Blood Can Be Drawn From A Vein In Many Ways, Depending On The Age And Condition Of The Patient.

Phlebotomy, also known as venesection, is performed by a nurse or a technician known as a phlebotomist. Blood is usually taken from a vein in the upper forearm (antecubetal fossa) is most often chosen for venipuncture. Arterial blood is required for blood gas measurements. Smaller quantity of blood may be obtained from the capillary bed by puncture of the skin ” a capillary puncture or skin puncture. Capillary blood is often used for point of care tests (POCT).

There are many ways in which blood can be drawn from a vein. The best method depends on the age and condition of the patient, equipment available and tests required. The veins generally used for venipuncture are those in the forearm, wrist, or ankle. Blood is most commonly obtained from the veins in the forearm since they are larger and more fuller. There are three main veins in forearm ” cephalic, median cubital, and median basilic. Usually median cubital vein in the forearm is chosen for venipuncture.

Blood is collected from an appropriate site using either syringe needle system, or an evacuated tube and needle system which were first introduced to market by a company called BD (Becton, Dickinson and company, BD Vacutainer system). For some collections from the back of wrist, syringe with a butterfly needle is used in combination with the evacuated tube method.

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.

Even before sample collection, patient identification is the first job of the phlebotomist. Taking blood specimens by correct puncture or incision is the duty of the phlebotomist cum hospital technician. Appropriate volume of blood should be collected as per the tests required and it is also the responsibility of the phlebotomist. Proper and accurate labeling of the samples is also another aspect of job of a hospital technician. Properly labeled samples should be promptly delivered to the testing laboratory which is ensured by the technician.

To achieve these competencies, training from a certified program, or on job training, or cross training from other healthcare profession can be completed by the phlebotomists. Professional association certification leads to fine tuned skills for already employed technicians / phlebotomists and learning basic skills for new graduates.