Understanding Phlebotomy PT 1 Flashcards
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
Phlebotomy is the process of collecting blood through vein by using incision or puncture method to draw blood for analysis or as part of _____ or ________ measures under the physician’s request
therapeutic, diagnostic
Phlebotomy is derived from two Greek words which are?
phlebos - vein
temnein/tomos(tome) - to cut
Phlebotomy is also called as _____________
Venesection
Venesection comes from the Latin words
Vena - vein
Sectio - cutting
Evolution of phlebotomy: used crude tools to cut vessels and drain blood from the body
stone age
Evolution of phlebotomy: Ancient Egyptians also practiced phlebotomy as form of “bloodletting”
1400 BC
Evolution of phlebotomy: Hippocrates believed that a person’s health depends on the balance of the four humors
460 - 377 BC
The four humors and their equivalent element: blood and brain
Earth
The four humors and their equivalent element: phlegm and lungs
air
The four humors and their equivalent element: black bile and spleen
fire
The four humors and their equivalent element: yellow bile and gallbladder
water
Evolution of phlebotomy:
blood letting was performed by barber-surgeons as part of the treatment for some illness
middle ages
Evolution of phlebotomy:
phlebotomy was treated as a major therapy
17th and 18th centuries
- alternative medicine
- application of special heated suction cups on the patient’s skin
- incision using a fleam or lancet
cupping
- known as Hirudotherapy
- uses leeches for bloodletting
- used for microsurgical replantation
leeching
Scientific term for medicinal leech?
Hirudo medicinalis
What is present in the saliva of leeches that acts as an anticoagulant?
Hirudin
3 main goals of phlebotomy
- for diagnosis and treatment using blood samples
- for transfusion, to remove blood from donor
- for removal of blood for polycythemia or therapeutic purposes
Two main methods of phlebotomy?
- venipuncture
- capillary puncture
The method of collection of blood through the vein using a needle
venipuncture
Method of collecting blood by puncturing skin using a lancet?
capillary puncture
Which hand is punctured with a lancet in capillary puncture method?
The non-dominant hand
Which fingers are best to puncture with a lancet during capillary puncture?
Middle or ring fingers (lateral)
3 listed credentials needed to be a phlebotomist
- certification or license
- continuing education
- trainings and seminars
Under professionalism:
* conservative clothing
* observe proper personal hygiene
professional appearance
Under professionalism:
- decisions and judgements to patients and fellow co-workers
self confidence
Under professionalism:
- is a personal feeling of “wholeness” derived from honesty and consistency of character
integrity
Under professionalism:
- means being sensitive to a person’s needs and willing to offer reassurance in a caring and humane way
compassion
Under professionalism:
- 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
Under professionalism:
- observe proper work ethic
- take personal responsibility for their actions
dependability
Under professionalism:
- 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
Basic concepts of communication in the healthcare setting: 3 components of good communication
verbal communication, non-verbal communication, and active listening
Type of patient:
non-ambulatory, admitted in the hospital (at least 24 hours)
inpatient
Type of patient:
ambulatory, patients who does walk-ins/follow up check ups
outpatient
3 levels of healthcare?
Primary, secondary, and tertiary
3 levels of healthcare:
healthcare units in rural areas and sub-units [focuses on prevention and basic laboratory routines]
primary
3 levels of healthcare:
non-departmentalized hospitals
secondary
3 levels of healthcare:
medical centers and large hospitals
tertiary
Other healthcare services: medical care given to patients requiring care of follow up check-ups after their discharge from the hospital
ambulatory care
Other healthcare services: done in a patient’s home in a long-term facility
homebound care
Other healthcare services: unit at the local level but are still under the jurisdiction of the health department of the govt.
public health services
- with permanent inpatient beds
- 24-hour nursing service
- managed by organized medical team
- 2 major divisions: clinical analysis area, anatomical and surgical pathology area
hospital
Is the DOH-designated EQAS
National Reference Laboratories (NRL)
National Kidney and Transplant Institute (NKTI) is the NRL-EQAS for?
Hematology and Coagulation
Research Institute of Tropical Medicine (RITM) is the NRL-EQAS for?
Microbiology (identification and antibiotic susceptibility testing, and parasitology (identification of ova and quantitation of malaria)
Lung Center of the Philippines (LCP) is the NRL-EQAS for?
Clinical chemistry (testing 10 analytes, namely glucose, creatinine, total protein, albumin, blood urea nitrogen, uric acid, cholesterol, sodium, potassium, and chloride)
East Avenue Medical Center (EAMC) is the NRL-EQAS for?
drugs of abuse (methamphetamine and cannabinoids)
Concerned with the diagnosis of diseases through microscopic examination of tissues and organs
anatomic pathology
- 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 disease
- 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 (FBS) and Glycosylated hemoglobin
Consists of:
* high and low density lipoprotein
* triglycerides
total cholesterol
this is for the diagnosis of cardiovascular diseases
Total cholesterol
total cholesterol is under what?
lipid profile
Fasting time for FBS?
8-10 hours
elevated levels indicate kidney disorders or gout
blood uric acid
Amount of this found in blood which could determine impaired renal function
blood urea nitrogen
Check for cases that indicate renal impairment of muscular dystrophy
creatinine
elevated levels indicate liver disorders
- alanine aminotransferase
- aspartate aminotransferase
elevated level indicate BONE or LIVER disorders
alkaline phosphatase
Elevated levels indicate liver or hemolytic disorders
Bilirubin
Elevated levels indicate early liver disorders
gamma-glutamyltransferase (GGT)
elevated levels indicate myocardial infarction or lung or liver disorders
lactic dehydrogenase
- elevates level indicate pancreatitis
- these are pancreatic markers
amylase and lipase
Evaluates 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 I
- focused on the identification of bacteria and fungi on specimens received
- most samples are obtained from blood, urine, throat, sputum, genitourinary tract, wounds, CSF, 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 determine the type of fungi
fungal culture
detects the presence of and aids in the identification of bacteria
gram stain
4 steps in gram stain
- crystal violet
- iodine
- alcohol
- safranin
Gram stain color: purple/violet
gram positive
gram stain color: pink or red
gram negative
deals with the enumeration of cells in the blood and other body fluids
hematology
focus on blood testing for the determination of various coagulation factors
coagulation studies
the most common body fluid analyzed in hematology section and a specimen obtained by using a collection tube with lavender stopper
whole blood
What does a collection tube with lavender stopper have?
ethylenediaminetetraacetic acid (EDTA)
liquid portion of blood if it is obtained from a sample that has been anticoagulated and contains fibrinogen
plasma
If the sample of an anticoagulated blood is allowed to clot is the ________?
serum
- most common type of test performed in the hematology section
- screening test to assess patient condition such as infections and malignancy
CBC
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
determine the oxygen-carrying capacity of rbc
hemoglobin
Band cell is an immature type of WBC?
neutrophil
increased levels of neutrophil indicate what?
bacterial infection
increased level of lymphocyte indicate what
viral infection
increased level of monocyte indicate
viral infection, chronic inflammation
increased level of eosinophil are usually shown during what?
allergic reaction and parasitic infection
increased level of basophil is shown during what
allergic infection
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 platelets in circulation blood
platelet count
Units used for mean corpuscular hemoglobin?
percentage (%)
Units used for mean corpuscular hemoglobin
picogram
Units used for mean corpuscular volume
fL
determines the number of RBC
RBC count
calculation to determine the difference in the size of rbc
rbc distribution width
determine the number of wbc in circulating blood
wbc count
determines the number and type of __________ (di kita sa vid)
body fluid analysis
determines the number and type of cell in bone marrow
bone marrow
determines the rate of rbc sedimentation
erythrocyte sedimentation rate
evaluates bone marrow production of RBC
reticulocyte count
used to test for sickle cell
sickle cell test
- overall process of homeostasis (stoppage of blood flow from a damage blood vessel) is evaluated; includes platelets, blood vessels, coagulation factors, fibrinolysis, inhibitors and anticoagulant therapy
- plasma from 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 thromboplastin time
screening test for increase clotting tendencies
antithrombin III
- evaluate the function of platelet
bleeding time
- measures abnormal blood clotting and fibrinolysis
d-dimer
detect factor deficiencies that prolong coagulation
factor assays
tests 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
