Chapter 11:
Past and Present and the Healthcare Setting
What is Phlebotomy:
Phlebotomy is the practice of drawing blood. The word phlebotomy is derived from Greek: phlebo- means "vein," and -tomy means "to make an incision.
Stone Age:
Crude tools used to cut vessels & drain out blood
Egypt (1400 BC)
- Tomb painting shows leech applied to patient for bloodletting
Middle Ages
- Barber-surgeons performed bloodletting & leeching
- Barber pole (red & white): represented blood of patient
- Bleeding bowl: used to collect blood from patient
17th & 18th Centuries
- Phlebotomy became a major therapy
- Lancets & fleams were used to cut veins & arteries
- Cupping & leeching were used
Art of Cupping
- Application of heated suction device, the cup
- Incision with a fleam (lancet)
Single or double-edged blade
Multiple fleams attached & folded for ease of carrying, blades wiped clean with a rag
Leeching
- Place drop of milk or blood on the patient's skin
- Introduce Hirudo medicinalis to the site that injects:
• Local vasodilator
• LocaI anesthetic
• Hirudin, an anticoagulant
• Present day
- Used in microsurgical replantation
MODERN PHLEBOTOMY
Modern phlebotomy shares little more than a name with these ancient practices. Today, phlebotomy is performed primarily for diagnosis and monitoring of a patient's disease condition, and it involves highly developed and rigorously tested procedures and equipment to ensure the safety and comfort of the patient and the integrity of the sample collected.
Goals and Methods of Phlebotomy Today
Remove blood for transfusions at a donor center
Remove blood for therapeutic purposes (polycythemia)
Obtain blood for diagnostic purposes & monitor treatment
Methods
Venipuncture: blood collection via a needle inserted in a vein
Capillary puncture: blood collection via skin puncture
Patient-Client Interaction
Customer Relations
- Phlebotomist may be only contact patient has with lab
- Patient may judge hospital based on encounter with phlebotomist
Goal: put patient at ease & establish positive relationship
Qualities of Professionalism
• Professional appearance
• Self-confidence
• Integrity
• Compassion
• Dependability
• Ethical behavior
Confidentiality
• Patient information must be kept private & confidential
• Ethical standards & laws enforce confidentiality
• Health Insurance Portability & Accountability Act (HIPAA)
- Safeguards confidentiality of protected health info (PHI)
-Established national standards for electronic exchange of PHI
- States that patients must be informed of rights
-Disclosure of PHI requires written authorization
Communication Skills
Communication:The means by which information is exchanged or transmitted
Verbal
- Active listening
- Nonverbal (body language)
Kinesics: study of nonverbal communication
Proxemics:use of space
• Appearance
• Touch
Elements of Effective Healthcare Communication
- Empathy
- Control
- Respect & confirmation
- Trust
