vi Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. vii
T he successful practice of phlebotomy requires a
combination of highly skilled technique, wide
knowledge of the current health care environment,
the essentials of the techniques before, during, and
after their practical laboratory experience.
In addition to thorough training in the skills of
and a sympathetic approach to patients of all ages, phlebotomy, this text provides an introduction to
backgrounds, and medical conditions. We have de- development of skills beyond blood collection
signed Phlebotomy: Worktext and Procedures Man- with a chapter on point-of-care testing. In this
ual, 4th edition, to provide a complete introduction way, phlebotomy students can begin their training
to the practice of phlebotomy in all its aspects. We as multiskilled health professionals ready for the
believe its emphasis on procedures, its up-to-date challenges of the modern health care workplace.
and thorough professional information, and its com-
prehensive approach to the many situations encoun-
tered by the modern phlebotomist make it a unique ORGANIZATION
and valuable offering in the field of phlebotomy The text is divided into five units. Unit 1 provides
training. an introduction and general information needed for
working in a health care facility. Unit 2 covers the
basics needed to study phlebotomy, from medical
WHO WILL BENEFIT FROM THIS terminology to anatomy and physiology. Unit 3
BOOK? features the various methods of specimen collec-
Phlebotomy: Worktext and Procedures Manual, tion, including venipuncture, dermal puncture, arte-
4th edition, is suitable for phlebotomy certification rial blood collection, and special procedures. Unit 4
programs, medical technologist and medical labo- presents specimen handling, processing, and point-
ratory technician programs, medical assisting pro- of-care testing. Unit 5 concludes the text with a
grams, and nurse training. No prior training in section on professional issues. Individual units and
phlebotomy is assumed. The text may also be used chapters may be taught in the sequence chosen by
by experienced phlebotomists, allied health profes- the instructor. Numerous Flash Forward and Flash-
sionals, or nurses seeking to expand or update their back notes help the student connect and recall mate-
training in phlebotomy. rial from different chapters. A comprehensive index
is provided to allow quick access to any topic.
WHY IS THIS BOOK IMPORTANT
,http://evolve.elsevier.com/Warekois/phlebotomy PREFACE ix
,Contents
UNIT 1 Introduction to Phlebotomy
1 Introduction to Phlebotomy, 1
2 Health Care Structure, 12
3 Safety, 26
4 Infection Control, 38
UNIT 2 Phlebotomy Basics
5 Medical Terminology, 55
6 Human Anatomy and Physiology, 65
7 Circulatory, Lymphatic, and Immune Systems, 95
UNIT 3 Specimen Collection
8 Venipuncture Equipment, 113
9 Routine Venipuncture, 128
10 Capillary Collection, 151
11 Venipuncture Complications, 166
12 Blood Collection in Special Populations, 181
13 Arterial Blood Collection, 195
14 Special Collections and Procedures, 206
15 Special Nonblood Collection Procedures, 222
UNIT 4 Specimen Handling
16 Specimen Handling, Transport, and Processing, 233
17 Point-of-Care Testing, 243
UNIT 5 Professional Issues
18 Quality Phlebotomy, 255
19 Legal Issues in Phlebotomy, 267
APPENDIXES
A Metric System Measurements, 279
B Common English-Spanish Phrases for Phlebotomy, 280
C Competency Checklists, 282
D Common Abbreviations, 297
E Mock Certification Exam, 299
F Answers to Chapter Questions and Mock Certification Exam, 315
Glossary, 343
Index, 353
, UNIT 1
Introduction to Phlebotomy
CHAPTER 1 Introduction to Phlebotomy
T he modern phlebotomist is a professional trained
to draw blood who has a variety of job skills and
personal characteristics, including communication
education courses keep the phlebotomist up to date on
the latest changes in techniques and regulations in the
field. The phlebotomist must also be aware of impor-
skills, organizational skills, and compassion. After tant legal issues, including patient confidentiality, in-
initial training, the phlebotomist may become certified formed consent, and Health Insurance Portability and
by one or more professional organizations. Continuing Accountability Act (HIPAA) regulations.
OUTLINE
What Is Phlebotomy? Professional Organizations and Legal Issues in Phlebotomy
Modern Phlebotomy Standards Informed Consent
Job Skills Accreditation Confidentiality
Job Duties Certification HIPAA
Personal Characteristics State Licensure Review for Certification
Continuing Education
OBJECTIVES
After completing this chapter, you should be able to:
1. Define phlebotomy. 5. Differentiate accreditation and certification.
2. List at least five job skills that are important for 6. Identify professional organizations with an interest
phlebotomists to have, and explain why each is in phlebotomy.
important. 7. Explain why informed consent and confidentiality
3. Describe the major duty of phlebotomists, and dis- are important legal issues for phlebotomists.
cuss four other responsibilities that are important.
4. List six personal qualities that characterize a profes-
sional, and explain how phlebotomists demonstrate
these qualities.
KEY TERMS
accreditation continuing education units phlebotomy standards
approval (CEUs) protected health
certification informed consent information
AB B R EVIAT IO N S
ACA American Certification Agency for Healthcare ASCP American Society for Clinical Pathology
Professionals ASPT American Society of Phlebotomy Technicians
AMT American Medical Technologists CEUs continuing education units
ASCLS American Society for Clinical Laboratory Science CPT certified phlebotomy technician
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. vii
T he successful practice of phlebotomy requires a
combination of highly skilled technique, wide
knowledge of the current health care environment,
the essentials of the techniques before, during, and
after their practical laboratory experience.
In addition to thorough training in the skills of
and a sympathetic approach to patients of all ages, phlebotomy, this text provides an introduction to
backgrounds, and medical conditions. We have de- development of skills beyond blood collection
signed Phlebotomy: Worktext and Procedures Man- with a chapter on point-of-care testing. In this
ual, 4th edition, to provide a complete introduction way, phlebotomy students can begin their training
to the practice of phlebotomy in all its aspects. We as multiskilled health professionals ready for the
believe its emphasis on procedures, its up-to-date challenges of the modern health care workplace.
and thorough professional information, and its com-
prehensive approach to the many situations encoun-
tered by the modern phlebotomist make it a unique ORGANIZATION
and valuable offering in the field of phlebotomy The text is divided into five units. Unit 1 provides
training. an introduction and general information needed for
working in a health care facility. Unit 2 covers the
basics needed to study phlebotomy, from medical
WHO WILL BENEFIT FROM THIS terminology to anatomy and physiology. Unit 3
BOOK? features the various methods of specimen collec-
Phlebotomy: Worktext and Procedures Manual, tion, including venipuncture, dermal puncture, arte-
4th edition, is suitable for phlebotomy certification rial blood collection, and special procedures. Unit 4
programs, medical technologist and medical labo- presents specimen handling, processing, and point-
ratory technician programs, medical assisting pro- of-care testing. Unit 5 concludes the text with a
grams, and nurse training. No prior training in section on professional issues. Individual units and
phlebotomy is assumed. The text may also be used chapters may be taught in the sequence chosen by
by experienced phlebotomists, allied health profes- the instructor. Numerous Flash Forward and Flash-
sionals, or nurses seeking to expand or update their back notes help the student connect and recall mate-
training in phlebotomy. rial from different chapters. A comprehensive index
is provided to allow quick access to any topic.
WHY IS THIS BOOK IMPORTANT
,http://evolve.elsevier.com/Warekois/phlebotomy PREFACE ix
,Contents
UNIT 1 Introduction to Phlebotomy
1 Introduction to Phlebotomy, 1
2 Health Care Structure, 12
3 Safety, 26
4 Infection Control, 38
UNIT 2 Phlebotomy Basics
5 Medical Terminology, 55
6 Human Anatomy and Physiology, 65
7 Circulatory, Lymphatic, and Immune Systems, 95
UNIT 3 Specimen Collection
8 Venipuncture Equipment, 113
9 Routine Venipuncture, 128
10 Capillary Collection, 151
11 Venipuncture Complications, 166
12 Blood Collection in Special Populations, 181
13 Arterial Blood Collection, 195
14 Special Collections and Procedures, 206
15 Special Nonblood Collection Procedures, 222
UNIT 4 Specimen Handling
16 Specimen Handling, Transport, and Processing, 233
17 Point-of-Care Testing, 243
UNIT 5 Professional Issues
18 Quality Phlebotomy, 255
19 Legal Issues in Phlebotomy, 267
APPENDIXES
A Metric System Measurements, 279
B Common English-Spanish Phrases for Phlebotomy, 280
C Competency Checklists, 282
D Common Abbreviations, 297
E Mock Certification Exam, 299
F Answers to Chapter Questions and Mock Certification Exam, 315
Glossary, 343
Index, 353
, UNIT 1
Introduction to Phlebotomy
CHAPTER 1 Introduction to Phlebotomy
T he modern phlebotomist is a professional trained
to draw blood who has a variety of job skills and
personal characteristics, including communication
education courses keep the phlebotomist up to date on
the latest changes in techniques and regulations in the
field. The phlebotomist must also be aware of impor-
skills, organizational skills, and compassion. After tant legal issues, including patient confidentiality, in-
initial training, the phlebotomist may become certified formed consent, and Health Insurance Portability and
by one or more professional organizations. Continuing Accountability Act (HIPAA) regulations.
OUTLINE
What Is Phlebotomy? Professional Organizations and Legal Issues in Phlebotomy
Modern Phlebotomy Standards Informed Consent
Job Skills Accreditation Confidentiality
Job Duties Certification HIPAA
Personal Characteristics State Licensure Review for Certification
Continuing Education
OBJECTIVES
After completing this chapter, you should be able to:
1. Define phlebotomy. 5. Differentiate accreditation and certification.
2. List at least five job skills that are important for 6. Identify professional organizations with an interest
phlebotomists to have, and explain why each is in phlebotomy.
important. 7. Explain why informed consent and confidentiality
3. Describe the major duty of phlebotomists, and dis- are important legal issues for phlebotomists.
cuss four other responsibilities that are important.
4. List six personal qualities that characterize a profes-
sional, and explain how phlebotomists demonstrate
these qualities.
KEY TERMS
accreditation continuing education units phlebotomy standards
approval (CEUs) protected health
certification informed consent information
AB B R EVIAT IO N S
ACA American Certification Agency for Healthcare ASCP American Society for Clinical Pathology
Professionals ASPT American Society of Phlebotomy Technicians
AMT American Medical Technologists CEUs continuing education units
ASCLS American Society for Clinical Laboratory Science CPT certified phlebotomy technician
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1
