When starting your phlebotomy training, it is essential to become familiar with the variety of equipment you will use regularly. The basic tools needed for blood collection include gloves, alcohol or iodine for cleansing the site, a tourniquet, blood collection tubes, a tube holder, needles, tape, and gauze.
While the blood collection process is generally the same for all phlebotomists, the specific equipment used can vary based on the patient’s size and the accessibility of their veins. Phlebotomists must have a solid understanding of the different types of supplies available to select the appropriate needle, disinfectant, blood collection device, tubes, and dressings for each patient.
A phlebotomist must be well versed in the different types of needles, tubes, and other equipment they will encounter in practice. Additionally, they should be familiar with the tools that assist them in performing their tasks efficiently.
Phlebotomy Supplies:
1. Phlebotomy Chair
Upon arriving for a blood draw, patients are typically seated in a specialized phlebotomy chair. These chairs are equipped with adjustable armrests, allowing the phlebotomist easy access to the patient’s arms.
2. Tools for Locating a Vein
Various phlebotomy tools are available to help locate a vein for drawing blood:
Tourniquet – A rubber-band-like device that temporarily restricts venous blood flow, helping the phlebotomist identify a vein. Once applied, the phlebotomist can feel for a vein, which will feel firm and elastic under pressure. Tourniquets are used for nearly all patients.
Hot Pack – Instant warm packs are often applied to the patient’s arm or heel to promote vein dilation, making veins more visible and easier to access, especially in patients with difficult veins.
Vein Finder – This electronic device uses light to detect veins, making it useful for phlebotomists who have trouble locating a vein manually.
3. Skin Disinfectant
Several disinfectants are used to clean the skin before needle insertion:
Alcohol Swabs – Small gauze squares soaked in alcohol, used to disinfect the skin.
Chloraprep – A disinfectant containing chlorhexidine with antiseptic properties, commonly used before taking blood cultures.
Iodine – Another antibacterial skin cleanser used for disinfection.
4. Needles
Needles are used to puncture the skin and access the vein. Different types and sizes of needles are available, and phlebotomists must choose the appropriate needle based on the blood draw required:
Butterfly Needles – Also known as winged infusion sets, these small needles have wings and are connected to flexible tubing. The tubing connects to a vacutainer for blood collection.
BD Eclipse – A multi sample vacuum collection needle with an attached safety feature, used in venipuncture with the vacuum tube collection system.
Multi Sample Blood Collection Needle – This multi sample needle device has two needles attached to a holder. One needle is inserted into the vein, while the other punctures the blood collection tube to allow sample collection.
Lancet – A small device containing a tiny needle that quickly punctures the skin to draw a small amount of blood. Lancets are typically used on heels or fingers, especially in patients with small or fragile veins.
5. Blood Collection Devices
These devices attach to the end of a needle, enabling the phlebotomist to draw blood from the vein into the blood collection tube.
Vacutainer System – A plastic tube that connects to butterfly needles, BD Eclipse, or multi sample blood collection needles. It features a rubber stopper that allows the vacutainer vials to be accessed without the use of an additional needle.
Syringe – Used for patients with small or fragile veins when the vacutainer system isn't suitable. The syringe is attached to the needle tubing, and after the needle enters the vein, blood is drawn into the syringe. Using a syringe requires an additional step: transferring the blood into collection tubes using a transfer device.
6. Transfer Devices
When blood is collected using a syringe, a transfer device is attached to the syringe. This mechanism safely transfers the blood into the collection tubes, reducing the risk of accidental needle sticks for the phlebotomist.
7. Blood Collection Tubes
These tubes are used to store and transport blood from the patient to the lab. Phlebotomists must follow a specific order when drawing blood into these tubes to ensure accurate lab results.
Blood Culture Bottle – Used to collect blood from patients suspected of having septicemia or bacteremia. These bottles are often compatible with vacutainer systems.
Vacutainer Tubes – Designed for use with vacuum systems or blood transfer devices. Each type of tube contains specific additives for different laboratory tests. Common types include:
Purple – Contains EDTA, an anticoagulant, used for complete blood count.
Green – Contains heparin, an anticoagulant, used for whole blood analysis.
Gold – Contains a clot activator and serum separator, commonly used for chemistry panels.
Blue – Contains sodium citrate, used for coagulation studies.
Microtainer Tube – Small tubes used to collect blood from a skin puncture, typically for patients with fragile or hard-to-locate veins such as infants, small children, or the elderly.
Microhematocrit Tube – Small glass tubes used to collect blood from capillary punctures, commonly used to determine the percentage of red blood cells.
8. Patient Label
After collecting blood, a label is applied to the collection tube to identify the patient. This label should include the date, time, and the phlebotomist’s initials to ensure accurate tracking.
9. Safety
Phlebotomists handle a significant amount of blood, so safety is a priority. Various devices help minimize exposure to bloodborne pathogens, and phlebotomists should be familiar with the available safety tools when dealing with biohazardous materials.
Preventing Accidental Needle Sticks – Devices that reduce the risk of accidental exposure to used needles.
Re-Sheathing Devices – Many needles are equipped with mechanisms that allow the phlebotomist to safely cover the needle after withdrawal without direct contact.
Needle Holders – These safety devices are used with vacuum collection systems to stabilize the needle during blood draws, eliminating the need to hold the needle while switching collection tubes.
Sharps Container – Used needles are disposed of in puncture proof, leak proof sharps containers, preventing exposure to bloodborne pathogens.
Biohazard Bags – Once the blood tubes are labeled, they are placed in biohazard bags for transport to the laboratory, clearly indicating the potential hazard of the material.
Gloves – Phlebotomists wear gloves throughout the entire blood collection process for protection.
10. Dressing Supplies
After the blood draw, the phlebotomist applies a dressing to the puncture site to prevent further bleeding.
Gauze – Pressure is applied to the vein with gauze (usually 2x2 size) immediately after the needle is removed.
Tape – Medical tape is used to secure the gauze to the skin, allowing the site to heal until the patient can remove it.
Band Aid – For smaller punctures with minimal bleeding, such as those from a lancet needle, a band-aid is applied, typically on the finger or heel.
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