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Phlebotomy ( Blood Collection/ Blood draw)

Phlebotomy means the removal of blood from the body. Blood collected for medical testing and also for blood donation. During blood collection, blood is collected from veins because,Veins are too close to the surface of the skin. This makes the process easier by avoiding a deep needle plunge just to draw a bit of blood. Arteries on the other hand, are a tad a bit deeper. The walls of veins are thinner than arteries. The blood pressure in vein is less than that in arteries. These equipments are used for phlebotomy.

•  Needles   (Used to puncture skin & vein during collection)

•  Syringes or Adapters   (like tube, blood stored during collection )

•  Tourniquets   (tied for blood pools and it enlarge vessel)

•  Gloves   (prevent from infectious body fluids)

•  Antiseptics    (used to clean the blood collection site)

•  Vacuum tubes   (used to suck the blood from the negative pressure vein)



Following are the common tubes 

• Blue-Top Tube - Sodium Citrate: This tube is primarily used for coagulation studies (PT and PTT). Complete filling of this tube is essential to obtain accurate results.

• Lavender-Top Tube - EDTA: EDTA is the anticoagulant used for most hematology procedures. Its primary use is for the CBC and individual components of the CBC. The larger (6ml) tube is used for blood bank procedures.

• Red-Top Tube - This tube has no anticoagulant and is used for many chemistry tests, drug levels, and blood bank procedures.

• Serum Separator Tube - This tube contains a clot activator and serum gel separator. It has no anticoagulant and is used for many chemistry tests. It cannot be used for certain drug levels or any blood bank procedures.  

     Procedure

• Check the requisition form for requested tests, other patient information and any special draw requirements. Gather the tubes and supplies that you will need for the draw.

• Position the patient in a chair, or sitting or lying on a bed.

• Wash your hands.

• Select a suitable site for venipuncture, by placing the tourniquet 3 to 4 inches above the selected puncture site on the patient. See below for venipuncture site selection “notes.”

• Do not put the tourniquet on too tightly or leave it on the patient longer than 1 minute.

• Next, put on non-latex gloves, and palpate for a vein.

• When a vein is selected, cleanse the area in a circular motion, beginning at the site and working outward. Allow the area to air dry. After the area is cleansed, it should not be touched or palpated again. If you find it necessary to reevaluate the site by palpation, the area needs to be re-cleansed before the venipuncture is performed.

• Ask the patient to make a fist; avoid “pumping the fist.” Grasp the patient’s arm firmly using your thumb to draw the skin taut and anchor the vein. Swiftly insert the needle through the skin into the lumen of the vein. The needle should form a 15-30 degree angle with the arm surface. Avoid excess probing.

• When the last tube is filling, remove the tourniquet.

• Remove the needle from the patient's arm using a swift backward motion.

• Place gauze immediately on the puncture site. Apply and hold adequate pressure to avoid formation of a hematoma. After holding pressure for 1-2 minutes, tape a fresh piece of gauze or Band-Aid to the puncture site.

• Dispose of contaminated materials/supplies in designated containers. 


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