What Is Phlebotomy? History, Procedure, and Job Description

Reviewed by AIMS Education Staff  

August 4, 2020

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The promising field of phlebotomy is growing at a fast pace due to the high demand for qualified professionals to perform phlebotomy procedures. Read on to find out what phlebotomy is and explore the exciting prospects of pursuing a career in this field.

Phlebotomy Definitions

What Is Phlebotomy?

The term phlebotomy originates from the Greek language and has its roots in the words phelps, meaning vein, and tomia, meaning cutting off. Phleb and phlebo are prefixes that you may hear in modern medicine. They stand for vein and indicate a vein in anatomy. Hence, phlebotomy describes the process of drawing blood by venipuncture. The procedure serves for diagnosing medical conditions by testing, implementing therapy, and blood donation. 

What Is a Phlebotomist?

Although doctors and nurses are capable of drawing blood, the qualified professionals to perform the procedure are called phlebotomists. They undergo specialized training that prepares them for the various job responsibilities. A phlebotomist's duties go beyond simply drawing blood. They can also assist with blood transfusions, lab processing, collecting blood for donations, and keeping patient records up to date. The interesting job of phlebotomists has an intriguing history.  You will surely love to discover some phlebotomy secrets and explore more facts about this practice. 

The Origins of Phlebotomy: Bloodletting

With a history spanning over 3,000 years, bloodletting is one of medicine’s oldest practices. It originated in ancient Egypt and later spread across Europe and Asia to become the standard method to prevent or cure illness and disease. Ancient people used it with varying success to treat hundreds of medical conditions such as fever, headache, cholera, plague, pneumonia, tetanus, tuberculosis, etc.  

Among the various methods that doctors applied back in time, venesection (phlebotomy) and scarification with leeches were most common. Physicians often recommended venesection, while surgeons or barbers carried it out. They performed the procedure by using lancets or fleams to puncture the larger external veins and thus draw blood. The use of leeches became more common during the early nineteenth century and involved placing them over certain areas and organs of the body. 

Modern medicine considers the ancient practice of bloodletting controversial because of the risk of losing too much blood. Instead, Western medicine uses therapeutic phlebotomy, which we will explore later on in this article.

The Phlebotomy Procedure

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The most common reason for carrying out phlebotomy is for diagnostic testing. The procedure itself could also serve for blood transfusion, apheresis, and experimental tests. Standards need to be followed before, during, and after phlebotomy. Students who start learning the basics need to understand them all as part of their training. 

Now let’s look into what a phlebotomist does and the best practices in blood collection.

Best Practices in Phlebotomy and Blood Collection

The World Health Organization issued a guide that defines the best practices in phlebotomy. Following these guidelines prevents many common risks of unsafe phlebotomy procedures. 

According to this guide, one should perform the method at an appropriate location with a written protocol at hand, where indications for blood sampling are clearly defined. Before carrying out the procedure, the phlebotomy technician needs to calculate the volume of blood to be drawn. It often depends on the purpose of the blood draw as different tests require specific amounts.

The phlebotomy procedure itself begins with collecting and assembling the equipment. After this, the phlebotomist checks the medical record, meets the patient, and prepares them. At this point, the phlebotomy tech may need to have the patient discontinue certain medications and schedule a later visit. 

Once the pre-phlebotomy preparation is over, the patient should be either lying down or sitting. They must not be drinking, eating, or chewing gum at the time of the procedure. This can prevent common risks like mild soreness or hematoma. The phlebotomist locates a visible vein of good size, disinfects the skin, and draws blood samples in the correct order. 

Lastly, the phlebotomy technician completes the procedure by preparing samples for transportation and cleaning up the site. These steps might slightly vary in the case of donation, transfusion, and apheresis.

Phlebotomy Order of Draw

Depending on the specific procedure, technicians must take blood samples in a strict order. Guidelines advise that the order of draw and additives in blood collection is as follows: 

  • Blood culture
  • Sodium citrate
  • EDTA (full blood count, etc.)
  • EDTA (transfusion samples)
  • Fluoride
  • Oxalate
  • Trace element

Each of them corresponds to a specific volume and cap color. Do you want to check your knowledge of the phlebotomy order of draw? Take this quiz on the tube colors and additives.

Therapeutic Phlebotomy

Therapeutic phlebotomy is the contemporary form of bloodletting.  It is still used for treating certain medical conditions and has way fewer risks compared to ancient practices. Therapeutic phlebotomy removes extra red blood cells, unusually shaped red blood cells, or extra iron in the blood. It is used to treat people with any of the below conditions:

  • Polycythemia vera (a type of blood cancer)
  • Hemochromatosis (iron overload)
  • Porphyria cutanea tarda (the most common type of porphyria)
  • Sickle cell disease (atypical hemoglobin)
  • NAFLD with hyperferritinemia (a type of liver disease).

Side effects during and after the procedure are uncommon. It is a preferred treatment for various blood disorders.

Mobile Phlebotomy Services 

Mobile phlebotomy is a convenient service that allows collecting blood samples outside of hospitals. It is a reasonable option for people working full time and those being physically unable to endure wait times.  

Since going to the hospital for a blood test can be a very stressful experience for the patients, mobile phlebotomy is a solution. They can organize it on a date, time, and location that suits their needs and schedule. What’s more, appointments can take place in a home, office, school, and almost any other setting. The service is convenient for nursing homes and care centers.

The mobile phlebotomy procedure itself strictly follows the well-known steps. Phlebotomy techs collect blood samples following the best practices, label them, and send them to the lab for analysis. The mobile service can come at a small cost, based on the condition of the individual that requires the testing, as well as their physical location. The only disadvantage of this method is that it doesn’t allow all phlebotomy procedures.

Is Phlebotomy a Good Career

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Phlebotomy Is in High Demand

Phlebotomy is a high demand field, projected to grow 23% between now and 2028. This means more job openings in various work environments, like hospitals, medical labs, and blood donor centers. 

Phlebotomy is one of the fastest-growing medical careers in New Jersey and offers promising employment opportunities across the US. Having in mind the short duration of the phlebotomy training program, it is worth the time and effort to pursue.

Phlebotomist Salary

According to the US Bureau of Labor Statistics, the median annual phlebotomy technician salary in May 2019 was $35,510. This number varies across different workplaces as outpatient care centers tend to pay most while hospitals report the lowest figure. 

Phlebotomists in certain settings and states can earn as much as $49,750 per year. The salary rates depend on the further education and qualifications of the phlebotomy technician. Additional skills and certifications open more opportunities for career progression and increased salary.

How to Become a Phlebotomist

You are probably wondering how long it takes to become a phlebotomist. Unlike other allied healthcare programs that can take up to 2 years, phlebotomy training can be completed in as little as 1-2 months.

Once you finish the class and lab instruction, getting certified is highly recommended. Although not mandatory, specialists who choose to obtain a phlebotomy certification have better chances of securing an entry-level job and receiving a higher salary.  

In conclusion, there are many great reasons to become a certified phlebotomist tech. It offers a fast-track career path to reach more senior roles and a good salary for such a short training period.