Phlebotomy is the practice of surgically opening or puncturing a vein with the intent of extracting blood or inserting another fluid. There are many different instruments and supplies used for blood collection and blood supply. This report will provide a comprehensive list of each commonly used instrument in blood collection and how they work. Understanding the importance of each of your supplies items is an essential component in your phlebotomy training curriculum.
Blood Drawing Station
A blood drawing station is essentially an area set aside in a medical laboratory or clinic for carrying out phlebotomy measures on patients. Patients will go to a blood drawing station after a physician has ordered blood work. They will usually schedule an appointment and then go in at the designated time for whatever procedure has been ordered.
Blood drawing stations are equipped with a table to store the equipment, phlebotomy supplies, and a special chair that the patient will sit in. There will also be a bed or a reclining chair available for patients that have a history of passing out or people that have decided to donate blood, etc. For small children or infants a small padded table or bed should be there as well.
Phlebotomy chairs have adjustable armrests that lock into place in case the patient loses consciousness. The armrests are also necessary so that the patients arm can be moved into the correct procedural position. They should also be comfortable so that the patient can relax.
Equipment carriers are necessary in the phlebotomy field so that blood collection equipment other phlebotomy supplies can be mobilized. Obviously there are going to be circumstances in which a patient cannot make an appointment and come to the laboratory’s blood drawing station. Phlebotomists must be able to go to the patient and they will need to bring their equipment with them. There are two types of equipment carriers:
- Handheld carriers- although probably self-explanatory, these are carriers that you can move with your hands. There are many different types of handheld carriers. They range from trays to boxes. These must have enough equipment for multiple blood draws and they are extremely useful for emergencies or when only a few patients need blood work done.
- Phlebotomy carts- Phlebotomy carts are usually made from stainless steel or other similar materials and have swivel wheels. They are typically used in hospitals and they enable phlebotomists to travel to every room in the building as long as there is an elevator. It allows phlebotomists to do “rounds” for people that need a lot of lab work. Because of the nature of the work, phlebotomy carts present a risk of infection, so they are never brought into a patient’s room. They should be left in the hallway at all times and the phlebotomist will bring the necessary phlebotomy supplies into the room.
Gloves and glove liners
The use of latex, or similar material, gloves while performing phlebotomy is a requirement of The Centers for Disease Control/ Healthcare Infection Control Practices Advisory Committee (CDC/HICPAC) and the Occupational Safety and Health Administration (OSHA) Blood borne Pathogen Standard. Every time a phlebotomist sees a new patient he or she must use a new pair of gloves and dispose of the old pair into a hazardous waste basket.
The acceptable materials for gloves to be made of are non-sterile disposable latex, nitrile, neoprene, polyethylene and vinyl.
Sometimes people can develop allergies from these materials. For individuals who suffer from glove related allergies or develop dermatitis (skin inflammation), there are glove liners available to prevent these occurrences. There are also hand creams that help to stop any skin irritation.
Powdered gloves are not recommended because the powder can contaminate some tests and it can also cause allergies for some people.
Glove quality is strictly regulated by the U.S. Food and Drug Administration (FDA).
Antiseptics are antimicrobial substances that are applied to the skin to reduce the chances of infection, sepsis, or putrefaction. Antiseptics thwart the growth and development of microorganisms but they do not necessarily destroy them. Studies have shown that they are safe to use on human skin. Phlebotomists will use antiseptics to clean the skin around the area where they will puncture the skin in order to collect the blood. The most commonly used antiseptic in phlebotomy is 70% isopropyl alcohol (isopropanol) in singly packaged prep pads.
If a stronger antiseptic is required, povidone-iodine can be used with a swab stick or sponge pad for blood culture collection or prep pads for blood gas collection.
It should be noted, however, that many patients are allergic to povidone-iodine and so the use of alcohol preparation is becoming more common in these cases.
Provided below is a list of antiseptics used in blood collection:
- 70% Ethyl alcohol
- 70% isopropyl alcohol (isopropanol)
- Benzalkonium chloride (Zephiran chloride)
- Chlorhexidine gluconate
- Hydrogen peroxide
- Povidone-iodine (0.1%-1% available iodine)
- Tincture of iodine
Disinfectants are chemical liquids that destroy bacteria. These can’t be used on human skin. They are usually corrosive, which means that they eat away or destroy things. Disinfectants are regulated by the Environmental Protection Agency (EPA). According to the CDC and HICPAC Guidelines for Environmental Infection Control in Healthcare Facilities, use of EPA-registered sodium hypochlorite products is preferred, but solutions made from generic 5.25% sodium hypochlorite (household bleach) may be used. A 1:100 dilution is recommended for decontaminating nonporous surfaces after cleaning up blood or other body fluid spills in patient-care settings. When spills involve large amounts of blood or other body fluids or occur in the laboratory, a 1:10 dilution is applied prior to cleanup. At least 10 minutes of contact time is required for disinfectants to be effective.
A hand sanitizer is essentially an antiseptic for our hands that we can use in the place of soap and water. The CDC recommends alcohol based hand sanitizers as long as the hands are not visibly contaminated.
If hands are visibly contaminated and there are no washing facilities available, the CDC recommends that hands be cleaned first with detergent-containing hand wipes followed by alcohol based hand sanitizer.
Gauze pads/ cotton balls
New, clean 2×2 gauze pads are used to apply pressure to the puncture wound after blood has been taken. Fluid resistant gauze pads are also available to help avert glove contamination from the puncture site.
The use of cotton balls to apply pressure on the puncture site is no longer recommended. Cotton balls frequently stick to the wound and cause bleeding to reoccur when removed.
Adhesive bandages are recommended to cover the site after the procedure. If there are no bandages available it is possible to use folded gauze pads sealed with paper, cloth or knitted tape.
For patients who are allergic to adhesive bandages, it is becoming increasingly common to use self-adhesive gauze which is placed over a gauze pad and wrapped around the arm.
“Please note that of all the phlebotomy supplies, adhesive bandages should not be used on babies under 2 years old because of the danger of aspiration and suffocation”
Needle and sharps containers
Needle and sharps containers are disposable boxes that come in many different shapes and sizes. They are usually red, although they sometimes come in other colors. They must be clearly marked with a biohazard sign. They are typically made from strong plastic material. They must be puncture and leak proof. They need to have locking lids which are to be closed and locked when they have reached capacity. They also are required to be disposed of as bio-hazardous waste.
Biohazard bags are plastic bags that are typically used to transport hazardous materials such as blood from the collection site to the laboratory. They must be leak proof and labeled with the biohazard symbol. They are designed to protect the person carrying the material and anyone that the transporter comes into contact with from the contents of the bag.
Pre-cleaned glass slides are a necessary tool in a phlebotomist’s phlebotomy supplies toolkit in order to study blood samples. They are usually 1×3 inches and they sometimes have a frosted area on one side so that the patients name can be written. All patient slides must be accurately labeled.
The most basic phlebotomy supply item that you can carry is a pen. It is essential that a phlebotomist always carry a pen with permanent, non-smearing ink. This is required so that he or she can accurately label samples and patient information.
It is imperative that phlebotomists have a watch on hand to accurately record specimen collection times and time certain tests. The watch should have a sweep second hand or timer if at possible.