PHLEBOTOMY
anticoagulant: Hirudin
PHLEBOTOMY: A historical perspective
 400-377 BC
VENESECTION
• Latin: Vena “vein” & Sectio “cutting”
• most common method of general
bloodletting in the time of Hippocrates
• Synonymous with PHLEBOTOMY
-Greek: Phlebos “vein” & Tome
“incision”
• -Hippocrates: Disease = imbalance of
Bodily Fluids
-Bile:
-Black Bile: melancholy
-Yellow Bile: choleric
-Phlegm:
Phlegmatic/apathetic
-Blood: Sanguine/Cheerful
 1210
• Venesection also practiced in the middle
ages by Barber-surgeons
Barber pole:
Pole = gripped to increase blood flow
Red Stripe = blood (arterial)
Blue stripe = blood (venous)
• 17th – early 18th century
• The Lancet: tool for cutting veins
during venesection.
• Cupping: heated suction apparatus pull
blood to the skin, then incisions to
capillary of that area made by lancet or
fleam
• Leaching: used for localized
bloodletting
Hirudo medicinalis
saliva: local vasodilator
local anesthetic
PHLEBOTOMY Today
• Obtain blood for:
-clinical tests
-therapeutic drug monitoring
• Treatment of Polycythemia vera
• Accomplished through:
-Venipuncture
-Capillary puncture
PHLEBOTOMIST
• any individual trained in the various
technique used to obtain blood for
laboratory testing or blood donation
• Trained by programs offered by
hospitals, schools, or colleges, approved
by the national accrediting agency for
clinical laboratory sciences.
Competency based on:
-manual dexterity
-communication skills
-organization skills
-knowledge on specimen requirements
PHLEBOTOMIST’S DUTIES AND
RESPOSIBILITIES
• Patient preparation for collection
procedures
• Collect specimens of skin puncture and
phlebotomy
• Prepare specimen for transport to
ensure stability of sample
• Maintain patient confidentiality
• Quality control checks
• Collect and perform POCT
 • Perform skin tests
• Collect urine drug screen specimens
Patient-Client Interaction
Face of the Laboratory
• Patients equate the caliber of health care
they will receive from the
hospital/laboratory based on the
phlebotomist
• Your competency reflects that of the lab
as a whole
Recognize Diversity
• Understand and respect the customs and
traditions of indigenous people
Professionalism
Conduct and qualities that characterize a
professional person
• General appearance and Grooming
• Conservative clothing
• Proper personal hygiene
• Physical well being
• Self-confidence
• Trust your own personal judgment
• Posture, professional appearance,
tactfulness in communication
• Integrity
• A personal feeling of wholeness deriving
from honesty and consistency of
character
• Seen in a person’s actions, values, and
beliefs
• Do what is right regardless of the
circumstances
• Compassion
• Being sensitive to a person’s needs and
willing to offer reassurance in a coring
and humane way
• Self-motivation
• Take initiative to follow through on
tasks.
• Consistently strive to improve and
correct behavior
• Take advantage of every learning
opportunity
• Dependability
• Takes personal responsibility for his or
her actions
• Works hard, shows constant, reliable
effort and perseverance
• Ethical behavior
• Centered on an individual’s conduct
• Make the right personal choices that help
maintain a high level of respect for you
and your profession
• The code of ethics
• A system of policies of principles which
leads to uniformity and defined
expectations for a member of that
profession
PATIENT’S BILL OF RIGHTS
• The patient is informed of these rights
when care is initiated
1. Right to appropriate medical care and
humane treatment
2. Right to informed consent
3. Right to privacy and confidentiality
4. Right to information
5. Right to choose healthcare provider and
facility
 7. Right to religious belief
Communication skills
The means by which information is
exchanged or transmitted
A. Verbal communication
• Involves the sender (speaker), and the
receiver (listener)
• Completion: Feedback is received
• Important for clarification
• Communication barriers:
• Language limitations
• Cultural diversity
• Emotions
• Age
• Physical disabilities
• use a vocabulary that is easily
understood by clients
• Active listening:
communicate ≠ speak
• Effective communication require
the listener to participate
• Take positive steps through feedback so
that the listener may interpret the
message as the speaker intended
B. Non-verbal Communication
80% of language is unspoken
• Kinesics : the study of non-verbal
communication
Facial expression Eye Contact
Gestures Body
language
• Kinesic slip: verbal and non-
verbal messages does not match
• Appearance
• Follow the healthcare facility’s
dress code
• This conveys level of confidence
and competence
• Touch
• Touching privileges are granted to
and expected of health care
workers under certain
circumstances
Effective communication in Healthcare
• Patients reach out for comfort and
assurance through conversation
• Elements of healthcare communication:
Empathy, control, trust, and confirmation
will help the phlebotomist to interact with the
patient successfully
• Empathy:
• Identifying with the feelings or
thoughts of the patient
• Control:
• Allow the patient to have a sense
of control
• Pro: Patients which are allowed to
assert their right often time end up
more agreeable
• Con: Time consuming
• Respect and confirmation
• Respect is an attitude that conveys
and understanding of the
importance of that person as an
individual
 • Avoid labeling the patient • Immunohematology
• Trust • Immunology & serology
• The unquestioning belief by the • Clinical microscopy
patient that health professionals
are performing their job Anatomical and surgical laboratory
responsibilities s well as they • Histopathology
possibly can.
• Tissue analysis
• Telephone communications
• Surgical biopsy
Observe proper telephone etiquette:
• Autopsy
• Answer promptly
• Frozen sections
• State your name and department
• cytology
• Be helpful
Clinical laboratory services
• Prioritize calls
Hematology
• Transfer and put on hold properly
• Test are used to identify diseases
• Be prepared to record info associated with blood and blood forming
• Know the laboratory’s policies tissues

• Defuse hostile situations • RBC count

• Try to assist everyone • WBC count

The Healthcare setting • WBC Differential Count

Routine CBC
Health care delivery
• Hemoglobin
• Two general categories of health care
facilities: • Hematocrit

a. Inpatient (non-ambulatory) • Studies the ability of blood to form and

dissolve clots: Coagulation studies
b. Outpatient (ambulatory)
Clinical Chemistry
• Uses serum, plasma, whole blood urine,
Two major divisions in the clinical and other bodily fluids and measures
laboratory: analytes such as glucose, proteins,
enzymes, hormones, etc.
Clinical laboratory
• Basic metabolic panel:
• Hematology
• Glucose
• Clinical chemistry
• BUN
• Microbiology
• Creatinine
 • Sodium • CSF
• Potassium • Amniotic fluid
• Chloride • Synovial fluid
• CO2 Microbiology
• Calcium • Analyzes body fluids and tissues for the
presence of microorganisms, primarily
Serology and Immunology by means of Culture and sensitivity
• Serology deals with the body/s response • Acid-Fast bacilli
to the presence of bacterial, viral, fungal,
or parasitic diseases stimulating antigen- • Culture and sensitivity
antibody reactions
• Blood culture
• Antinuclear Antibody
• Gram stain
• Anti-streptolysin O
Anatomical and surgical laboratory
• FTA-ABS: Fluorescent
Treponemal Antibody Absorption Histology
test • The study of the microscopic structure of
• Hepatitis B surface Antigen tissues

Immunohematology • Evaluate samples of tissue from

surgeries and autopsies, to determine if
• This section of the laboratory prepares they are normal or pathological.
blood products to be used for patient
transfusions. • Biopsy

• ABO type • Frozen section

• Rh Type Cytology

• Cross matching • Concerned with the structure of cells

• Antibody screening • Used to diagnose malignant and

premalignant conditions
• Pap smear
Clinical Microscopy
• Performs chemical and microscopic
analysis of urine and other bodily fluids Clinical Laboratory Personnel

• Urinalysis  Laboratory Director/Pathologist

• Pathologist: physician who
• Stool analysis specializes in diagnosing disease,
through the use of laboratory test
• FOBT results
• Semanalysis
 • Laboratory director: may be a certification from a military or
pathologist, or a clinical laboratory proprietary school
scientist which a doctorate. • 74.9-70 GWA
• The laboratory director and the • Performs:
administrator share responsibilities o Routine testing
for managing the lab o Operating all equipment
o Performing basic instrument
 Laboratory administrator/manager maintenance
• A medical technologist with an o Recognizing instrument
advanced degree and several years of problems
experience o Assisting in problem solving
• Oversee all operations involving
physician and patient services.  Clinical laboratory assistant
• May also supervise ancillary services • A position before automation of
such as radiology and respiratory laboratory instruments
therapy • With phlebotomy experience
• Skilled in specimen processing and
 Technical supervisor basic laboratory testing
• For each laboratory section or sub
section, there is a technical supervisor  Phlebotomist
who is responsible for the: • Trained to collect blood for
o administration of the area laboratory tests
o Reports to the laboratory • Requirements:
supervisor o Highschool diploma
• Usually has additional education and o Finished a phlebotomy
experience in one or more of the program in college
clinical laboratory areas o 1 year work experience
o Certification from passing a
 Medical technologist/Medical
national examination
laboratory scientist
• Has a bachelor’s degree plus
additional studies and experience in
the clinical laboratory setting
• Licensed
• Performs the following:
o all levels of testing in any area
of the laboratory,
o reporting results performing
quality control,
o evaluating new procedures,
o conducting preventive
maintenance
o Troubleshooting instruments.
 Medical laboratory technician
• An individual with an associate
degree from a 2 year program or