Blood Collection Procedures – There Are Many Ways In Which Blood Can Be Drawn From A Vein.
Generally a nurse or a phlebotomy technician performs venesection, also known as phlebotomy. A vein in upper forearm (antecubetal fossa) is used for blood collection mostly. Blood gas measurements use arterial blood. Capillary bed is used for smaller quantity of blood and a capillary puncture or skin puncture is the method used. Point of care tests use the minimum quantity of blood and are performed by capillary puncture.
Venous blood can be collected in many ways. Venipuncture methods can vary depending on the test requirements, age, and physical condition of the patients. The sites to use are those in forearm, wrist, or ankle but the common is forearm veins. This is because forearm veins are generally more fuller and larger than other veins. Three main veins in the forearm are cephalic, median cubital, and median basilic.
An evacuated tube and needle collection system or a sterile syringe and needle can be used for collection of blood from a vein. BD Vacutainer system tubes are widely used where BD represents the company Becton, Dickinson and company, which first marketed these tubes. Evacuated tubes can be combined to use in an infusion or butterfly set.
Vacutainer system makes use of a double ended hypodermic needle, and a holder covers the second short needle for safety. One end of the needle is inserted into the vein and the other end of the two-way needle is semi attached by a holder to the rubber stopper of vacuum tube. Blood rushes into the vacuum tube due to pressure difference between blood volume and vacuum in the tube. When the first tube gets filled with blood, it is removed and another can be filled in the same manner, thus multiple samples can be collected by single puncture. There are published standards for the use of vacutainer tubes for blood collection by the Clinical and Laboratory Standards Institute (formerly known as NCCLS).
A syringe and needle system is often used to collect blood from patient with difficult veins. This is useful for patients that have smaller veins that collapse under the vacuum of BD Vacutainer tubes. An infusion set (Butterfly) is often used for coagulation studies, for babies, and small children with small veins, for obese patients with hard to find veins, for patients receiving intravenous therapy with scarred veins, and for veins other than those in antecubital fossa (wrist, back of hand, ankle, foot, or scalp).
Phlebotomist can have various duties depending on the place of work. Providing assistance to doctors is the primary duty of a phlebotomist in a hospital. Nurses and phlebotomists work in coordination in hospitals. Blood or tissue sample collection is one of the major duties of a hospital technician working as a phlebotomist.
The phlebotomist ensures that a patient is appropriately identified before samples are taken. Part of the hospital technicians duties as a phlebotomist is to correctly puncture or incise a patients skin to take specimens. The phlebotomist is responsible for the amount of blood or tissue taken should be enough for the specified test. Another aspect of the hospital technicians duties as a phlebotomist is that samples are properly labeled. The technician also ensures that properly labeled samples are delivered to the laboratory on time.
Phlebotomists can complete either on job training, cross train from another health care profession, or a formal program from phlebotomy training schools to attain these competencies. Phlebotomy certification from professional associations leads to skill refinement and continuous education for practicing phlebotomists.
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