Understanding Phlebotomy Flashcards
It is the process of collecting blood through vein by using incision or puncture method to draw blood for analysis or as part of THERAPEUTIC or DIAGNOSTIC measures under the physician’s request.
Phlebotomy
What does phlebos mean?
Vein
What dies temnien/tomos/tome mean?
To cut
Phlebotomy also called as
Venesection
Vena means
Vein
Sectio means
Cutting
In this age, crude tools were used to cut vessel and drain blood from the body.
Stone Age
Ancient Egyptians also practiced phlebotomy as form of “bloodletting”
1400 BC
In 1400 BC, what did they use to suck blood?
Leeches
What year did Hippocrates believed that a person’s health depends on the balance of the four humors?
460-377 BC
Earth corresponds to
blood and brain
Air corresponds to
phlegm and lungs
Fire corresponds to
black bile and spleen
Water corresponds to
Yellow bile ad gall bladder
- It is the alternative medicine
- application of special heated suction cups on the patient’s skin
cupping
- known as Hirudotherapy
- use leeches for bloodletting
- used for microsurgical replantation
Leaching
Hirudin means
anticoagualant to prevent the blood to clot
for diagnosis and treatment using blood samples
for transfusion, to remove blood from donor, and
for removal of blood for polycythemia or therapeutic purposes
Main Goals of Phlebotomy
What is the two main methods of phlebotomy
Venipuncture and Capillary puncture
Is the method of collection of blood through the vein of arm, back of the hands, or foot using a needle
venipuncture
Blood is collected by puncturing the skin using a lancet
capillary puncture
The ff is the
- Good manual dexterity
- Thorough knowledge of laboratory specimen requirements
- Special communication skills
- Training in phlebotomy skills
- Good organizational skills
Traits that form the Professional Image of the Phlebotomists
What are the need credentials of phlebotomist to practice?
- Certification or license
- Continuing education
- Trainings and seminars
- Reassuring and pleasant
- Good communication with patients
- Maintain positive customer relations
- Understand patient’s diversity
Patient-Client Interaction
- conservative clothing
- observe proper personal hygiene
Professional appearance
- decisions and judgements to patients and fellow co-workers
Self confidence
is a personal feeling of “wholeness” derived from honesty and consistency of character
. Integrity
- means being sensitive to a person’s needs and willing to offer reassurance in a caring and
humane way.
Compassion
- takes initiative to follow through on tasks
- consistently strives to improve and correct behavior
- makes every effort to provide excellence in all aspects of patient care
Self-motivation
- observe proper work ethic
- take personal responsibility for their actions
Dependability
- is a system of moral principles or standards that govern conduct and the distinction between
right and wrong. - code of ethics
- PRIMARY OBJECTIVE: to safeguard the patient’s welfare
- to avoid harming the patient in any way
. Ethical behavior
- takes initiative to follow through on tasks
- consistently strives to improve and correct behavior
- makes every effort to provide excellence in all aspects of patient care
Self-motivation
- observe proper work ethic
- take personal responsibility for their actions
Dependability
Basic Concepts of Communication in the Healthcare Setting are:
verbal, non-verbal communication and active listining
type of communication, expressing ideas through words
Verbal Communication
type of communication,
- patient’s facial expressions and
- kinesics - body motion and language
- proxemics - individual’s concept and use of space
- appearance - attire
- touch - thoughtful expression
Non-verbal communication
Two types of the Healthcare Setting
inpatient and outpatient
Inpatients means
non-ambulatory
Outpatient means
ambulatory
level of healthcare
health units in rural areas and sub-units
primary
level of healthcare
non-departmentalized hospitals
secondary
level of healthcare,
– medical centers and large hospitals
tertiary
medical care given to patients requiring care of follow up checkups after their discharge from the hospital
Ambulatory care
done in a patient’s home or in a long-term facility
Homebound care
unit at the local level but are still under the jurisdiction of the health department of the government
Public Health Services
- With permanent inpatient beds
- 24-hour nursing service
- Managed by organized medical team
Hospital
2 major divisions of hospital
- Clinical analysis area
- Anatomical and Surgical Pathology area
This section is intended for the testing of blood and other body fluids to quantify essential soluble chemicals including waste products useful for the diagnosis of certain diseases.
▪ analyzes serum and plasma for chemical constituents to evaluate general health and disorders of body systems and organs
Clinical Chemistry
for the diagnosis of diabetes mellitus
fasting blood sugar or FBS and Glycosylated Hemoglobin
- High- and Low-Density Lipoprotein
- Triglycerides
- For the diagnosis of cardiovascular diseases
Total Cholesterol
Elevated levels indicate kidney disorders or gout
Blood uric acid
Elevated levels indicate kidney disorders
Blood Urea Nitrogen
Elevated levels indicate kidney disorders
Creatinine
Elevated levels indicate liver disorders
Aspartate aminotransferase
Elevated levels indicate bone or liver_ disorders
Alkaline phosphatase
Elevated levels indicate liver or hemolytic disorders
bilirubin
Elevated levels indicate early liver disorders
gamma-glutamytransferase (GGT)
- Elevated levels indicate myocardial infarction or lung or liver disorders
lactic dehydrogenase
Elevated level indicate pacreatitis
amylase and lipase
Evaluate body fluid balance
electrolytes (Na, K, Cl, CO2)
– levels of the BNP hormone in the blood which could indicate
congestive heart failure
B-type natriuretic Peptide (BNP) test
monitors therapeutic range to avoid toxic levels for drugs
drug analysis
– used to check liver and kidney disorders
total protein
– used for early diagnosis of acute myocardial infarction
troponin 1
This section is subdivided into four sections:
* Bacteriology
* Mycobacteriology
* Mycology and Virology
* Focused on the identification of bacteria and fungi on specimens received.
* Most samples are obtained from the blood, urine, throat, sputum, genitourinary tract, wounds,
cerebrospinal fluid, and feces
Microbiology
Detect microbial infection and determines antibiotic treatment
culture and sensitivity
Detects bacteria and fungi in blood
blood culture
Detects the presence of and determines the type of fungi
fungal culture
Detects the presence of and aids in the identification of bacteria.
gram stain
This section deals with the enumeration of cells in the blood and other body fluids (e.g., CSF,
pleural fluid, etc.)
* Coagulation studies focus on blood testing for the determination of various coagulation factors
Hematology and Coagulation studies
- Is the most common type of test performed in the Hematology section
- Screening test to assess patient conditions such as infections and malignancy
Complete Blood Count
Determines the percentage of the different types of WBC and evaluates RBC and platelet morphology
differential
Determines the volume of RBC packed by CENTRIFUGATION
hematocrit
Determines the OXYGEN-carrying capacity of RBC
hemoglobin
Determines the amount of hemoglobin in RBC
mean corpuscular hemoglobin
Determines the weight of hemoglobin in RBC and compares it with the size of the cell
mean corpuscular hemoglobin concentration
Determines the size of RBC
mean corpuscular volume
Determines the number of RBC in circulating blood
red blood cell count
Calculation to determine the differences in the
red blood cell distribution width
Determines the number of WBC in circulating blood
white blood cell count
- Determines the number and type of cells in bone marrow
▪ Hematology and Coagulation studies
body fluid analysis
Determines the number and type of cells in bone marrow
bone marrow
Determines the rate of RBC sedimentation
erythrocyte sedimentation rate
Evaluates bone marrow production of RBC
reticulocytes count
Screening test for sickle cell anemia
sickle cell
increased of the neutrophils will lead to:
bacterial infection
increased of the ff will lead to: lymphocytes =
viral infection
increased of the ff will lead to: monocytes=
viral infection or chronic inflammation
increased of the ff will lead to: eosinophil =
allergy and parasitic infection
increased of the ff will lead to: basophil =
= allergic reactions
- In this area, the overall process of Hemostasis (stoppage of blood flow from a damaged blood vessel) is evaluated; this includes platelets, blood vessels, coagulation factors, fibrinolysis, inhibitors and anticoagulant therapy
- Plasma from a sample drawn in tube with light blue stopper that contains the anticoagulant sodium citrate
Coagulation Section
Evaluates the intrinsic system of coagulation cascade and monitors heparin therapy
activated partial thrombosplatin time
Screening test for increased clotting tendencies
antithromblin III
- Evaluate the function of platelets
bleeding time
- Measures abnormal blood clotting and fibrinolysis
▪ Hematology and Coagulation studies
D-dimer
- Detect factor deficiencies that prolong coagulation
Factor Assays
Test for increased fibrinolysis
Fibrin degradation products
Determines the amount of fibrinogen in plasma
Fibrinogen
Evaluates the function of platelets
Platelet aggregation
Evaluates the extrinsic system of coagulation cascade and monitors Coumadin therapy
Prothrombin time and international normalized ratio
Determines if adequate fibrinogen is present for normal coagulation
Thrombin time
This section comprise two areas
* Urine analysis and other body fluids
* Examination of stool or routine fecalysis
* Urinalysis is the routine screening procedure to detect disorders and infections of the kidney
and to detect metabolic disorder such as diabetes mellitus and liver disease.
* Consists of physical, chemical, and microscopic examination in urine
Clinical Microscopy
- detects blood, bilirubin and other pigments
- Depends on hydration status
- Normal color of urine = yellow
color
Detects cellular and crystalline elements
Appearance
Measures the concentration of urine
Specific gravity
Determines the acidity of urine
ph
Elevated levels indicate kidney disorders
Protein
Elevated levels indicate diabetes mellitus
Glucose
Detects red blood cells or hemoglobin
. Blood -
Elevated levels indicate liver disorders
Bilirubin
Elevated levels indicate liver or hemolytic disorder
Urobilinogen
Detects bacterial infection
Nitrite
Detects WBC and indicates urinary tract infection or UTI if there is a lot of neutrophils
Leukocyte esterase
determines the number and type of cellular elements
Microscopic
blood typing and compatibility test are the two main activities performed in this section.
Screening for all antibodies and identification of antibodies as well as blood components used for transfusion are also conducted.
* Blood bank samples are collected in plain red, lavender, or pink stopper plasma.
Immunohematology/Blood Banking
ABO and Rh typing
Group and Type
Detects abnormal antibodies in serum
Antibody screen
Detects abnormal antibodies on RBCs
- Direct antihuman globulin test or direct Coombs
Identifies abnormal antibodies in serum
Panel
ABO, Rh typing, and compatibility test
. Type and crossmatch
ABO, Rh typing, and compatibility test
Type and screen
- Performs tests to evaluate the body’s immune response; that is, the production of antibodies and cellular activation
- Analyses of serum antibodies in certain infectious agents (primarily viral agents) are performed in this section bacterial infection and indicates urinary tract infection or UTI if there is a lot of neutrophils cellular elements blood typing compatibility test
antibodies serum antibodies - Hepatitis B profile tests, serological test for syphilis, and tests for hepatitis C and dengue fever
are some examples of antibody screening tests - Blood for this section is collected with red stoppers
Immunology/Serology
Screening test for _human immunodeficiency virus
Anti-HIV
Hormone found in the urine and serum during pregnancy
Human chorionic gonadotropin (HCG)
Elevated levels indicate inflammatory disorders
C-reactive protein (CRP)
Detects cytomegalovirus infection
Cytomegalovirus antibody (CMV)
Detects hepatitis A current or past infection
hepatitis A
Detects hepatitis B current or past infection
hepatitis B
Detects hepatitis C current or past infection
hepatitis C
Evaluate the function of immune system
. Immunoglobulin (IgA, IgG, IgM) levels
screening test for syphilis
Venereal Disease Research Laboratory (VDRL) and Rapid Plasma Reagin (RPR)
stands for short turnaround time
STAT
STAT means
Immediately
Usually located near the emergency room of some tertiary-care facilities
STAT Laboratory
Is a large and independent laboratory
Reference laboratory
Provides specialized and confirmatory laboratory tests for blood, urine, and tissues
FAST turnaround time
Reference Laboratory
Phlebotomy came from the greek words, phlebos which means vein and ________ which means to cut
temnein or tomos
. Cupping and leeching during the 17th century were performed using ________ and fleams.
Lancet
The main goals of phlebotomy practice are ________________ and treatment, transfusion and removal of blood for therapeutic purposes.
Diagnosis
The credentials of the phlebotomist are certification, _____________, and continuing education.
Licensure
. Area in the laboratory where microscopic structure of tissues are performed.
Anatomical and surgical pathology
This urine reagent strip parameter indicates patient with urinary tract infection
Leukocyte esterase
Reference laboratory for hematology
NKTI
Lipase is laboratory test that is performed in what section in the clinical laboratory?
Clinical Chemistry
. What section in the clinical laboratory does rapid plasma reagin is performed?
Immunology and Serology
Required fasting hours for fasting blood sugar
8-10 hours
