Phlebotomy Procedure Steps

In order to perform a safe and successful phlebotomy procedure, the technician must follow all the steps correctly. A correct , non-contaminated draw is needed to perform various blood studies in making accurate diagnosis in patient’s conditions. It is a procedure that many patients fear and can become an unpleasant experience based on the techniques used by the phlebotomist. There are specific steps in performing a phlebotomy procedure in order to achieve the best results.

Phlebotomist Procedure Checklist

Step 1 – Patient Awareness

Once the phlebotomist receives the order to take a blood sample, the equipment is prepared and each patient has their registration number on a sticker that is used to label the samples. The patient is approached and informed about the procedure. Proper identification of the patient MUST be followed for safety purposes.

Step 2 – Proper Sanitation

Proper hand washing is performed by the phlebotomist and then examination of the patient’s veins to identify the most suitable site  to perform the venepuncture. The insertion area is also cleansed with an antiseptic preparation pad.

Step 3 – Vein Preparation

A tourniquet is applied above the site to allow the vein to bulge and become more prominent before the needle is inserted. The hand is held steady and the patient is cautioned that a needle will be introduced into the vein, the procedure will be quick and it’s important the patient understands not to move the arm or hand even if they experience temporary pain or discomfort.

Step 4 – Needle Size Selection and Angle

The needle size used is determined by the actual size of the patient’s vein. It is held with the bevel up and at a twenty five (25) to thirty five (35) degree angle for accurate insertion. The angle of insertion is also based on the comfort level and experience of the phlebotomist. Once the needle is introduced, blood will flow into the tube that is attached to the needle.

Step 5 – Blood Draw

When the desired amount of blood is collected in the container, the tourniquet is pulled and the needle removed slowly and a band aid is applied over the puncture site. Slight pressure is applied to the post insertion site to stop the bleeding.

The patient can be asked to continue to apply pressure as well. The phlebotomist should never leave the room until clotting is finalized. This is to prevent prolong bleeding and ensure the safety of the patient. The blood samples are then shaken to prevent coagulation, prepared and labeled before leaving the room.

Final Considerations

A phlebotomist will encounter many patients that have a fear of needles and/or  the sight of blood. Many patients are also concerned that the phlebotomist will miss the vein, fearing that once the vein is missed, there will be another attempt.  Another fear is of the needle going through the whole vein.  Even though the phlebotomist properly identified the vein and is confident that the needle will go directly in, the skin can slide which can cause the needle to go all the way through, causing a hematoma to be formed from bleeding under the patients skin, with mild bruising that will last for several days.

Although there are some minor risks, it’s important the phlebotomist reassures the patient and takes time to follow all  the steps outlined correctly.

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