7 Questions Every Phlebotomist Must Answer Correctly
Your laboratory's ability to manage risk and the well-being of your patients is at stake.
By Dennis J. Ernst, MT(ASCP)
Anyone who has seen the Hitchhiker's Guide to the Galaxy can tell you the answer to every question in the universe is 42. However, if you manage phlebotomists or other laboratorians drawing blood samples from patients, 42 is the wrong answer for these seven questions. The future of the galaxy may not be at stake, but your laboratory's ability to manage risk sure is, and so is the well-being of your patients.
Question 1: To what extent can you relocate the needle if you miss the vein?
We can put a man on the moon, so why we can't put a needle into someone's vein precisely every time? We're not guiding a lunar lander through space, that's why. We're navigating surgical steel in the dark, relying only on our mind's eye to sense the exact location of the vein, stop it precisely in the center, and extract blood for testing. And we're doing it hundreds of thousands of times each year. We only put twelve men on the moon.
What does your staff do when they miss? If their answer is 42 they need to stop watching sci-fi movies. It's all about preventing nerve injuries. Of all the veins that traverse the antecubital vein, the nerves most often injured during needle relocation lie perilously close to the basilic vein, which is on the inside (medial) aspect of the antecubital area. When the basilic is missed, the standards specifically forbid side-to-side needle relocation. For veins not close to vulnerable nerves a calculated relocation may be acceptable, but probing is beneath the standard of care on any planet.
Question 2: At what angle should the needle be inserted into the arm?
If it can be shown in a legal case involving an alleged injury during a venipuncture that the angle of insertion was in excess of 30 degrees, the facility may be liable for the injury. Does your staff know what 30 degrees looks like? Don't be sure. Show them an illustration (one exists in the CLSI venipuncture standard), demonstrate, and approximate. At the very least, instruct your staff or students to enter the skin at the lowest angle possible, and your patients will be hitchhiking to a less litigious outcome for your facility.
Question 3: How much time passes between when you release pressure and apply the bandage?
Seconds matter in space travel, intergalactic warfare, and phlebotomy. If your staff lets patients bend their arms up as a substitute for direct pressure, then bandages at the speed of light after the tubes are mixed and labeled, they need to abort their take-off. The standards say not to let patients bend the arm up, and that we must be sure bleeding has stopped. When those who draw blood lift the gauze, blink, and bandage, there's no way they can be sure. It takes at least 10 seconds of observation. The next exit on the Intergalactic highway is to remedial training. Make sure they take it.
Question 4: Can you puncture the first good vein you find?
Today is a great day to break away from the gravitational pull that keeps specimen collection personnel from conducting a thorough survey of all accessible venipuncture sites. As mentioned in Question #1, accessing the basilic vein carries a higher risk of arterial and nerve injury than other antecubital veins. That's why the standards mandate we select a median or cephalic vein before drawing from the basilic. Draw from the basilic vein only when no other antecubital vein is accessible and hitchhikers who come to your universe for healthcare will be glad you're commanding the starship.
Question 5: What constitutes proper patient identification?
Up to 16% of identification bracelets contain erroneous information. Don't trust them; they could be on alien imposters. Identify patients by asking them to state, not affirm, their name, address, unique identification number and/or birth date. Have them spell their last name whenever possible. Compare the information given with the information on the order, requisition, and identification band if available. If patients can't participate, have a caregiver or family member provide the identifiers for them, then document the name of the verifier. May the force of positive patient identification be with you.
Question 6: How can you protect fainting patients from injury?
Make sure every patient your staff draws is either lying down or seated in a chair with armrests-not sitting upright in their hospital bed, not on exam tables, and not in any chair without side supports. Never leave the patient's side throughout the procedure in case they pass out and fall forward.
Ask patients if they've ever fainted during a blood draw and if they feel all right before sending them back to their mother ship.
Question 7: What do you do when the patient expresses shooting pain?
Should the patient express excruciating pain during a venipuncture attempt, even tingling or numbness in the hand or fingers, the draw must be discontinued immediately. Make a second attempt, preferably in a different location. Because these are symptoms of impending nerve injury, any other reaction can bring liability. Especially if the patient is an inhabitant of Earth where they'll sue for coffee being too hot.
If your staff can answer these seven questions correctly, congratulations. The potential for your facility to injure patients just hitched a ride to a more hospitable solar system, and your potential to manage the risk of phlebotomy will live long and prosper.
Dennis J. Ernst is the executive director of the Center for Phlebotomy Education, Inc. and publisher of the Phlebotomy Today family of e-newsletters accessible at www.phlebotomy.com.
Changing Lives through Faith, Wellness and Training!
EQUAL OPPORTUNITY NOTICE : We hereby advise students, parents, employees and the general public that we offer employment programs and educational opportunities, including career & technical education opportunities, without regard to gender, race, color, national origin, handicap or any other legally protected status. Inquiries regarding this non-discrimination policy and grievance procedures may be directed to: Human Resources Director, Bruen Medical Partners, 2 Elting Court, Ellenville, NY 12428; 845-853-0676
ABOUT THE INSTRUCTOR: Elizabeth Bruen-Bolton is a medical technologist and lab supervisor at Merck Pharmaceuticals. She received a B.S. in Medical Technology from Indiana State University and a Master’s degree in Public Service Administration from Indiana University. She has extensive experience in various aspects of phlebotomy techniques, lab management, OSHA requirements, infection control, and training/ evaluation of personnel.
Awards & Certifications: ASCLS / NPA / AMT / ASCP American Society for Clinical Pathology
Associations: American Society for Clinical Laboratory Science
2018-2019 SCHEDULE : Monday, Wednesday and Friday 9:00 AM – 1:00 PM COURSE LENGTH Lecture and Student Lab – 10 weeks (60 hours) 2 mornings a week – Monday & Wednesday. 8:30 AM – 4:30 PM Clinical Practicum – a minimum of 100 hours is required. Monday through Friday 7:00 AM – 3:00 PM or 8:00 AM – 4:00 PM
CLASS SIZE IS LIMITED — REGISTER SOON! This program is approved by the New York State Education Department for Veterans’ training.
Target Audience: Anyone who wants to enter the healthcare field on the clinical side.
Learning Outcomes: Upon successful completion of this course, the student will be able to:
Describe effective infection control in the healthcare setting.
Explain healthcare privacy practices (HIPAA), laws and ethics.
Define the structure of the cardiovascular system, to include the associated medical terms, disorders, and diagnostic tests.
Obtain non-blood and blood specimens competently.
Demonstrate common blood collection procedures.
Methodology: Lectures, discussions, and skills training and demonstration. Assessment is conducted through exercises, role play and skills demonstration.
Criteria for Successful Completion: Students must attend 100% of all class sessions, actively participate in class discussion, complete all quizzes and tests when due, receive 100% satisfaction on skill lab checklist, and earn a final grade of 75 or higher to receive a Bruen Medical Partners Continuing Education certificate. The final grade is calculated using the following breakdown:
Quizzes: 75% of grade
Final Exam: 25% of grade
Phlebotomy Technician Certificate Program
Changing Lives through Faith, Wellness and Training!
Employment for phlebotomists is projected to grow 25 percent from 2014 to 2024, much faster than the average for all occupations. Hospitals, diagnostic laboratories, blood donor centers, and other locations will need phlebotomists to perform bloodwork.
Blood analysis remains an essential function in medical laboratories and hospitals. Demand for phlebotomists will remain high as doctors and other healthcare professionals require bloodwork for analysis and diagnosis.
The number of individuals who have access to health insurance is expected to continue to increase because of federal health insurance reform. There will be greater demand for blood tests and other bloodwork-related services, increasing the need for phlebotomists. According to the U. S. Department of Labor and Statistics.
All Classes will be held at our Office or our Training Center 2 blocks from our office depending on class size.
This course is designed to teach and give hands on training to individuals desiring to enter the field of allied health care. The primary goal is to instill the latest information on blood collection techniques, skills and equipment for a safe and effective specimen collection, thus enhancing customer service and promoting patient care. The program includes 78 hours of classroom instruction and 100 hours of clinical internship. This program curriculum meets all requirements necessary to sit for the ASCP National Board Certification for Phlebotomy Technicians. The Bruen Medical Partners Phlebotomy Technician Program trains students in venipuncture and dermal puncture techniques. Phlebotomy Technician students obtain hands on clinical internship experience at approved sites by Bruen Medical Partners.
Certified Phlebotomy Technician Training
Phlebotomists are health care professionals who draw blood and other specimens from patients or blood donors for medical testing and processing. Phlebotomists work in hospitals, HMO’s, home health agencies, clinics, large medical offices, laboratories and blood banks. The demand for phlebotomists is rising. Increased population growth and the number of laboratory tests ordered by physicians due to advances in biotechnology have contributed to the demand. This certificate program includes classroom & lab instruction followed by an internship where the student will get the opportunity to further develop these critical workplace skills. The courses that comprise the program are Introduction to Phlebotomy, Medical Law and Ethics, Medical Terminology, Asepsis and Infection Control, CPR and First Aid, Blood Collection Procedures, Specimen collection (non-blood) and Occupational Communication. This course prepares you to sit for the Certified Phlebotomy Technician (CPT) exam. The CPT is a national credential for the Phlebotomy Technician profession. Certification through the National Health career Association recognizes the competency and proficiency of a clinical individual and is accredited by the National Commission for Certifying Agencies (NCCA).
Phlebotomy Technicians will gain the skills needed for the proper collection of blood and other specimens used for diagnostic testing. Emphasis is on ethics, legalities, medical terminology, safety and universal precautions, health care delivery systems, patient relations, anatomy and physiology, and specimen collection. Certification is provided by the National Health career Association.
College and University students
RNs and LPNs
Physician Office Associates
Front/Back Office Staff in a doctor's office or clinic
Program Length -
9:00 a.m. to 1:00 p.m.
Monday, Wednesday, Friday
*Schedules and Location are subject to change*
*National Certification is $150.00 to be
payed before testing*
* Phlebotomy Technician Certification (CPT)
The NPCE phlebotomy exam is offered to those who have already acquired 50 or more venipunctures. Proper documentation of this experience is required before access to the exam will be granted. To be eligible to earn an NPCE certification, the individual must meet ALL of the following requirements:
*Possess a High School Diploma, or the equivalent.
*Have successfully completed a training program or one year of work experience within the field.
*Have a clean background check.
*Vaccinations and booster shots. You must get the required shots as well as a tuberculosis test.
*Training/work experience must include a minimum of 50 successful venipunctures and 10 successful capillary sticks.
*Candidates must be able to provide written proof of training or experience and/or documentation of education completion.
*The examination fee of $125.00 is due upon the submission of the application.
Online Phlebotomy Exam Benefits
Testing On-Demand: NPCE’s online phlebotomy exam allows phlebotomy employers to test at their convenience, reducing assessment planning time and scheduling delays.
Security: NPCE’s phlebotomy exam solution eliminates the need for local storage, ensuring that test materials remain secure. In thousands of phlebotomy exam administrations to date, there has never been a breach in either testing materials, student information, or student results.
Reduced effort: Our online phlebotomy exam reduces the administrative burden associated with paper-and-pencil administrations such as receiving and shipping test materials, ordering answer sheets, and waiting for test results.
Immediate access to results and data: NPCE’s online scoring and reporting system—provides rapid, informative access to employee performance to help employers make immediate instructional decisions for employees.
Increased employee motivation: Scientific investigations by NPCE staff have found that overwhelmingly employees and employers prefer the experience of testing via computer over paper-and-pencil administrations.
Training and support materials. The NPCE online system is supplemented by phlebotomist and educator tutorials, practice tests, and manuals that help ensure audiences are prepared to use the system efficiently and easily.
*Two-and-a-half additional weeks of clinical internship after classroom training required.
Cost of Program:
$1900.00 (See below for payment plan)
$317.00 deposit ( non-refundable)
$317.00 – First Payment
$317.00 – Second Payment
$317.00 – Third Payment
$317.00 - Fourth Payment
$315.00 - Fifth Payment
Ask us for more information on other flexible payment plans.
Admission Information & Registration:
Contact Bruen Medical Partners for registration details. Call (845) 853-0676 or go to our contact page and submit your questions.
Lab work that comes to you!
The training class price does not include the book which the student will have to purchase separately:
Garza EdD MLS (ASCP) CM, Diana; Becan-McBride EdD MLS (ASCP) CM, Kathleen Author
Published by Pearson (2014)
ISBN 10: 0133144569 ISBN 13: 9780133144567
Cover type: Paperback
Edition/Copyright: 9TH 15
Publisher: Prentice Hall, Inc.
Call Us: (845) 853-0676
Bruen Medical Partners
Bruen Medical Partners NPI# 1205288966 / Elizabeth Bruen NPI#: 1043670284
Phlebotomy Handbook, 9/E
As a Phlebotomy Technician, the laboratory relies on you to collect quality samples from the patient to produce quality laboratory results. To do this, a phlebotomy technician must create an atmosphere of trust and confidence with patients while drawing blood specimens in a skillful, safe and reliable manner.