Things Every Phlebotomist Should Know

Drawing blood from a patient is not as simple as it appears. Sure, it can take a few seconds to get the job done, but there are usually specific safety procedures that the phlebotomist must follow. For example, a phlebotomist should avoid inserting the needle too far into the vein to prevent hematoma. There is also an angle that the needle should be inserted into the vein. Hence, if you’re a phlebotomist, making precise calculations in your mind is part of your routine. For those who just completed the training program and applying for a job, below are a few things you ought to know as a phlebotomist. Remember, the knowledge will be crucial to passing the interview for your first phlebotomy job.

Identifying the right patient is very important

In healthcare facilities, patients wear identification bracelets on their arms. But did you know that at least 16 percent of patients’ identification bracelets contain misleading information? It won’t be a surprise if there are patients who exchange their identification bracelets. Yes, it happens sometimes. That is why it is very important for a phlebotomist to confirm the identity of patients by asking them to state their names.  Moreover, you can also ask them to state their date of birth, unique id number, address or even spell their last name if possible. Don’t take any chances at this point. Always verify their information by making sure it matches with the information form, requisition and identification band. If the patient is sedated or half-conscious, it is likely the patient will answer affirmatively to any question. However, you can confirm their identity with their nurse or caregiver.

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The angle of insertion should not exceed 30 degrees

When performing venipuncture, the phlebotomist should insert the needle at the lowest angle possible to reduce the risk of bruising underlying structures such as nerves, arteries and tendons. Usually, the most preferred angle is 15 degrees. Anything past 30 degrees could make you liable for injury. Of course, you will not be walking around with a protractor to quantify the size of your angles. The trick is to penetrate the skin at the lowest angle possible and everything will turn out okay.

Prioritize the median vein

This is something that you have probably been taught at your phlebotomy training program. When drawing blood from the antecubital area, always aim for the median cubital vein. The reason why phlebotomists are trained to aim for the median vein is that it is not situated close to nerves and arteries. Not to forget, it is closer to the skin and less when painful when punctured. If the median cubital vein is not visible in both arms, you can choose the cephalic vein as the second option. The basilic vein should always be the last resort since it is the most challenging to penetrate and demands much proficiency.

Always apply the pressure

Phlebotomist Should KnowAfter performing venipuncture on the arm, it is crucial to remove the needle gently and let the patient apply pressure to the site with dry cotton wool or clean gauze. Make sure the patient applies the pressure gently until the bleeding stops. At no time should the patient try to bend their arm up when applying the pressure. If the patient is half-conscious or sedated, you can apply the pressure yourself. The bandage should only be attached after the bleeding has stopped. After the patient has released the pressure, the phlebotomist should observe the site for at least 10 seconds to ascertain the bleeding has stopped before putting the bandage.

Protect patients from passing out

While drawing blood, it is normal for some patients to feel dizzy. Hence, the phlebotomist should make sure the patient is seated comfortably in a chair in a backward position or lying down. Before the venipuncture, the phlebotomist should ask the patients if they usually faint during a blood draw. Otherwise, you can refer to the patients’ receiving order handed out by the physician or nurse to know if they have any allergy or medical condition you should be aware.

Collect blood from an acceptable site

If the phlebotomist cannot locate veins in the usual places, it is allowed for phlebotomists to perform venipuncture on the foot and ankle veins. However, it is vital to seek the assistance or approval of the physician or registered nurse in charge before proceeding to perform venipuncture on the ankle or foot veins. Don’t beat yourself down if you’re unable to withdraw blood from a patient. Sometimes there are patients who give even the most skillful collectors a hard time when drawing their blood. If you’re unsuccessful in drawing a patient’s blood after two attempts, you should consider calling in for someone else.

Label the samples immediately

To avoid inaccurate specimen identification, it is recommended to label the samples at the bedside immediately after acquiring them. Who knows? Maybe you could get interrupted and leave the room for a minute only to come back and mix up the samples unknowingly. In fact, you should fill up the complete identification on the specimen and not just temporary pointers to remind you later to add the missing details. Just another thing; don’t forget to invert the tubes that contain anticoagulants immediately after transferring the blood to the tubes. Additionally, the time it takes to transfer the blood from the syringes to the tubes should not exceed 1 minute.  The reason for such counter-measures is to prevent pre-mature blood clotting.