What Is a Phlebotomy Technician?

Phlebotomy technicians or simply phlebotomists are an integral part in the healthcare system. But because they are not as popularly advertised as doctors or nurses, not a lot of people know about them. Some patients even label them as a nurse or medical technologists, whenever their blood is drawn. Although any medical personnel can draw blood, this is primarily the job of a phlebotomist, making it a sort of specialty field.

Phlebotomy Technician Explained

Job Responsibilities

As previously mentioned, blood collection and preparation of blood samples are the primary role of a phlebotomy technician. But that is not all. Their responsibilities can vary, depending on their level of work experience and certification, but the fundamentals are the same.

credit:NYmedtraining

Proper Patient Care and Interaction

Collecting blood sample is more terrifying to patients than to phlebotomy technicians, especially to those who faint at the sight of blood or needles. This is why phlebotomists are trained in patient management before, during and after blood collection.

The first thing they must do is to identify patients correctly, based on the laboratory order form provided or from a doctor’s written request. To ensure accuracy, patients should be asked to state their full name and birth date, and then compare the data against the request form. The same thing must be done with inpatients. If they are asleep, a phlebotomy technician must wake them up and go through the standard procedure.

In the event that verbal communication is not feasible, such as on newborn babies or comatose patients, identification will then be based on the medical wristband. Based on the details gathered, they must then label vials with the patient’s name and the date of sample collection. It is also their job to identify which blood collection procedure is appropriate for the patient—fingerstick, venipuncture, etc?

The next step is to explain to the patient what is about to happen. Give them a walkthrough of the blood drawing process, testing and other procedures involved, at the same time, giving assurances that everything will be fine. Part of a phlebotomist job is to be friendly, courteous and sympathetic. It is also essential to check for any allergies to latex, adhesives or even antiseptics, by asking the patient directly, checking the armbands or observing any reaction post-blood collection.

Most importantly, phlebotomy technicians must provide a calm, clean and safe environment for the patients. They must prepare the site where the blood will be drawn, disinfecting it every time, and keeping it organized at all times, particularly their equipment cart or tray.

Collect Blood Samples

There are different ways that phlebotomists can draw blood, including venipuncture, skin puncture and capillaries. Among the three, the first one is the most common. Blood is drawn using a needlestick to the vein, usually located inside the elbow or the back of the hand. Routine venipuncture may also use Butterfly needles, syringes and blood collection tubes.

Skin puncture, on the other hand, covers fingerstick and heelstick procedure to collect plasma, serum and whole blood. The equipment used would differ for different puncture sites. Spring-loaded lancets are used on the finger, while yellow lancets that penetrate 3.2mm are used for the heels.

Then, there is capillary blood collection that is often performed on small children and where only a small amount of blood is required or just for point-of-care testing. But this is also employed for patients with severe burns, have thrombotic tendencies or are obese.

Throughout all these processes, it is the phlebotomists’ job to ensure that the proper puncture site is chosen, the tourniquet is used accordingly and that all safety protocols are followed, especially after the needlestick is removed from the puncture site.

Blood Sample Handling and Processing

Depending on a phlebotomist position and job scope, their duties could extend beyond labeling and transporting blood specimens.

Sample labeling is essential to ensure that the tests match the patient’s ID. The key elements that a phlebotomy technician must check are the patient’s complete name, ID number (which must be identical with that on the requisition form), date and time when the blood was drawn and the initials of the phlebotomist. Automated systems use bar codes to label a sample.

Blood sample centrifugation is essential when separating serum from the cells. To ensure the integrity of the sample, proper pre-centrifugation handling is vital, which includes keeping vacutainer tubes stored at 4-25⁰C and allowing serum separator tubes to clot for a full 30 minutes in vertical position. Centrifugation must be done at most 2 hours after blood is drawn. Throughout the process, safety measures must be observed, such as the following:

• Never interfere with an activated centrifuge
• Do not operate a centrifuge without a cover in place or when it is not properly balanced
• All specimens must be covered prior to centrifugation
• A centrifuge must be cleaned daily with a paper towel and disinfectant, and immediately after spills happen or tubes break

Follow Safety and Infection Control

Blood can be a source of contamination, which is why a phlebotomy technician must be aware of how to keep possible infection under control or limit exposure as much as possible. For their personal protection, they must observe universal precautions.

• Gloves and a laboratory coat must be worn when handling blood or any body fluids
• Gloves must be disposed of properly and replaced after every procedure is completed, especially in events of a suspected contamination
• Phlebotomists must wash their hands properly at all times

Aside from these, they need to dispose of needles and other equipment used properly. A separate disposable bin must be used, with access only granted to medical personnel. In the event that a phlebotomist accidentally punctures himself with a used needle, he must squeeze the puncture site so it will bleed out, wash the affected area well with soap and water, and then follow guidelines regarding treatment. He should also take note of the patient’s identification from which the needle was initially used.

Any blood spills must be cleaned up and then disinfected with freshly made 10% bleach.

To keep patients safe, proper hygiene and safety protocols must be followed. It is also vital that all blood collection equipment is placed away from them, particularly children as well as psychiatric patients.

Carry Out Clerical Duties

A phlebotomist needs to update a patient’s information, record the blood test result on written logs or through computer data entry. When working at an entry level or internship, part of their job is to perform reception work, write out requests for blood sample, and answer telephone calls to set appointments.

There are other details a phlebotomy technician must be aware of, such as the order of draw and which tube should be used based on the additives present. This is why proper training is essential. The most extensive it is the better.