Equipment Used in Phlebotomy
In the world of modern medicine, phlebotomy stands as a crucial bridge between diagnostics and patient care. The seemingly simple yet intricate procedure of drawing blood has far-reaching implications, aiding in disease detection, treatment monitoring, and research advancements. Behind every successful phlebotomy procedure lies an array of specialized tools and equipment that ensure not only patient comfort but also the accuracy and reliability of the collected samples. In this article, we delve into the realm of phlebotomy equipment, exploring the indispensable instruments that empower healthcare professionals to extract this vital fluid with precision and compassion. From the classic needles and syringes to advanced vacuum systems and safety mechanisms, join us as we unravel the essential components that underpin the art and science of phlebotomy. Whether you’re a seasoned medical professional, an aspiring phlebotomist, or simply intrigued by the medical field, this guide will provide valuable insights into the tools that make modern healthcare possible.
Phlebotomy Equipment Breakdown
Vials for blood collection
Collection vials are categorized according to the blood test that will be performed to prevent mix ups. They can come plain, or pre-coated with an additive that will mix with the extracted blood to complete a particular test.
Microtainers are sometimes used to draw blood from a skin puncture, such as on the heels or fingers. Most of the time, these microcollection tubes are used for patients where drawing blood is quite difficult, or those with difficult veins. But these are only applicable for tests where only small quantities of blood are needed.
There is also a microcapillary tube that is used to draw an even smaller amount of blood, most common in hematocrit testing. It is a fairly slim tube with a colored ring or tip to indicate the presence of an additive. A red tip indicates a sodium herapin additive, green tip is ammonium herapin, and the blue tip means the tube is plain or has no additive.
Westergren Erythrocyte Sedimentation rate (ESR) tubes, on the other hand, may be used to draw blood in a liquid sodium citrate vacuum tube, or through a saline-diluted EDTA vacuum tube.
For patients suspected to have septicemia or bacteremia, blood culture bottles are used to collect the specimen. Due to the high risk of contamination, the venipuncture site must be properly prepared and strict procedures must be followed, most especially drawing sufficient amount of blood into the bottle.
Anticoagulants
Most tubes used in a hematology laboratory are color coded according to the anticoagulants they contain, which prevent blood from clotting. The color of the caps used will tell the characteristics of coagulants.
Red – No additive. For collection of serum
Tiger – Polymer gel and clot activator. For collection of serum.
Lavender – Contains EDTA. For the collection of whole blood
Green – Contains heparin. For the collection of whole blood
Blue – Contains buffered sodium citrate. For coagulation studies.
White – Contains anticoagulant and glycolytic inhibitor. Use for glucose determinations
Yellow – Contains acid citrate dextrose solution. For preservation of red blood cells.
Full article on phlebotomy tubes here
Types of Anticoagulants
- EDTA (sequestrene or versene)
This is the most commonly used anticoagulant, and is generally available as the dipotassium, disodium or tripotassium salt of ethylenediaminetriacetic acid. It prevents coagulation by binding the calcium found in blood.
- Sodium citrate (buffered or non-buffered)
How sodium citrate prevents coagulation is basically the same as EDTA, but also helps in retaining the functional capabilities of the platelets. The International Committee for Standardization in Hematology recommends the use of sodium citrate in a concentration of 0.109 M.
- Heparin
Heparin prevents coagulation by interacting with the antithrombin III and subsequent inhibition of thrombin. While it doesn’t alter the size of the red blood cells, it can cause white cells and the platelets to clump.
Syringe and Needles
To ensure a patient’s comfort, phlebotomists use the smallest needle possible, or with a gauge that ranges from 18 to 22, 1.20 to 0.70mm, respectively. As you can see, the higher the gauge of the needle, the smaller its size. The syringe and needle combination is best used on patients with small or fragile veins. Because phlebotomists can control the amount of vacuum applied, they can draw blood without causing the veins to collapse, or reduce the possibility of this from happening.
Another tool they use is the BD Eclipse blood collection system. It is composed of a disposable tube holder and a multi-sample vacuum needle, which is called as such because it has two needles, one on opposite sides. The first one is inserted into the vein, while the needle at the other end punctures the vacuum blood collection tube. This blood collection system also uses the Portex needle pro, which is a needle safety device. It permanently covers the needle after phlebotomy procedure has been completed.
Then, there is the Butterfly (winged infusion set) needles that are also used for patients that are difficult draw, such as elderly, newborns and other patients with difficult veins. Also known as a scalp vein set, it consists of a hypodermic needle, two bilateral wings, transparent tubing that is small and often measures 20 to 35cm long, and a connector that will be attached to a syringe, vacuum tube holder or infusion pump.
Microhematocrit Centrifuge
The microhematocrit centrifuge is used to determine the blood’s hematorcit and help diagnose anemia, bone marrow failure, blood loss and polycythemia. In phlebotomy, the device uses microhematocrit tubes that will separate liquid from suspended particles or liquids that have different densities. By applying centrifugal force while the tubes are spinning in the centrifuge, blood cells will be separated from the plasma.
For safety reasons, a centrifuge should never be used with the lid open to prevent tubes from flying out or causing hazardous materials from being splashed all over the laboratory or on personnel.
Tourniquets and Lancets
Phlebotomists use a tourniquet to cause the veins to swell and make it easier to draw blood. Tourniquets can be made of different materials, but a safer option is a latex free product as they can be used on all patients, including those with latex allergy.
When transferring blood from a syringe to a vacuum tube, a safety transfer device must be used to prevent the technician from being pricked with a needle, which could be infected with a disease or infection. As for moving serum or plasma from one tube to another, a transfer pipet is used.
Lancets are often used for microcapillary puncture. If only a small quantity of blood is required, a lancet is often used. Lancets usually come in different point sizes that help control the depth of the puncture. The higher the gauge, the smaller the hole the lancet makes.
PPE – Personal Protective Equipment
Gloves, mask and safety glasses for personal protection during medical procedures.
For the safety of phlebotomist, they must be equipped personal protective equipment that includes face masks, disposable lab gowns, head coverings and vinyl or latex gloves. Ideally, gloves must be placed in dispenser boxes that not only protect, but ensures they are within reach as well. Phlebotomy trays are also provided to keep all equipment and supplies organized.
For the comfort of patients, most blood rooms have blood-drawing chairs that are padded, have adjustable exam tables, and flip-up armrests. Other specialized chairs have attachments where tubes, needles and other tools are stored.
Since phlebotomists also perform urinalysis, appropriate tools and equipment are also required.
Aside from the specialized items used in the blood-drawing process, laboratories must have proper disposable containers. Because none of the venipuncture tools must be reused, they have to be thrown away immediately in their proper containers. This will limit the chances of contamination from spreading. There should be a sharp garbage container where used needles are kept to avoid any accidental punctures. It comes in various sizes, but must have a biohazard icon to alert anyone who uses it of the potential dangers of the items kept inside it.
Due to the complex procedures involved in phlebotomy, the right equipment and supplies must be used. From the PPE for the phlebotomist to the blood-drawing chair for the patients, everything must be well thought out.
Closing
The seamless functioning of modern healthcare systems owes a significant debt to the array of sophisticated equipment used in phlebotomy. These tools not only ensure the safety and comfort of patients but also contribute to the accuracy of diagnostic procedures, ultimately aiding medical professionals in making informed decisions about patient care. From the humble yet crucial needle and syringe to the advanced technologies of vacuum tubes and blood culture systems, the phlebotomy landscape has evolved significantly to meet the demands of modern medicine.
As technology continues to advance, we can anticipate further refinements and innovations in phlebotomy equipment. Automation and digital integration are poised to streamline the collection, labeling, and transport of blood samples, reducing the chances of human error and enhancing the overall efficiency of the process. However, amidst these advancements, it’s crucial not to lose sight of the human element that underpins phlebotomy—a compassionate touch and clear communication are just as vital as any cutting-edge tool.
In essence, the tools of phlebotomy serve as silent yet indispensable partners in the healthcare journey, embodying the spirit of progress and dedication to patient well-being. By staying abreast of emerging technologies, healthcare professionals can ensure that their practices remain at the forefront of safe, efficient, and patient-centered phlebotomy techniques. As we look toward the future of medical care, let us remember that behind every piece of equipment lies a commitment to healing, a commitment that transcends the boundaries of technology and resonates in the heart of every healthcare provider.
