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Phlebotomy
Worktext and Procedures Manual
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4
TH
PhlebotomEDITIONy
Worktext and Procedures Manual
Robin S. Warekois, MT(ASCP)
Avee Laboratory
Clearwater, Florida
Richard Robinson, NASW
Sherborn, Massachusetts
Consulting Educator
Pamela B. Primrose, PhD, MLS(ASCP)
Program Chair of Medical Laboratory Technology
Professor of Medical Laboratory Technology/Life Sciences
Ivy Tech Community College
South Bend, Indiana
3251 Riverport Lane
St. Louis, Missouri 63043
PHLEBOTOMY: WORKTEXT AND PROCEDURES MANUAL ISBN: 978-0-323-27940-6
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and retrieval system,
without permission in writing from the publisher. Details on how to seek permission, further information about
the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge
of their patients, to make diagnoses, to determine dosages and the best treatment for each individual
patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material
herein.
International Standard Book Number: 978-0-323-27940-6
Content Strategist: Kristin Wilhelm
Content Development Manager: Ellen Wurm-Cutter
Publishing Services Manager: Jeff Patterson
Senior Project Manager: Mary Stueck
Design Direction: Margaret Reid
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Contributors
MOCK CERTIFICATION EXAM
Rachel Houston
CMA(AAMA)
Program Director, Medical Assistant Program
Cabarrus College of Health Sciences
Concord, North Carolina
TEST BANK
Nicole Palmieri
BSN, RN
Medical Assistant Instructor
Advantage Career Institute, Inc.
Eatontown, New Jersey
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. v
Reviewers
Belinda Beeman Pamela B. Primrose
MEd, CAM(AAMA), PBT(ASCP) PhD, MLS(ASCP)
Medical Assisting and Phlebotomy Instructor Program Chair of Medical Laboratory Technology
Eastern New Mexico University Professor of Medical Laboratory Technology/Life
Roswell, New Mexico Sciences
Ivy Tech Community College
Sylvia R. Crawford South Bend, Indiana
PBT(ASCP)
Karen Marie Ragusa
Phlebotomy Instructor
Bellevue College PBT(ASCP)
Bellevue, Washington Adult Educator
Monroe 2 Orleans BOCES
Susanna M. Hancock Rochester, New York
AAS-MOM, RMA, CMA, RPT, COLT
Mary Stassi
Medical Program Consultant
Retired Medical Assistant Program Director RN
American Institute of Health Technology Health Occupations Coordinator
Boise, Idaho St. Charles County Community College
St. Charles, Missouri
Julie S. Monsegur
RN, MSN-Ed Margie West
Health Programs Laboratory Assistant Phlebotomy Instructor
Pasco-Hernando Community College Petra Allied Health
New Port Richey, Florida Springdale, Arkansas
Anne O’Neil Carole Stemple Zeglin
MT(ASCP) MSEd, BSMT, RMA(AMT)
Retired MLT Program Director Associate Professor
Lakewood, Washington Director Clinical Laboratory Programs & Medical
Assisting
Kathleen Park Westmoreland County Community College
MA, MT(ASCP) Youngwood, Pennsylvania
Associate Professor
Austin Community College
Medical Laboratory Technology Program
Round Rock, Texas
vi Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Acknowledgments
We are grateful to the many people who have contributed their time and expertise to
help make this fourth edition of Phlebotomy: Worktext and Procedures Manual a
valuable teaching tool. Our reviewers continue to provide important insights into the best
ways to communicate concepts based on their own classroom experience. Pam Primrose
and Kristin Wilhelm offered valuable help, each in her own way, in bringing this edition
forward. As we have in the past, we offer our deepest gratitude to Ellen Wurm-Cutter,
whose continued dedication to this text and unflappable good cheer have made our jobs
easier and our book better.
Robin S. Warekois
Richard Robinson
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved. vii
Preface
The successful practice of phlebotomy requires a the essentials of the techniques before, during, and
combination of highly skilled technique, wide after their practical laboratory experience.
knowledge of the current health care environment, In addition to thorough training in the skills of
and a sympathetic approach to patients of all ages, phlebotomy, this text provides an introduction to
backgrounds, and medical conditions. We have de- development of skills beyond blood collection
signed Phlebotomy: Worktext and Procedures Man- with a chapter on point-of-care testing. In this
ual, 4th edition, to provide a complete introduction way, phlebotomy students can begin their training
to the practice of phlebotomy in all its aspects. We as multiskilled health professionals ready for the
believe its emphasis on procedures, its up-to-date challenges of the modern health care workplace.
and thorough professional information, and its com-
prehensive approach to the many situations encoun-
ORGANIZATION
tered by the modern phlebotomist make it a unique
and valuable offering in the field of phlebotomy The text is divided into five units. Unit 1 provides
training. an introduction and general information needed for
working in a health care facility. Unit 2 covers the
basics needed to study phlebotomy, from medical
WHO WILL BENEFIT FROM THIS
terminology to anatomy and physiology. Unit 3
BOOK?
features the various methods of specimen collec-
Phlebotomy: Worktext and Procedures Manual, tion, including venipuncture, dermal puncture, arte-
4th edition, is suitable for phlebotomy certification rial blood collection, and special procedures. Unit 4
programs, medical technologist and medical labo- presents specimen handling, processing, and point-
ratory technician programs, medical assisting pro- of-care testing. Unit 5 concludes the text with a
grams, and nurse training. No prior training in section on professional issues. Individual units and
phlebotomy is assumed. The text may also be used chapters may be taught in the sequence chosen by
by experienced phlebotomists, allied health profes- the instructor. Numerous Flash Forward and Flash-
sionals, or nurses seeking to expand or update their back notes help the student connect and recall mate-
training in phlebotomy. rial from different chapters. A comprehensive index
is provided to allow quick access to any topic.
WHY IS THIS BOOK IMPORTANT
TO THE PROFESSION? DISTINCTIVE FEATURES
AND LEARNING AIDS
Students, above all, learn by doing. Teaching phle-
botomy technique is at the heart of this book, and Phlebotomy courses are offered in a variety of set-
we have therefore designed it as a worktext for tings. Phlebotomy: Worktext and Procedures Man-
both the classroom and the laboratory. Each major ual, 4th edition, provides the essential learning tools
skill in phlebotomy, from handwashing to veni- students need to succeed in each of them. Because
puncture to preparing a blood smear, is shown and we believe that students learn best when they know
described in step-by-step, fully illustrated proce- the “why” as well as the “how,” we explain the rea-
dures. We believe these will provide the student soning behind the clinical information they must
with an invaluable visual tool for understanding learn to become successful phlebotomists.
viii Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
