Steps in a Blood Draw for a Phlebotomist

Phlebotomy, the act of using a needle to draw blood, is a specialized skill of great importance to the health care field. Blood tests are frequently used in the medical arena, and it is extremely important that the phlebotomist is well versed in the techniques needed for a successful blood draw. A phlebotomist can prevent errors and maintain a controlled work environment by following some basic steps for each and every venipuncture.

Check for Physician's Orders

• Blood tests can only be drawn if a physician has ordered them. It is the phlebotomist’s responsibility to assure that the order has been received, via phone, fax or in writing.

Identification of the Patient

• Undoubtedly the most essential step in a successful phlebotomy is the correct identification of the patient. Hospital patients should have identification bracelets which match the order slip. Any patient, either inpatient or outpatient who is able to speak coherently, should be asked to state their name. In an outpatient setting, other identifying information also should be requested, such as address, date of birth or Social Security number, along with photo identification. A patient may be seriously harmed if they are given the wrong test results due to a mix-up during identification.

Setting Out Supplies

• Hands should be washed prior to touching any supplies. Supplies should be taken out prior to beginning a blood draw. At minimum, a successful blood draw requires a pair of gloves, alcohol or iodine, a tourniquet, tubes, tube holder, needles, gauze and tape. Determine which tests are ordered and choose tubes accordingly. Choose your needle size based on your patient and the number of tubes needed. The phlebotomist should know in which order the tubes should be drawn. It is necessary to ensure that a sharps receptacle is in close proximity and that extra supplies are within reach in case something is dropped.

Reassure the Patient

• Be sure the patient knows what to expect. Seat her comfortably or ensure that she is comfortable in a hospital bed and be sure to ask if she has any questions before you begin. Encourage the patient to let you know if she feels uncomfortable at any point.

Prepare the Vein

• Be sure to have your gloves on. Place the tourniquet on the patient's arm and identify the best vein to use. Cleanse the area appropriately for the test ordered and allow the antiseptic to dry.

Perform Phlebotomy

• Tell the patient that a minor pinch is possible and quickly enter the vein and draw all tubes in the correct order. Be sure to pay attention to your patient during this time, watching him for any signs of faintness or discomfort. Loosen the tourniquet and extract the needle, while at the same time applying slight pressure on the site using sterile gauze.

Bandage

• Keep pressure on the puncture site for about one minute. Check to be certain all bleeding has ceased. Then you can place tape across the gauze or apply a bandage.

Advise and Thank the Patient

• Be sure the patient is feeling well enough to leave. Tell him to avoid any strenuous lifting with the arm for a few hours. Thank the patient and be sure to ask if he has any final questions.

Label all Tubes

• Once your patient is taken care of, labels should be placed on each tube of blood that was drawn. If no printed labels are available, you should write the patient name, date of birth, medical record number, date of draw and your name on the tube to prevent confusion later.

Wash Hands

• It is imperative to wash your hands before and after each and every patient to prevent the transmission of disease.