Phlebotomy is the act of drawing or removing blood from the circulatory system through a cut (incision) or puncture in order to obtain a blood sample for analysis and diagnosis. Phlebotomy is also done as part of the patient\’s treatment for certain blood disorders.

Phlebotomy can be of various types depending on whether the sample drawn from various vessels – vein, artery or a cannulated vessel in the circulatory system.
Phlebotomy: venous blood sample – Venipuncture is the procedure to collect venous blood from patients. It is also known as venipuncture or venepuncture, phlebotomy or blood draw.
Phlebotomy: arterial blood sample- Arterial blood is drawn from an uncannulated artery to carry out blood gas analysis and to check acid base balance.

Phlebotomy cannualted Vessel: It is classified as a nursing intervention. Which specific skills are required for collection of blood from cannulated vessels or catheters for lab tests.
Phlebotomy blood unit acquisition: Phlebotomy is also used for collection of blood and blood products for blood transfusion and is a nursing intervention from the Nursing Interventions Classification.

Functions of Phlebotomy
Medical Treatment
Polycythemia vera is a disorder in which the bone marrow produces excessive number of red cells, is characterized with elevated hematocrit. Phlebotomy treatment is the removal of blood from a vein in a manner similar to a blood donation. Another disorder called Hemochromatosis causes the body to absorb and store too much iron which builds up in the blood to very high levels. Treatment is done by phlebotomy which removes blood the same way it is drawn from donors at blood banks. Pulmonary Edema patients are treated by use of phlebotomy to decrease their total blood volume.

Phlebotomy as pharmacologic intervention
Pharmacological drugs like morphine are used to decrease the liquid accumulated in lungs by accumulating blood in capacitance vessels in critical care.

Diagnosis
Phlebotomy is also used to remove blood from the body during blood donation and for analysis of the substances contained within it. The analysis of blood from patient can provide a vast amount of information to the physicians about the physical condition of the patient. The blood tests can be related to blood chemistry, hematology or immunohematology.

Screening and Diagnostic tests are done on blood to determine the course or presence of the diseases. Detection of a disease is done by screening tests especially when there is not enough information about the suspected disease in a person. Verification of presence and assessment of severity of a disease is done by use of diagnostic tests.

Therapeutic drug monitoring
Pharmacologic drug levels in the blood of a patient are monitored at specific time intervals to evaluate the efficacy of the drug, by a division of clinical chemistry called therapeutic drug monitoring. The difference between the toxicity levels/side effect levels and efficacy level of the drug being monitored generally lies in very close range.

Written by Phlebotomy Training specialist Dr Shahbaz A. Cheema, Course Director for Maxis Healthcare who run NHS Accredited Phlebotomy Training courses for medical and non medical practitioners. Learn the 3 Steps To Become a Phlebotomist

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