Phlebotomist

Phlebotomy involves the practice of drawing blood for patients and taking the blood specimens to the laboratory to prepare them for testing. To better understand this practice, let’s explore the three phases of lab testing. The first phase is the pre-analytical phase, which is the part phlebotomists are involved in. This phase, which begins the moment a physician orders a test, includes communication of the order, addressing the patient, drawing the blood, transporting the blood, and processing the blood for testing. Secondly is the analytical phase of lab testing which involves the laboratory personnel testing the specimen and deriving results that can be reported. Finally, the post-analytical phase includes the test coming off the machine and results being reported which mainly involves transcription.

Again, the phlebotomist’s role in the lab testing comprises the first, and many would say most important, phase. There are many ways a phlebotomist can alter test results that come out of the post analytical phase. For instance, if the blood is not drawn properly a patient has the potential to be treated according to inaccurate results that do not represent their actual physiology and that could lead to complications, misdiagnosis, and even medication errors.

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Not only do phlebotomists draw blood, they also transport it to the laboratory, and sometimes process it. Processing typically involves putting the blood in the centrifuge, which is a piece of equipment that rotates the tubes of blood at high speeds to separate the components. Sometimes the specimen being tested is not the entire liquid portion but rather a certain component of the blood. When a patient has their blood drawn they may notice that there are different colored tubes or stoppers. This is because some of the tubes have a component in them that prevents the blood from clotting, whereas others promote the specimen to clot. Typically, when blood is drawn into a tube that promotes it to clot, it is placed in the centrifuge within 20-30 minutes of the blood draw. This centrifuge then spins the gelatinous mass, which is the clot, down to the bottom of the tube. What is left in the upper portion of the tube is a liquid called “serum”. Sometimes labs test serum rather than whole blood. “Whole blood” remains fluid, as when an anticoagulant prevents clotting.

Various Types of Puncture

Phlebotomy is the general term for accessing a vein. More specific terms include venipuncture, skin puncture, and arterial puncture. Venipuncture is by far the most common means of collecting a blood specimen and involves placing a needle in a vein, typically at the bend of the arm or back of the hand. A skin puncture involves piercing tissue that will bleed to collect a small amount of blood for minimal testing. An example of a skin puncture would be a finger prick. A third but much less common method of collection is an arterial puncture (commonly referred to as an ABG), which involves drawing blood from an artery, typically done in the wrist. This kind of draw is typically done on patients who have a respiratory condition. Many ABGs are done on asthmatics. Only 10% of phlebotomists perform arterial punctures.

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Average Duration of Phlebotomy Career

There are many phlebotomists who love their career and plan to stay. There are also many people who use this line of work as a stepping-stone into other health care professions such as medical assisting or nursing. It is a field that takes only 6-12 weeks to complete training and provides an intriguing insight into the human body and the nature of health care, sickness and injury. There are many who chose to start in this profession and eventually move “up the ladder” so to speak in the health care world.

Hospital Settings and Blood Collection

Every hospital manages blood collection responsibilities differently. In certain units of some hospitals nurses will draw blood and in other places they have a laboratory-based phlebotomy service. Nurses do not receive training in drawing blood in school so they are 100% on the job trained. Oftentimes nurses don’t have a full appreciation of the importance of drawing blood specimens and how test results can be altered during the collection process if it is not performed properly.

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Other Medical Professionals

Inside the laboratory phlebotomists are in constant communication with the medical technologists who are testing the specimen. Outside the laboratory setting, nurses would be the main health care professionals phlebotomists come in contact with. They may also talk to EMTs, nursing assistants, and sometimes physicians in smaller hospitals.