Phlebotomy
Donna Goodroe BS, and Paul Fekete MD
This online continuing education and refresher course is a comprehensive review of beginning to intermediate aspects of phlebotomy. Covers anatomy, components of blood, equipment and supplies, blood drawing procedures, specimen identification, and venipucture complications. Twelve caste studies emphasize real-world application of learned skills. Ideal for phlebotomy and clinical laboratory science students, this program is also suitable as a review and/or CE for practicing phlebotomists.
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Continuing Education Credits
Objectives
- Introduce students to the theory and practice of phlebotomy.
- Teach students how to interact professionally with patients.
- Teach students about occupational health hazards and appropriate precautions, including the Needlestick Safety and Prevention Act.
- Teach anatomy and physiology appropriate to drawing a blood specimen.
- Show and explain the equipment and supplies used to draw blood.
- Demonstrate phlebotomy procedures.
- Explain specimen identification, labeling, and processing.
- Describe complications of venipuncture and how to handle them.
Course Outline
Click on a link in the outline to view a sample page from this course.
- Introduction
- What is Phlebotomy?
- Laboratory work flow cycle
- Professionalism
- Professionalism: maintaining confidentiality
- Professionalism: attitude
- Professionalism: appearance
- Professionalism: appearance continued
- What are bloodborne pathogens?
- What are bloodborne pathogens?
- Important bloodborne pathogens
- Safety precautions
- OSHA bloodborne pathogens standard
- Standard precautions
- Standard precautions continued
- Personal protective equipment
- Hand washing
- Hazardous waste disposal
- Needlestick safety and prevention act
- Needlestick safety and prevention act continued
- Needlestick safety and prevention act continued
- Needlestick safety and prevention act continued
- Anatomy & Physiology
- Definitions
- Anatomy & physiology: definitions
- Anatomy & physiology: essential to phlebotomy
- Integumentary System
- Integumentary system: structure
- Integumentary system : function
- Cardiovascular System
- Cardiovascular system : structure & function
- Circulation: venous portion
- Circulation: arterial portion
- Circulation: capillary portion
- Blood
- Whole blood: components
- Plasma
- Plasma components
- Plasma water
- Plasma water continued
- Plasma electrolytes
- Plasma sugars
- Plasma proteins
- Plasma lipids
- Plasma drugs and toxins
- Whole blood formed elements
- Red blood cells
- White blood cells
- Platelets
- Blood clots
- Serum
- In the laboratory
- Blood Tests
- Common lab tests
- Panels or profiles
- Hemogram (CBC)
- Electrolytes panel (Lytes)
- Basic metabolic panel (BMP)
- Comprehensive metabolic panel (CMP)
- Obstetric panel
- Lipid panel
- Acute hepatitis panel
- Hepatic function panel
- TORCH panel
- Equipment
- Introduction to phlebotomy equipment
- Phlebotomy trays
- Blood collection tubes: introduction
- Blood collection tubes: types
- Hemogard ™ blood collection tubes
- Blood collection tubes: inversion
- Blood collection tubes: sizes
- Blood collection tubes: expiration dates
- Blood collection tubes: common types
- Lavender top tubes
- Light blue top tubes
- Green top tubes
- Red top tubes
- Speckle top tubes
- Gray top tubes
- Yellow top tubes
- Royal blue top tubes
- Blood culture bottles
- Needles
- Needle components
- Blood transfer device
- Single draw needles
- Multiple draw needles
- Needles with built-in safety devices
- Multiple draw needles with built-in safety features.
- Butterfly needles
- Butterfly needles continued
- Butterflies with built-in safety features
- Butterfly needles with built-in safety features continued
- Lancets
- Plastic holders used with the evacuated tube system
- Needle holders with built-in protection devices
- Needle holders, built-in protection devices contd
- Syringes
- Syringes with built-in safety devices
- Syringes with built-in safety devices contd.
- Tourniquets
- Sterilization materials for phlebotomy
- Bandaging materials
- Gloves
- Sharps disposal containers
- Marking pen
- Collecting Blood
- Routine Venipuncture Procedure
- Greeting
- Greeting continued
- Patient Identification
- Importance of Patient ID
- Patient Identification continued
- Special Requests
- Venipuncture Standard precautions
- Wash hands and apply gloves
- Positioning the patient
- Applying the tourniquet
- Applying the tourniquet continued
- Patient clenches fist
- Choosing a site
- Choosing a site continued
- Alternate Sites
- Sites to avoid
- Routine venipuncture equipment
- Routine Venipuncture equipment continued
- Cleaning the site
- Cleaning the site continued
- Attach needle to holder
- Place tube into holder
- Hold vein in place
- Insert needle
- Push tube onto holder
- Blood won't flow
- Adjust needle
- Multiple tube collections
- Remove needle
- Apply pressure
- Apply adhesive pressure
- Activation of safety device
- Needle disposal
- Specimem labeling
- Specimem labeling continued
- Finger stick - Specimen collection
- Other Blood Collection Procedures
- Heelstick - Pediatric collection procedures: Introduction
- Heelstick - Neonatal Blood collection
- Heelstick - Site selection and preparation
- Heelstick - Puncture
- Heelstick - specimen collection
- Heelstick - Apply sterile gauze
- Butterfly needle - Butterfly needle collections
- Butterfly needle - Butterfly needle collections continued
- Butterfly needle - Butterfly needles and needle-stick injuries
- Butterfly needle - Butterfly needles with built-in safety features
- Butterfly needle - Angel WingTM safety butterfly
- Butterfly needle - Punctur-GuardTM safety butterfly
- Finger stick - Finger stick collections
- Finger stick - Site preparation
- Finger stick - puncture
- Finger stick - Wipe away the first drop
- Finger stick - Specimen collection continued
- Syringe - Syringe blood collections
- Syringe - Syringe blood collections continued
- Syringe - Transferring blood to collection tubes
- Syringe - Transferring blood to collection tubes contd
- Measuring Bleeding Time
- Introduction
- Introduction continued
- Performance
- Bleeding time
- Apply blood pressure cuff
- Prepare the site
- Make the incision
- Wick the blood
- Record elapsed time
- Bandage the incision
- Blood Cultures
- Introduction
- Avoid skin contamination
- Equipment
- Select the site
- Site preparation
- Site preparation continued
- Feel the vein
- Cleen the bottle tops
- Collection methods
- Volume is important
- Activate needle safety device
- Remove iodine
- Additional tips
- Additional tips continued
- Special Blood Collections
- Glucose Tolerance Test
- Introduction
- 12 hour fast
- Collection tubes
- Administration of glucose
- Specimen collection
- Patient observation
- One hour screening test for gestational diabetes
- Therapeutic drug monitoring
- Introduction
- Peak and trough levels
- Collection times
- Legal specimens
- Introduction
- Collection kits
- Urine
- Urine continued
- Blood
- Documentation
- Blood bank specimens
- Patient Care
- Hollister and similar systems
- Hollister and similar systems
- Concept of Hollister and similar systems
- Hollister system: specimen collection and labeling
- Hollister system: armbands
- Hollister system: armbands continued
- Special Patient Procedures
- Uncooperative patients
- Patients refusing blood work
- Fainting
- Fainting continued
- Hematosis
- Blood should not be drawn from arms with IVs
- Signs
- Arms to avoid
- Allergies
- Blood Collection Problems
- Unsatisfactory Specimens
- Unsatisfactory specimens
- Causes
- Hemolysis
- Causes of hemolysis
- Clots
- Causes of clotting
- Insufficient volume
- Partial collection tubes
- Labeling errors
- Causes of labeling errors
- What if no blood flows when the needle is in place?
- Case Studies
- Case Study 1
- Case
- What crucial step did Julie fail to perform?
- Discussion
- Case Study 2
- Case
- Which site should Bobby choose for the venipuncture?
- Discussion
- Case Study 3
- Case
- What had Marcie done to hemolyze the specimen?
- Discussion
- Case Study 4
- Case
- What could have caused the clotting?
- Discussion
- Case Study 5
- Case
- At this point, what should John know to do?
- Discussion
- Case Study 6
- Case
- What did the phlebotomist do wrong?
- Discussion
- Case Study 7
- Case
- What should Julie have done to prevent the needle stick?
- Discussion
- Case Study 8
- Case
- In which order should evacuated tubes be filled to obtain optimal results?
- Discussion
- Case Study 9
- Case
- What did Bobby do that could have falsely prolonged the bleeding time?
- Discussion
- Case Study 10
- Case
- What should the phlebotomist do now?
- Discussion
- Case Study 11
- Case
- In what direction should the lancet be placed on the patient’s finger ?
- Discussion
- Case Study 12
- Case
- What could the phlebotomist do at this point to renew blood flow?
- Discussion
Additional Information
Level of Instruction: Basic
Intended Audience: Phlebotomists and Trainees
General Information: This phlebotomy course covers all basic aspects of phlebotomy with special emphasis on avoidance of exposure to bloodborne pathogens, collecting adequate specimens with analysis of insufficient specimens, collected blood cultures with minimum contamination, and pediatric and neonatal blood collection. It includes 12 interactive case studies.
Author Credentials: Donna Goodroe, BS, is an experienced phlebotomist at Gwinnett Medical Center near Atlanta, and Dr. Fekete is an AP/CP board certified pathologist practicing at the same institution, where he is Medical Director of the Clinical Laboratory. Dr. Fekete was formerly Assistant Professor of Pathology at Emory University. He has authored numerous peer-reviewed journal articles, and several book chapters.
Phlebotomy Keywords
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