Phlebotomist

A **phlebotomy** is the process of making a puncture in a vein usually in the arm, with a cannula, for the purpose of drawing blood. The procedure itself is known as a venipuncture. A person who performs a phlebotomy is called a *phlebotomist*, although most doctors, nurses, and other technicians can also carry out a phlebotomy. It is different from a phlebectomy.

Phlebotomies that are carried out in the treatment of some blood disorders are known as *therapeutic phlebotomies*.

## Phlebotomies

Phlebotomies are carried out by phlebotomists – people trained to draw blood mostly from veins for clinical or medical testing, transfusions, donations, or research. Blood is collected primarily by performing venipunctures or by using fingersticks for the collection of minute quantities of blood or a heel stick in infants. The duties of a phlebotomist may include interpreting the tests requested, drawing blood into the correct tubes with the proper additives, accurately explaining the procedure to the person, and preparing them accordingly, practicing the required forms of asepsis, practicing standard and universal precautions, restoring hemostasis of the puncture site, giving instructions on post-puncture care, affixing tubes with electronically printed labels, and delivering specimens to a laboratory. Some countries, states, or districts require that phlebotomists be licensed or registered.

A **therapeutic phlebotomy** may also be carried out in the treatment of some blood disorders such as chronic hives.

### Australia

In Australia, there are a number of courses in phlebotomy offered by educational institutions, but training is typically provided on the job. The minimum primary qualification for phlebotomists in Australia is a Certificate III in Pathology Collection (HLT37215) from an approved educational institution.

### United Kingdom

In the UK there is no requirement for holding a formal qualification or certification prior to becoming a phlebotomist as training is usually provided on the job. The NHS offers training with formal certification upon completion.

### United States

Special state certification in the United States is required only in four states: California, Washington, Nevada, and Louisiana. A phlebotomist can become nationally certified through many different organizations. However, California currently only accepts national certificates from six agencies. These include: American Certification Agency (ACA), American Medical Technologists (AMT), American Society for Clinical Pathology (ASCP), National Center for Competency Testing/Multi-skilled Medical Certification Institute (NCCT/MMCI), National Credentialing Agency (NCA), National Healthcareer Association (NHA), National Phlebotomy Certification Examination (NPCE).[8] These and other agencies also certify phlebotomists outside the state of California. To qualify to sit for an examination, candidates must complete a full phlebotomy course and provide documentation of clinical or laboratory experience.

## History

Main article: Bloodletter

Early "phlebotomists" used techniques such as leeches and incision to extract blood from the body. Bloodletting was used as a therapeutic as well as a prophylactic process, thought to remove toxins from the body and to balance the humours. While physicians did perform bloodletting, it was a specialty of barber surgeons, the primary provider of health care to most people in the medieval and early modern eras.