Phlebotomist

A phlebotomist (φλέψ = vein, τομός = cutting) is an individual trained to draw blood, either for laboratory tests or for blood donations.

Their role

Phlebotomy is the act of collecting blood either for testing or transfusion. It is a skill employed by physicians and many professionals in allied health fields, including nurses, medical assistants, cardiac physiologists (UK) and clinical laboratory scientists. Health care is a rapidly expanding industry, and a new professional, the certified phlebotomist, helps to reduce the workload of doctors and nurses by focusing exclusively on blood collection, particularly in hospitals and blood drives.

Depending on the regional characteristics of the organisation they work for, phlebotomists may have to travel to collect samples (this is referred to as a domiciliary service). They may travel to nursing homes or outpatient clinics to collect samples.

Phlebotomists collect blood primarily by performing venipuncture and, for collection of minute quantities of blood, fingersticks. Blood may be collected from infants by means of a heel stick or from scalp veins with a butterfly needle. Specially trained Phlebotomists collect arterial blood samples from the radial or ulnar arteries near the wrist.

Phlebotomists do not administer intramuscular or subcutaneous injections. These tasks must be performed by doctors or nurses. In some states, depending on state law, Phlebotomists are authorized to administer Heparin or Saline flushes. This often includes more training and is widely used in some states where Phlebotomist are hired as Dialysis Technicians. Phlebotomists sometimes perform other tasks as required such as urine collection and testing. In the United States, a phlebotomist is paid competitively.

Training and certification

Most countries are working towards more standardized training including certification.

• In the UK, no special certification is required, only training, often on the job.[1]
• In New Zealand, phlebotomists must have a high school degree and First Aid Certificate, with all other skills being taught on the job.[2]
• Australian phlebotomists are heading towards a minimum requirement of Cert III in Phlebotomy. This must be from a nationally accrediated course. Employers already are looking for this on applicants resumes. Currently a two-week Phlebotomy Training Course is run three times a year through the Royal Perth Hospital. This is followed by a competency exam then the trainee can move on to four weeks of part-time practical experience. The skills encompass all methods of blood collection, and other types of pathology specimen collection including urines, swabs and skin scrapes. Applicants need no previous medical experience. Further on the job training is then supplied by employers. Annual Competencies/Assessments are being carried out by some leading Pathology services to set a benchmark for Phlebotomists.
• In the United States, requirements vary by state. Currently California and Kentucky are the only states that require certification.
• In Greece, this job is undertaken by nurses assigned to the haematology departments and is part of their normal training. Individuals certified for First Aid can legally do this in research and diagnostic laboratories, but not in blood donation centres.

Education

Phlebotomy used to be a skill picked up on the job, but today, most phlebotomists in the United States train approximately four months in a career center or trade school or one year in a study anatomy, how to interact with patients, legal aspects of blood collection, Universal and Standard Precautions, and blood collection techniques. A prospective phlebotomist should have a high school diploma or GED and be able to follow simple directions and procedures and handle blood and other bodily fluids without discomfort. Australian phlebotomists require no specific educational pre-requisites in order to undergo training, other than culturaly relevant language skills. A medical or laboratory technician background would be advantageous to undertake training.

Certification and Licensing

Phlebotomists can be certified upon examination by a number of agencies, including the American Society of Clinical Pathologists (ASCP), the American Medical Technologists (AMT), the American Association of Medical Personnel (AAMP), and the National Credentialing Agency (NCA). The ASCP has the most stringent certification requirements. The American Association of Medical Assistants (AAMA) also covers phlebotomy on their nationally recognized exam. Certified Medical Assistants (CMA) are commonly hired to be phlebotomists. In the United States, phlebotomists are not required to be certified except in California, although almost all are.

Remuneration

In Australia the starting salary for a phlebotomist is about $40,000(AUD) and this may go as high as $45,000 for someone with more years' experience. A phlebotomist working at supervisory level can earn in the vicinity of $53,000

The National Healthcareer Association (NHA) offers a national certification for Phlebotomy Technician (CPT), as well as certificates for Clinical Medical Assistants (CCMA), and Patient Care Technicians (CPCT). The CPT and CCMA certifications include the EKG Technician certification (CET) and Phlebotomy Technician certification in one general certification. Certification is also available to individuals that have 2+ years hands on experience as a home study exam; however is not available in the state of California. A person can become certified in the state of California with the National Healthcareer Association (NHA) certification; however they must take the National Healthcareer Association (NHA) at an approved testing site set forth by the state of California

See also

• Bloodletting (medieval)
• Vacutainer
• Blood test
• Medical technologist