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Phlebotomy Questions

Questions Phlebotomists Ask:

I am a phlebotomy student in my last semester. My instructor encourages us to take home venipuncture supplies to practice on our family, or friends. The truth is, I am not 100 per cent comfortable with that. What if I damage a vein or nerve. What is the law? My sister says that if my child gets a bruise I can be reported to the Children's and Youth Services for abuse.

Allowing phlebotomy students to practice venipunctures and fingersticks on family members unsupervised at home is most certainly a recipe for disaster and a serious lack of judgment on everybody's part. Aside from the fact that phlebotomy must always be practiced in an appropriate setting, it causes the children unnecessary pain. Anything can go wrong. Nor you, or your instructor have taken into consideration that the following events can easily happen, and then what?

bruising/hematoma

allergic reaction to latex

anxiety attacks

sudden fainting

needle stick injuries

damage to a nerve

injury of a blood vessel

contamination/sepsis

If investigated, this will be seen as child endangerment and abuse. Thing is, only you will be the one held accountable. Be smart! Practice only in your school's clinical lab under the direct supervision of your instructor on fellow students, or the "fake" arm. And if it happens again, report your instructor's action to the head of department at your school.

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I am currently working in a small family practice as "girl Friday". I serve as the front office's receptionist, bookkeeper, secretary, and back office assistant to the doctor. It's a very small practice, and the doctor is used to drawing his own blood samples, but now wants to show me to learn how to do it. He thinks it's a great opportunity to broaden my skills, however, I am worried. With only a little understanding of the arm's anatomy, I feel nervous. The doctor says, it's not that hard, and since I am working under his supervision, nothing can go wrong. I wonder, if venipuncture is really such an easy skill that anybody can learn in 1-2 weeks? Our patients age ranges from the very young, to the very old, and everything inbetween. Please advice.

..Phlebotomy is more of an art than a skill. Perhaps best put as a "skillful art." It starts with proper training which includes the anatomy of the blood vessels, and the arm, hand, wrist, etc.. Also other locations to obtain a blood sample must be learned. Then there is the equipment, and all sorts of techniques, and specimen collection methods. Not to forget the order of draw, labeling, charting, preservation, and transport. Universal precautions, and proper disposal of sharps. Needle stick injuries, and how to handle them... Last but not least the unexpected situations, and emergencies.

I believe that good training and then, lots of practice every day is necessary to become a good phlebotomist. It's nothing to be just "thrown into". Recently I hear a lot of talk about "anybody can be taught to be a phlebotomist" and surprisingly, many programs, and doctors seem to do just that.

Is there something I can suggest to parents with small children? What can I say, or tell them to do to make their child's blood draw experience (and ours) less traumatic?

If your facility agrees with it suggest Emla® cream on both arms (antecubital fossa) applied 1 hour before the appointment. It can make all the difference.

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