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What does a phlebotomy technician do?
Phlebotomy technicians collect blood from patients and prepare the samples for testing. Most work in hospitals and clinics, but some collect blood for donation purposes. Phlebotomy technicians are important members of the health care team and often need to explain the blood-drawing procedure and put patients at ease.
With constantly evolving medical technologies, phlebotomy technicians must know the difference in blood test types and should be aware of how medications and diet impact blood samples.
Scope of practice
Phlebotomy technicians are responsible for drawing samples of blood and preparing them for testing. Common tasks and duties include:
- Explaining procedures to patients
- Comforting patients that might be nervous about needles
- Taking blood pressure, pulse, and respiration readings
- Drawing blood
- Applying bandages after blood is drawn
- Sending blood, urine, or fecal samples to the lab for testing
- Sterilizing equipment and cleaning workspaces
- Updating patient medical records
Work environment
Phlebotomy technicians work in hospitals, clinics, doctors’ offices, nursing homes, private home care, medical labs, blood donation centers, research institutes, and insurance companies. They may work day, evening, or night shifts, including weekend and holiday hours. The majority of their time is spent on their feet, interacting with patients or preparing samples to be sent to the lab.
Becoming a phlebotomy technician
Due to the intricate work of inserting needles into hard-to-find veins, phlebotomy technicians need to have well-tuned fine motor skills. They need to be able to handle difficult and emotional patients that might be afraid of needles. Finally, they need to be detail-oriented and able to remember safety precautions, how different diets can affect blood samples, and exactly how samples need to be treated to appropriately test them.
Higher education requirements
To become a phlebotomy technician, you must have a high school degree or equivalent and a phlebotomy technician training program. These programs can last a few months to a year.
Certification process
The certification process can vary depending on which organization is certifying the phlebotomy technician. These organizations include the American Society of Clinical Pathologists, National Healthcareer Association, and the American Medical Technologists. Requirements typically include a high school diploma or GED, a phlebotomy training program, and potentially some work experience.
Career opportunities and outlook
Phlebotomy technicians can expect a median salary range of $37,380.
Phlebotomy is an expanding field with excellent career opportunities. The Bureau of Labor Statistics expects employment of phlebotomist technicians to grow much faster than average. Blood testing is an essential task in health care so demand for phlebotomy technicians is likely to increase since doctors use blood work for analysis and diagnosis.
To advance their careers, some phlebotomy technicians choose to get certified in a particular area to become phlebotomy specialists or donor phlebotomy technicians. With additional experience and education, others become medical lab technicians, medical assistants, or registered nurses (R.N.s).
By the numbers
1
year or less of higher education
22%
job growth projected from 2020-2030
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| The phlebotomist notices a sore at the site in which the tourniquet is to be applied. What action is taken to apply the tourniquet? | Tie the tourniquet over the patient’s sleeve. |
| Which should the phlebotomy technician recognize as the appropriate order of steps in routine venipuncture? | Access the site, cleanse the site, and insert the needle. |
| Which of the following specimens should be placed in an ice bath within 30 minutes after collection? | Arterial Blood Gas (ABG) specimen. |
| A patient is allergic to alcohol. Which antiseptic solution should be used to prepare the site for venipuncture? | Chlorhexidine. |
| The phlebotomist should invert anticoagulant tubes to prevent which complication? | Hemolysis. |
| The phlebotomy technician is preparing to perform venipuncture on a patient with pneumonia. Which PPE, besides gloves, should you choose? | A mask. |
| Which test requires that the phlebotomy technician follow the chain of custody guidelines? | Blood alcohol level test. |
| Which question should the phlebotomist ask when identifying a patient in an outpatient setting? | Ask the patient to state and spell their full name as well as provide their date of birth. |
| When identifying a patient in an inpatient setting, which type of identification should be used ? | Verbal and wristband. |
| At what temperature should a semen sample be transported? | 36-38°C |
| Which vaccine should the employer offer to the phlebotomist at no cost? | Hepatitis B. |
| Which is the regulation that ensures a phlebotomy technician is proficient to perform job duties? | CLIA. |
| A phlebotomy technician is using a glucose monitor to perform a fasting POC test on a patient. Which result should you immediately notify the physician about? | 130 mg/dL. |
| What is the maximum amount of time the phlebotomist may leave a tourniquet on a patient’s arm? | One minute. |
| The phlebotomist is collecting blood specimens for a blood assay. Which tube should be filled first? | The yellow topped tube. |
| Which should the phlebotomist recognize as the meaning of the abbreviation SD? | Standard Deviation. |
| For which of the following tests should you follow COC (chain of custody) guidelines? | Paternity testing. |
| A phlebotomy technician is performing venipuncture on an adolescent patient who weighs 42.6 kg (94lbs). What is the appropriate amount to draw when the maximum allowable volume is 1%? | 40 mL. |
| The phlebotomist is obtaining a specimen for blood cultures. Which additives are required in the tube drawn? | Sodium polyethanol sulfonate in a yellow topped tube. |
| A patient becomes pale and diaphoretic during venipuncture. Which condition is the patient at risk for ? | Syncope (fainting) |
| The phlebotomist is preparing to perform a draw on a patient who is sleeping. Which is the appropriate action to take? | Wake the patient before collection to verify identity and obtain consent. |
| The phlebotomist is collecting a routine CBC from a healthy 10 month old. Which is the appropriate site to choose for collection? | Either heel. |
| The phlebotomist is collecting a specimen from a patient with cutaneous diphtheria. Besides gloves, what PPE should be used ? | A gown. |
| A phlebotomist is performing a POC test to determine a patient’s WBC count. Which results should you immediately notify the providIng physician about ? | 1.8 mm 3. |
| A patient has a right sided mastectomy. Which site should you choose to draw from? | The left arm. |
| A phlebotomy technician is performing venipuncture using the evacuated tube system. Which is the appropriate action taken ? | Position the needle in the same direction as the vein at a 30 degree angle with the bevel facing up. |
| Which is the appropriate technique for anchoring a vein before inserting the needle ? | Use the thumb to anchor the vein 5cm (2 in) below the site. |
| Which is part of the post examination phase of the CLSI workflow pathway? | Enter critical lab data. |
| Which is the proper action when applying a tourniquet? | Tuck a section of the free end to form a partial loop underneath the tourniquet. |
| A stat specimen has been ordered and the phlebotomist forgot to fill out the patient Id number on the tube. Which action can the phlebotomist expect the laboratory to take? | The laboratory will reject the specimen. |
| The phlebotomist is collecting a urine specimen for a pre-employment drug screening. Which is the correct action taken? | Verify that the specimen contains at least 45 mL of urine. |
| According to CLSI order of draw guidelines, which samples should be collected first? | Blood cultures to prevent cross contamination. |
| How many times is a Lavender topped tube inverted? | 8-10 times. |
| The phlebotomist is collecting a specimen to measure the trough level of a medication. At which time should the specimen be collected? | Within 15 minutes before the next dose of medication. |
| The phlebotomist is collecting from the hand of a patient with difficult veins. Which device should be chosen to use for the collection? | A hand immobilizer. |
| The phlebotomist has instructed a patient how to perform at home collection for a semen specimen. Which statement made by the patient lets the phlebotomist know that they understand? | “I will collect the specimen in a sterile container and deliver to the lab within 1 hour.” |
| What is a reason to document total blood volume drawn? | To determine the risk of latrogenic anemia. |
| The phlebotomist is collecting a blood donation in a collection bag when the vein collapses and the bag is only half way filled. What action should the phlebotomist take? | Use a new collection bag to draw a new unit of blood. |
| The phlebotomist is preparing to dispose of contaminated sharps. What is the appropriate action taken? | Replace the sharps container when it is 2/3 full. |
| The phlebotomist is washing her hands at the beginning of a shift. Which is the appropriate step taken? | Use enough soap to form a lather. |
| A patient reports a sharp pain radiating down their arm while a blood draw is taking place. What is the appropriate action to take? | Release the tourniquet and remove the needle. |
| A requisition should always include what? | A specimen ID code. |
| Which vein should the phlebotomist attempt to draw from first? | The median cubital vein. |
| What identifies a specimen for as long as it is in the laboratory? | Accession number. |
| Correct Order of Draw | Yellow, Light Blue, Red, Green, Lavender, Gray. |
| The phlebotomist is performing a capillary blood collection on an older adult patient. Which is the appropriate site for selection? | The distal phalanx or either middle finger. |
| A phlebotomist is involved in an accidental needle stick. What is the first step taken afterwards? | Flush the puncture site with water. |
| Which action can result in a grossly hemolyzed specimen? | Using the incorrect needle gauge. |
| A patient states that he ran to the facility. Which precautionary action should be taken? | Have the patient rest comfortably for 15 minutes before the procedure. |
| The phlebotomist is collecting a urine specimen for a pre- employment drug screening. Which is a sign that tampering of the specimen has occurred? | The temperature of the specimen is 30° C / 86° F. |
| The phlebotomist is instructing a patient on a midstream clean catch. Which cleanser does the phlebotomist instruct the patient to use? | Mild antiseptic soap. |
| The phlebotomist is performing a draw and notices swelling and a large hematoma developing at the puncture site. Which is the appropriate action to take? | Release the tourniquet, remove the needle, and stop the draw. |
| Which color signifies a health hazard in the NFPA 704 marking system? | Blue. |
| The phlebotomist witnessses a coworker receive a major electrical shock. Which action does the phlebotomist take first? | Shut off power to the instrument. |
| What action is taken after collecting an ammonia specimen? | Place in an ice water slurry. |
| For which reason does the phlebotomist avoid drawing blood on the leg or foot of a diabetic patient? | These areas are more susceptible to infection. |
| What is the total blood volume of an infant weighing 3.3 kg (7.3) lbs? | 240-330 mL |
| The phlebotomist is collecting from a donor and has already assessed and cleansed the site. What is the next step? | Instruct the patient to open and close their hand gently throughout the collection procedure. |
| You notice the patient’s last name on the requisition differs from the provided ID. What is the appropriate action to be taken in this situation? | Contact the ordering provider to correct the requisition form. |
| The phlebotomist enters a patient’s room for a stat specimen and the patient’s nurse and provider are in the room. What is the appropriate action to take first? | Introduce yourself to the patient and other health care members. |
| What is the appropriate action to take to prevent bleeding from the site after the needle is removed? | Apply pressure to prevent leakage of blood into the surrounding tissues. |
| What is the appropriate action to take when removing gloves after a procedure? | Remove the 1st glove so that it turns inside out during removal. |
| Why should the phlebotomist allow the site to completely dry after cleansing with alcohol? | Alcohol requires time for the antiseptic action to take place. |
| The phlebotomist enters a patient’s room to find them sleeping. What is the appropriate action taken? | Gently wake the patient to identify them and obtain consent. |
| Which color tube should be used for erythrocyte sedimentation rate? | Lavender. |
| The phlebotomist is preparing to store a blood specimen. What is the appropriate temperature to store the specimen at? | 2 to 8° C |
| A patient begins to seize during collection. What is the appropriate action taken? | Discontinue the draw. |
| For which reason should capillary collection be used instead? | When the patient’s veins are inaccessible. |
| What action can cause a hemolyzed specimen? | Shaking a collection tube vigorously. |
| What glucose level is outside of range and should be reported immediately? | 200 mg/dL |
| During a collection, several drops of blood land on the phlebotomy chair. Which cleaning solution should be used to clean the area? | 1:10 bleach and water solution. |
| After applying the tourniquet, the phlebotomist does not see a vein to use in sight. What is the appropriate action taken? | Have the patient dangle their arm for 1-2 minutes for veins to fill with capillary blood. |
| After verifying when the last dose of medication was administered, how long should the phlebotomist wait to perform the draw for a peak level? | 2 hours. |
| Which is the appropriate statement to make prior to venipuncture If a patient ask why the procedure is necessary? | Your provider has requested the test/s be done. |
| Which action is appropriate when verifying the quality of venipuncture supplies? | Inspecting the integrity of the needle’s seal. |
| Which piece of information ensures accurate inpatient ID? | Medical Record # |
| How frequent should quality control tests be done on a glucometer? | Every day the meter is used. |
| Which action is part of maintaining HIPAA compliance? | Clearing phone #s from the fax machine. |
| Which is the appropriate instructions to give a patient on collecting a 24/hr urine specimen? | Discard the 1st void of the morning. |
| Proper instructions on how to collect an occult fecal specimen? | Avoid taking ibuprofen. |
| The phlebotomist is preparing to enter a patients room. What is the appropriate first step to take? | Communicate your name and department affiliation to the patient. |
| Which is part of quality control record updating? | The expiration date. |
| When verifying a patient’s identity, which information is to be requested? | Patient’s full name and DOB. |
| What is the 1st step in the blood collection procedure? | The test requisition. |
| Which task is within the phlebotomy technician’s scope of practice? | Providing instructions to patients for specimen collection. |
| The phlebotomist is preparing to perform a fingerstick. What is the 1st step of action? | Confirming the identity of the patient. |
| Specimen that should be placed in ice following collection? | Ammonia. |
| A phlebotomist obtains two readings of 17 mg/dL when performing glucometer testing. What is the appropriate action to take? | Perform a set of liquid controls. |
| The phlebotomist is performing a hand draw. What is the appropriate action taken before the needle is withdrawn? | Disengage the tube from the adaptor. |
| Tube with which additive is used to collect a CBC specimen? | EDTA. |
| What is the most common POC test performed at home and in medical facilities? | Glucose. |
| The phlebotomist is instructing a patient on collecting a sputum sample. Which is the proper instructions? | Breathe deeply and then cough up sputum into the container. |
| What is the correct action taken when collecting a lactic acid specimen? | Collect the specimen in a gray topped tube. |
| What is the purpose for centrifuging a serum specimen before transport? | The cells must be separated from the serum. |
| Which is the correct procedure when performing a heel puncture for neonatal screening? | Saturate each circle with one drop of blood. |
| The phlebotomist is performing a draw on a patient with a left sided mastectomy and an IV in the right arm. Where should the phlebotomist draw from? | Below the IV site. |
| What type of consent is being provided when a patient extends their arm out? | Implied consent. |
What should a phlebotomist do when the patient is sleeping?
The Sleeping or Unconscious Patient: If the patient is sleeping, the phlebotomist should gently wake the sleeping patient and then allow the patient a few minutes to orient himself or herself before beginning the identification process.
Which of the following actions should a phlebotomy technician take when performing a venipuncture using an evacuated tube?
Which of the following actions should a phlebotomy technician take when performing a venipuncture using an evacuated tube system? The technician should position the needle in the same direction as the vein and at a 30 degree angle with the bevel up.
Which of the following actions should a phlebotomy technician take when performing a venipuncture?
Which of the following actions should the phlebotomy technician take when performing a venipuncture using n evacuated tube system? Position the needle at a 30 degree angle in the same direction as the vein and with the bevel up.
Which of the following sources for patient identification should a phlebotomy technician use in an inpatient setting?
Which sources for patient identification should a phlebotomy technician use in an inpatient setting? Verbal and wristband. A phlebotomy technician is reviewing a lab test result form before obtaining blood specimens from a patient.