Phlebotomy

Donor Preparation:

1.    The phlebotomist should wash his/her hands with soap and water and should wear sterile gloves.

2.    Select the required bag and write donor no., date of collection and expiry.

3.     Inspect the bag for leakage or any other defect. The anticoagulant solution must . be clear. Place the bag on a pre-programmed blood collection monitor and press the start button.

4.     Choose the site of venipuncture in the anticubital are of the arm. Apply blood pressure cuff, inflate to 50-60mm of Hg and select a prominent and firm vein in the area that is free of any skin lesions/needle marks. Asking the donor to close the fist usually helps in bringing the vein in to prominence.

5.    Release the blood pressure cuff and thoroughly clean the selected site of venipuncture with an antiseptic lotion in the following way.

a)     Clean 4-5 cm area starting at the site of venipuncture and moving outwards in a concentric spiral way with methylated spirit/alcohol.

b)    Apply about 10% providone-iodine solution (betadine) in the same way - as spirit. Allow it to dry.

c)    Clean with methylated sprit or alcohol and allow it to dry.

d)     The cleaned area is ready for venipuncture and should not be touched.

Method of Phlebotomy

1.    Inflate blood pressure cuff to maintain pressure 50-60mm of HG. Ask the denor to close the fist.

2.     Uncover the needle and perform venipuncture immediately, using aseptic procedure.

3.     Ask the donor to open and close hand or to squeeze the rubberball.

4.    The donor should be under constant observation throughout the phlebotomy and

should never be left an attended.

5.    As soon as the required amount of blood is collected, remove the blood pressure cuff.

6.    Place a sterile swab at the venipuncture site and withdraw the needle applying light pressure.

7.    Take the bag to the processing table, transfer 3 ml of blood from the tubing to 2 pilot tube attached to the bag (clotted & citrated) and make a blood smear for detection of malarial parasite

8.    Make sure that some blood remains in the tubing

9.    Seal the tube with dielectric tube sealer and separate the needle

10. Needle is destroyed with needle destroyer

11. Keep the blood bag at 2 - 6°C in the untested refrigerator immediately. If platelets are to be harvested the bag should be kept at 20-22° (room temp.) till platelets are separated.

12. The donor should remain on the bleeding couch for 8-10 minutes under observation of the staff. Then the donor is allowed to sit up and go for refreshment.

13. Check the arm and apply band-aid after bleeding stops.

14. Light refreshment like biscuits and tea/coffee/soft drinks are given to donors.

15.  Following instructions are given to the donors.

a.    Drink more fluids than usual in the next 4 hours. Do not remain hungry.

b.    Do not smoke for half an hour.

c.     Do not take alcoholic drinks for at least 6 hours.

d.    If there is bleeding from the phlebotomy site. Raise the arm and apply  pressure.

e.    If there is feeling of faintness or dizziness, either lie down or sit with head between knees. If symptoms persist, ask for help, return to the blood bank or consult any doctor.

f.     Remove the band- aid after 5-6 hours

Therapeutic Phlebotomy:

Therapeutic phlebotomy shall be done only on the request of the patient's physician. The blood collected in such circumstance shall not be used for transfusion.