blood Cell): part of the immune system.
• Thrombocyte (Platelet): involved in blood clotting.
• Hemoglobin: carries oxygen in red blood cells, an oxygen transporter, and a pigment in blood.
• Hematocrit levels: 45% blood to 55% plasma.

Urine Analysis

• Color:
  • Dark yellow: dehydration.
  • Pale light yellow: hydration.
  • Orange/Red: blood in the urine (hematuria).
• Odor:
  • Fruity: presence of ketones.
  • Foul: presence of bacteria.
• Transparency:
  • Clear: normal urine samples.
  • Cloudy: potential UTI or presence of blood cells or pus.