I know you could be asking yourself; "What's phlebotomy? What are the types of phlebotomy? Which procedures are involved in phlebotomy? Which vein is used in phlebotomy? What methods of drawing blood are used in phlebotomy?" This and many more questions are going to be responded to simply and plainly and you will learn a lot. Sit tight 🤭.

Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a needle or a cannula for the purpose of drawing blood. Phlebotomy is performed for various reasons, such as medical testing, blood donation, or treatment of certain blood disorders. Phlebotomy is also known as venipuncture or blood draw.

There are different types of phlebotomy depending on the purpose and the amount of blood drawn. Some of the common types are:

🔅 Diagnostic phlebotomy

– This type of phlebotomy is done to collect blood samples for laboratory analysis and diagnosis of various diseases or conditions. The blood is usually drawn into tubes with different additives or anticoagulants depending on the type of test required. The tubes are then labeled and sent to the laboratory for processing.

🔅 Therapeutic phlebotomy

– This type of phlebotomy is done to treat certain blood disorders that cause excess iron or red blood cells in the body, such as hemochromatosis, polycythemia vera, or porphyria cutanea tarda. The blood is usually drawn into a bag or a syringe and discarded. The amount and frequency of blood removal depend on the patient's condition and iron levels. Therapeutic phlebotomy can help reduce the symptoms and complications of these disorders, such as liver damage, heart failure, diabetes, arthritis, or skin discoloration.

🔅 Blood donation

– This type of phlebotomy is done to collect blood from healthy volunteers for transfusion to patients who need it. The blood is usually drawn into a bag with an anticoagulant and a preservative solution. The blood is then screened for infectious diseases and separated into different components, such as red blood cells, plasma, platelets, or cryoprecipitate. The blood components are then stored and distributed to hospitals or blood banks according to the demand and availability. Blood donation can help save lives and improve health outcomes for patients with various conditions, such as trauma, surgery, anemia, bleeding disorders, or cancer.

The procedures involved in phlebotomy vary depending on the type of phlebotomy, but some general steps are:

🔅 Prepare the patient

– Explain the procedure and its purpose to the patient and obtain informed consent. Check the patient's identification and medical history. Ask the patient to relax and sit or lie down comfortably. If the patient is fasting or taking any medications, make sure they follow the instructions given by the doctor or the laboratory.

🔅 Gather the supplies

– Select the appropriate needle size, holder, tubes, syringes, bags, labels, tourniquet, alcohol wipes, cotton balls, bandages, gloves, and sharps container. Make sure the supplies are sterile and not expired. Arrange them in order of use and within easy reach.

🔅 Find a vein

– Choose an arm that is free of injury, infection, edema, scars, or intravenous lines. Apply a tourniquet around the upper arm to make the veins more visible and palpable. Ask the patient to make a fist without pumping their hand. Feel for a vein that is large, straight, bouncy, and not too close to an artery or a nerve. The most common vein used for phlebotomy is the median cubital vein in the antecubital fossa (the bend of the elbow), but other veins in the arm or hand may also be used if necessary. Avoid using veins in the legs or feet unless instructed by a doctor.

🔅 Cleanse the site

– Use an alcohol wipe to disinfect the skin over the selected vein in a circular motion from inside to outside. Allow the skin to dry completely before puncturing it to avoid stinging and contamination. Do not touch or palpate the site after cleansing it.

🔅 Insert the needle

– Put on gloves and inspect the needle for any defects or obstructions. Remove the needle cap and hold the needle at a 15 to 30 degree angle to the skin with the bevel up (the slanted part facing up). Anchor the vein by pulling the skin below it with your thumb. Tell the patient to expect a sharp prick and quickly insert the needle through the skin into the vein with one smooth motion. You should see a flash of blood in the needle hub or tubing when you enter the vein. Release the tourniquet as soon as blood starts flowing. Do not insert the needle too deep or too shallow to avoid injuring the vein or surrounding tissues.

🔅 Collect the blood

– Attach the tube, syringe, or bag to the needle or holder and allow the blood to fill it by vacuum or gravity. Do not fill the container more than the recommended level. If using tubes, follow the correct order of draw to prevent cross-contamination of additives. Gently invert the tubes several times to mix the blood with the additives. If using a syringe, pull the plunger back slowly and steadily to avoid hemolysis (breaking of red blood cells). If using a bag, squeeze the drip chamber to start the blood flow. Label the containers with the patient's name, identification number, date, and time of collection.

🔅 Remove the needle

– When enough blood is collected, remove the container from the needle or holder and activate the safety device to cover the needle. Place a cotton ball or gauze over the puncture site and withdraw the needle in one smooth motion along the line of insertion. Apply gentle pressure to the site for a few minutes or until bleeding stops. Do not bend the patient's arm or use alcohol to clean the site after removing the needle. Dispose of the needle and other sharps in a puncture-resistant container. Do not recap or reuse needles.

🔅 Care for the patient

– Check the patient's condition and vital signs. Apply a bandage or tape to the puncture site and instruct the patient on how to care for it. Ask the patient to stay for 10 to 15 minutes and observe any signs of adverse reactions, such as fainting, bleeding, bruising, or infection. Offer the patient some water or juice and a snack if they are not fasting. Thank the patient and escort them out of the room. Send the blood samples to the laboratory or blood bank as soon as possible and document the procedure in the patient's record.