About Phlebotomy

Phlebotomy goes by many names. It is also known as venipuncture, venisection, bloodletting or drawing blood. Simply put, it is the process or procedure by which a sample of blood is taken from the patient for medical testing. While it is a very common practice nowadays, it got its start in the barbaric practice of bloodletting or bleeding a patient and has a very long history which has claimed many lives in the 2,000 years of its existence.

Invented

The practice of bloodletting was originally invented by the Greeks around the time of Hippocrates, though the person who invented it is not currently known. Many famous Greek physicians expounded the virtues of phlebotomy and bloodletting. Herophilus, Archagathus, and Galen all claimed that bloodletting was necessary to return an individual who was sick, back to health. "Bleeding" a patient was based on the fact that women menstruate regularly. Since it was a natural occurrence this was assumed as a sign of good health. Hippocrates thought this was a process by which bad humors were naturally purged from the body and proposed that a physician might mimic this by inducing a patient to bleed for the same reason.

History of

Early methods of bloodletting involved cutting shallow lines into various spots of the body to induce heavy bleeding. This was based on the principle that the body and its health were controlled by the presence of four fluids or humors. Should the ratio of these humors become unbalanced, this would result in illness. As the centuries passed very little about this theory changed. People were bled dry by physicians as a treatment for wounds which were, in and of themselves, not dangerous save for serious blood loss. By the mid-1800s it was believed that you could reduce infection in a given area by "clearing out" the veins of infected blood. It was here that the term phlebotomy came into use. It was not until 1901 that the practice of bloodletting or phlebotomy was considered quackery. The practice was altered significantly as medical science improved over the following decades. Tests used to detect diseases were developed which required small samples of blood. This is where the term phlebotomy was revived, albeit its purpose changed. Rather than a treatment, phlebotomy had become part of a diagnostic process, which it still is today.

Function

Nowadays phlebotomy is performed under very rigidly regulated conditions. A licensed phlebotomy technician sits the patient down. The technician dons a set of sterile latex gloves and puts a tourniquet over the limb of the patient which she intends to extract blood from. Typically blood is taken from the large vein running down the interior of the elbow joint. Babies must have blood taken from a vein between the toes as it is the only one very well developed. The technician feels for the vein lurking beneath the skin and marks it typically with a pen or marker. She sterilizes the area against infection with a swab of isopropyl alcohol. If only a single sample need be taken the technician readies a plain syringe. If multiple blood tests are to be performed the technician readies a syringe connected to an open bodied tube called a Vacutainer. The technician punctures the skin with the tip of the needle and eases it into the vein. She will then draw back the plunger on the syringe to take the sample or connect a vacuum sealed tube to the back of the Vacutainer. The tube will fill up with blood. The technician simply removes the tube and fits another into place until all the sample tubes have been filled. The technician presses a bandage over the puncture and removes the needle, applying pressure to prevent any bleeding. The bandage is taped in place and the patient is free to go.

Benefits

The benefit of phlebotomy is enormous. Without the ability to draw blood, no blood tests could be performed. With the inability to perform blood tests, thousands of dangerous, communicable or deadly diseases would go undiagnosed. The death rate from disease would be incalculably vast and many diseases which the people of the world have successfully eradicated would still be running rampant. Phlebotomy is used to test blood sugar levels for people with diabetes. It tests hemoglobin levels in those prone to anemia. DNA tests and comparisons are most easily performed with blood samples. Almost none of the medical advances made over the last century would have been made without safe and humane methods of phlebotomy.

Risk Factors

Despite the vast leaps that medical science has made in the last century, there are still risks involved in any medical procedure, no matter how minor. The most common of these risks are minor infections in the area where the needle has punctured the skin. This can lead to serious fever and the development of scar tissue in the effected area. Septicemia, more colloquially known as blood poisoning, can occur if non-sterile materials are used for phlebotomy. This can result in fever, brain damage, damage to the internal organs, necrotization of the affected tissues and death. This is why it is so important that needles never be reused and the skin surrounding the vein is sterilized of all pathogens. People with certain genetic predispositions can develop Hemochromatosis from repeated punctures by phlebotomy needles. This is a potentially fatal buildup of iron levels in the body. As the disease manifests shortly after being punctured by iron or steel, it tends to make itself known very early in a person's life.