TOP

Phlebotomists

 Phlebotomists collect blood samples for clinical laboratory testing or transfusion. They also assist in reducing workloads for doctors and nurses by focusing exclusively on the collection of blood specimens, particularly in hospitals. Phlebotomy is the act of drawing blood, and a skill employed by physicians, nurses, paramedics, researchers and laboratory scientists across a wide range of allied health care fields, in both the public and private sectors.

Phlebotomist is a term derived from two Greek words φλέψ (phleps) meaning a vein, and τομός (tomia) which means cutting. Phlebotomists may comprise of specialised laboratory technicians, clinical support workers, or assistant healthcare scientists who are qualified to collect blood specimens from patients for examination, the results of which may provide valuable information for diagnosing blood disorders and illness.

Phlebotomists are trained to draw blood from veins by performing venipuncture. Others are specially trained to collect arterial blood samples from the brachial artery in the antecubital fossa, an area in the bend of the arm, or from the radial artery of the wrist or kateva. For the collection of minute quantities of blood, fingersticks are used, and from infants by means of a heelstick. Phlebotomists are required to have a high level on manual dexterity and be able to manipulate small objects, needles and collection tubes.

The laboratory analysis of blood specimens have multiple clinical purposes. Blood samples are used to assist in accurate diagnosis, monitoring therapy, and assessing therapeutic effects of treatment. The primary function of a Phlebotomist is to safely and reliably collect blood specimens for laboratory analysis.  Diagnostic laboratory tests are used to identify and determine the extent of abnormalities present in diseased states. Although Phlebotomists are  involved in the preanalytical phases of laboratory blood testing,  their role is not to interpret test results or offer personal opinions on diagnosis or treatment of patients.

phleb syringe tubes Phlebotomists follow a number of organisational policies which include infection control, prevention of needlestick injury, fire and safety procedures, and a dress code. Phlebotomy certification is legally required in the UK, but is mandatory in only two states of the USA. Health care is a rapidly expanding industry and created a new para-medical discipline for a certified professional. Phlebotomists work in a wide variety of settings including hospitals, GP clinics, mobile healthcare units, donor collection, and in patients own homes. Depending upon the organisation they work for, Phlebotomists may be required to travel to nursing homes or outpatient clinics to collect blood specimens.

Read More
TOP

Haemophilia

 Phlebotomists may encounter patients with a genetic blood disorder known as Haemophilia. Haemophilia is a rare inherited blood condition with virtually every sufferer being male, as menstruation would certainly be life threatening or even fatal for a female haemophiliac.

This serious blood condition causes excessive bleeding and is due to the very slow clotting time of the blood. This is a life-long problem for a haemophiliac due an absence of a specific blood protein clotting agent called `Factor VIII’, one of the many different elements required for the process of normal coagulation of blood.

Factor VIII is essential for the clotting complex mechanism, and in all haemophiliacs this is missing, due to a defective gene. Genes are the body’s messenger carriers, conveying vital information from parents to offspring. Half of our genes come each of our parents and carry within their coding the ‘blueprint’ for producing the body’s cells, tissues, organs, enzymes and hormones etc. Each cell in our bodies carries more than 20,000 such genes.

Bleeding commonly occurs from blood vessels that are cut or bruised. The most common are injuries to joints which are a frequent source of problems to haemophiliacs. Research shows that the majority of male haemophiliacs have a close male relative with the same condition, such as a brother, uncle or grandfather, however, over one third appear to have no family history of the condition.

Once a haemophiliac child starts to walk, they will experience trauma to their joints as they stumble and fall. Bleeding then occurs into their muscles and joints, with resultant bruising, swelling, discomfort or pain in the affected area, usually the knees, elbows and wrists. If bleeding is not treated swiftly, then marked deformities of the joints may occur. As all haemophiliac children bleed profusely, even after the mildest of injuries, and for this reason dental treatment is of a proimary concern as this can result in horrendous haemorrhage.

Phlebotomists are often trained in research methods and found investigating family history. If the condition is suspected, it may be diagnosed before birth, in the fetus in the womb, using a technique called amniocentesis. After delivery, the condition may be diagnosed by measuring the blood level of Factor VIII, which is abnormally low or absent in haemophiliacs.

As the condition is the result of having low levels of Factor VIII, receiving regular intravenous injections of this clotting factor can prevent flare ups of the disease. Infusions of Factor VIII immediately after an injury will also prevent severe haemorrageing, and Phlebotomists have taught many patients to self administer their own treatment. Before the discovery of Factor VIII deficiency, most haemophiliacs died before reaching adultdhood.

 The clotting Factor VIII, has to be obtained from blood that has been donated and pooled from blood transfusions from thousands of people. During the first few years of the AIDS epidemic, many haemophiliacs became infected with the HIV virus from contaminated blood transfusions given at that time from people undiagnosed as having AIDS. As a result, some haemophiliacs and their sexual partners have died as a result of developing AIDS.

All blood is currently screened for the HIV virus and all Factor VIII infusions are heat treated to eliminate all possible blood borne infecting viruses.

Phlebotomists strongly advise all haemophiliac children  to avoid `contact sports’, such as rugby, football and martial arts. Injuries should be treated as quickly as possible, and the child encouraged to engage in easier leisure pursuits such as swimming, hiking, or to adopt artistic and musical interests.

Read More
TOP

The Heart

Phlebotomists have an excellent knowledge of human anatomy and physiology, epecially of the circulatory system. The heart is the prime organ and is suspended by ligaments in the centre of the chest.  It has an unimpressive form being a reddy brown colour, around 15 cm long, 10 cm wide, weighs in about 340 grams and appears more pear shaped than a Valentine.

The heart is a tough four chambered pump – actually two pumps, with one to push de-oxygenated blood to both lungs where gaseous exchanges happen, and the other to force oxygenated blood out into and around the body.

Every day the heart pumps blood through about 97,000 km of blood vessels, enough pumping to fill a 15,000 tank and working twice as hard as a sprinters leg muscles. No muscles in the body are stronger except those of a woman’s uterus during childbirth, however the uterus does not keep up its work rate 24/7 for 75 years. The heart does have a rest period, of about half a second between beats. Also during sleep, a large percentage of our capillaries are inactive and the heart rate slows from a normal 72 beats per miniute down to around 55.

Phlebotomists typically have working knowledge of the heart’s firing system and of any cardiac abnormalities which may prevent the safe practice of collecting blood specimens. The heart generates it’s own electicity and occasionally a heart will misfire, piling one beat upon another and creating the feeling of it having ‘skipped a beat’, however this is not the case, and is just a normal function of the heart momentarity becoming out of tune. This misfiring happens often and usually occurs without our knowledge.

The heart consumes about ten times the nourishment of the body’s other organs and tissues, and receives its own supply directly from the blood via the coronary arteries. Although only weighing a two-hundreth of total bodyweight, it requires one-twentieth of the total blood supply. It takes around tree-tenths of a second for the left ventricle to pump blood out into the body with a force powerful enough to reach every milimetre of the body’s bilions of cells. Blood pressure is measured using a mercury sphygmomanometer. Normal blood pressure is 120/80 mmHg and in healthy, fit individuals the heart is capable of working optimally within a wide range of physical and emotional demands.

Phlebotomists are widening  their role as health professionals to encourage patients to take more care of their hearts and circulatory sytems i.e. quitting smoking, eating a balance diet, reducing stress, taking regular exercise and maintaining an appropriate bodyfat to bodyweight ratio. High percentages of bodyfat, and accompanying subcutaneous fat makes the Phlebotomists job much more difficult in locating veins with which to draw blood. Each and every kilo of excess bodyfat contains something around 150 kilometres of additional capillaries through which the heart must pump blood.

 Whilst a growing academic opinion is now focused upon Regenerative Medicine, and how we can utilise the body’s own capability to repair itself, this requires  increased investment in stem cell research.

Currently the only way to replace the heart is through human donor transplant, or the use of an artificial heart manufactured to duplicate the functions of the organic pump. Phlebotomists need to be aware of the potential downside of any transplant procedure i.e., the high risk of organ rejection, and how the immune response is controlled and supressed through the life-time use of a powerful drug regime.

Read More
TOP

Blood Pressure

sphygmomanometer

Phlebotomists are often required to measure a patient’s blood pressure before the drawing of blood samples. This is achieved using an inflatable cuff connected to a pressure gauge which fits around the upper arm, known as a sphygmomanometer.

Around 40% of the UK population have high blood pressure  or Hypertension, but many are unaware of their condition as it usually does not cause them any symptoms.

Hypertension significantly increases the risk of heart disease, heart failure, a stroke and kidney disease. Phlebotomists are trained to recognise all major circulatory risk factors which may affect a patients health, and also the Phlebotomists ability to safely and reliably obtain blood specimens.

The blood pressure readings are expressed as milimetres of mercury (mmHg), and are measured at two phases using two figures e.g. 120/80 or 120 over 80 in a healthy, youg adult. The upper reading (120), is know as the systolic pressure, and is created by the contraction of the ventricles of the heart and exerted by the flow of blood through the main arteries. The lower reading (80), is known as the diastolic pressure, and is your blood pressure recorded during relaxation of the ventricles when the heart is at rest between beats. The diastolic reading reflects the peripheral resistence, the force created by all the small arteries and the load against which the heart must work.

Blood pressure ranges:

  • Low – 90/60
  • Ideal – 120/80
  • High – 140/90

 Phlebotomists recognise that blood pressure measurements often vary with age, between individuals, and also at different times with the same individual e.g., after a meal, alcohol, sex, exercise or anxious, stressful experiences.

Sustained levels of low blood pressure is termed hypotension and in the UK this is not considered a serious enough condition to desrve treatment. Having a family history of hypertension is a significant risk factor, but you are more likely to develop high blood pressure as you age, if overweight, smoke, do little in the way of physical exercise, and have an unhealthy diet.

Cholesterol

Phlebotomists are often required to test bloods for cholesterol levels.  And there are two numbers used for diagnosing; the number which records the total level of cholesterol circulating in the blood; and the number which determines  how much LDL-cholesterol is present.

High blood cholesterol is a major risk factor for developing high blood pressure, heart disease and stroke. However,  it’s the LDL – or bad cholesterol – which doctors focus on. Too much bad cholesterol in the blood can gradually build in the arteries, leading to narrowing of the arteries, heart disease, stroke and blood clots. Conversely, higher levels of HDL – or good cholesterol – are better, as these higher levels appear to protect against heart disease.

Healthy cholesterol numbers:

  • Total cholesterol – less than 5mmol/L
  • LDL cholesterol – less than 3mmol/L
  • HDL cholesterol – more than 1mmol/L

Body Mass Index

Phlebotomists employed as research assistants deliver clinical, anthropometric and body composition measurement services for paediatric healthcare. This involves taking  Body Mass Index (BMI) measurments such as  the Diet and Nutrition Survey of Infants and Young Children (DNSIYC). Your BMI is a good indication if you are a healthy weight in relation to your height.

To do this, divide your weight in kilograms (kg) by your height squared in metres.

BMI numbers:

  • Underweight – less than 20
  • Normal – 20 – 25
  • Overweight – 25 – 30
  • Obese – 30 – 35
  • Severely obese – above 40

However, there are a some exceptions to the rule. The BMI does not differentiate between fat and muscle. This means that muscular athletes and bodybuilders may have a high BMI, although they are not actually overweight. Phlebotomists aim for the most visible veins in order to draw blood. Patients with high bodyfat percentages, and high levels of subcutaneous fat, just under the skin, make it much more difficult to locate surface veins.

Similarly, older people, or someone with a disability who may have some sort of muscle wasting, may have a low BMI, but this does not mean they are underweight. This is why some experts prefer to use waist size as a more accurate indication of health risk.

The UK now has more obese people than any country in Europe. People who are obese are at risk of serious health conditions such as high blood pressure, heart disease, type 2 diabetes, high cholesterol levels, and osteoarthritis.

Waist size

Research has shown that people who carry extra fat around their waist are at a higher risk of developing obesity related health problems than those who carry it upon their hips and thighs.

Men with a waist circumference of 94cm (37″), and women who measure 80cm (32″), are at higher risk of obesity-related disease.

Men measuring 102cm (40″), and women 88cm (35″), around the waist have an even higher risk.

If you fall into the overweight or obese category, you should contact your doctor. Depending on how overweight you are the practice Phebotomist may carry out tests for high blood pressure (Hypertension), diabetes and cholesterol,.

Read More
TOP

Haematomas

A haematoma is a collection of localised blood, usually in liquid form, outside the blood vessels, and is generally the result of a hemorrhage within the tissue. A haematoma is distinguished from a simple bruise or ecchymosis in that it forms a sac or pocket of blood, rather than a thin spread of blood immediately under the skin. The word “hematoma” is devised from the Greek terms hema- referring to the blood + -oma, from the root word oma – meaning body, or a bloody body, i.e. a collection of blood.

Hematomas mostly occur within skeletal muscle and can form into A hard mass under the surface of the skin. Typically the sac of blood or hematoma eventually dissolves; however, they may continue to grow or show no change. The very slow process of reabsorption of a hematoma can allow the broken down blood cells and hemoglobin pigment to migrate into connective tissue. If the haematoma does not disappear, then it may need to be surgically removed if it is restricting the mobility of a joint or causing unsightly embarrassment to the patient.

Phlebotomy haematomas may be caused by the perforation of the bottom or sidewall of a vein causing the release of blood and localized inflammation. This can be avoided by applying better technique i.e. inserting the needle in at the correct angle and depth, and keeping the needle steady throughout the procedure whilst attaching and changing tubes. Attention must also be given to the removal of the needle after the collection taking care to withdraw smoothly and straight. Haematomas may also be caused by forgetting to remove the tourniquets before removing the needle and therefore not allowing a reduction in the pressure at the wound site.

 

Following the procedure pressure must be applied to the wound site until bleeding has stopped. This may take a few minutes if the patient is taking any anticoagulant medicines, and if so time allowed for clotting factors must be considered. If there has been inadequate pressure applied or for not long enough then a haematoma may develop. If a heamatoma is present then apply a fresh dressing to the site, secure tourniquets, apply pressure and supervise the patient with the same technique. It’s important to stay with the patient, reassuring them, and to suggest gentle massaging of the swelling, or perhaps ice packs if appropriate.

Read More
TOP

Infection Control

 Phlebotomist training involves paying very close attention to what may appear to be minor details, but which can have a major impact on the health and safety of their patients and colleagues.

Infection control is a great area of concern in the NHS. Armstrong-Esther (1982) stated that ‘The prevention of infectious diseases is a much more sensible method of control than waiting until a disease or epidemic occurs and then attempting to deal with the consequences in a hurry.’ He also argued that the success of vaccines and antibiotics leads to increased pressure for their abandonment as mutating bacteria become resistance to the overprescribing of generic antibiotic drugs and thus weaken our efforts to control them.

While most medical problems are associated with infections, and are the result of immunological mediated hypersensitivity reactions to protein component common in the environment, a number of serious healthcare-associated infections continue to be a high priority. Although the H1N1 and SARS viruses continue to create newspaper headlines, the MRSA outbreaks with UK hospitals continues to claim lives. The Health Protection Agency 2010 reported a total of 1,898 cases of MRSA bacteraemia in 2009/10, which represents a reduction of 35% in reported cases from the previous year when 2,935 cases were recorded, and demonstrates the efforts made to reduce the risk as a result of extensive and collaborative research.

Phlebotomists are usually in close proximity with large numbers of patients and are especially vulnerable to cross infections. Particularly at risk are the very young, elderly and those receiving immunosuppressive treatments, where regular blood collection samples may be critical to the accurate diagnosis and monitoring of those treatments. As government budget cuts impact heavily upon NHS resources the problem is to develop a method of infection control that is safe, effective, and can be repeatedly delivered at low cost. The Royal College of Nursing (1995) states that correct hand washing is the single most effective measure in which a healthcare worker can control and prevent the spread of infections in hospitals.

The Integumentary system consists of the skin, hair, sweat and oil glands, teeth and nails, and has multiple functions including sensory reception, thermal regulation, insulation, absorption and excretion. However its primary role is that of protection from the millions of potentially harmful bacteria, viruses, fungi and parasites that aim to gain entry. The skin is the largest organ in the body and forms the outer surface of the entire body. It functions to keep internal tissues free from infection by forming a physically protective water proof layer.

It also has another defense mechanism by providing a home to millions of comensual, ‘friendly’ bacteria that create conditions unsuitable for potential pathogens to grow or establish themselves. Senior K 2011. Each and every individual has a different complement of comensual bacteria on their skin surface. As many as 180 different species can be growing there including benign species of Staphylococcus hominis, Arcanobacterium haemolyticum, Staphylococcus epidermidis, and Micrococcus luteus.

Removing all dirt and infectious contaminants from the skin is particularly important. Hands and other soiled areas of the body, clothing and equipment should be cleaned at least at the end of each working shift, prior to and after meal breaks, and after visiting the toilet. It is usual to wash the hands before any direct contact with a patient, after contact with blood or bodily fluids, after removing gloves, and before any aseptic techniques.

The correct method of hand cleaning is essential to reducing infections and developing a good hand washing technique will to ensure hands are cleaned thoroughly. Special attention should be paid to the backs of the hands, fingertips and the thumb areas as these are the most frequently missed. Avoid scrubbing the hands as this will remove many of the comensual bacteria offering protection to the skin. For heavily soiled hands most manufacturers recommended applying an appropriate specialist hand cleanser directly to the skin before wetting.

 

 

1. Rub palm to palm

 

2. Rub palm over back of hand, fingers interlaced

 

3. Palm to palm,
fingers interlaced

 

4. Fingers interlocked
into palms

 

5. Rotational rubbing of thumb
clasped into palm

 

6. Rotational rubbing of
clasped fingers into palm

 

To avoid the risk of drying out and chapping of the skin especially during cold weather the hands should always be properly dried. The use of barrier creams and emollients can also reduce damage to hands from the continued washing and drying. Clean towels should always be available as dirty, ‘communal’ towels would expose the skin to more dirt and lead to the risk of infection. If possible, Antibacterial paper or ‘single issue’ disposable towels should be used, and also the liberal use of alcohol based gels and sprays to further reduce contamination.

Regular hand washing will become an unconscious behaviour or ‘habit’ if practiced repeatedly for around twenty one days. It takes approximately three weeks for new neural pathways are to created and strengthened for any new learned behaviour or skill,  and hand washing is an extremely useful behaviour worth developing in the control of the spread of infection.

Phlebotomists are among a main group of healthcare sector workers considered most at risk from  transmission infections by what is more commonly referred to as a needlestick or ‘sharps’ injury. Needlestick injuries also occur in other fields of work such as the police, prison and probation services, social work, body art and piercing industry, customs and excise, and the funeral industry. Phlebotomists follow a standard safety procedure adopted in the UK for the prevention of needlesticks.

The major risk posed by needlestick injury to workers is exposure to blood-borne viruses (BBV).  The main viruses involved are:

Hepatitis B (HBV)

Hepatitis C (HCV)

Human immunodeficiency virus (HIV)

Phlebotomists may acquire a BBV infection if they are exposed to infected blood or body fluids. This could be either via the mucous membranes (eyes, inside of the mouth and nose), through broken skin or through an inoculation injury route, where the skin is punctured or scratched by a needle or ‘sharp’ that has been used in a medical procedure.

In the case of HBV an effective protective vaccine is available; however no such protection is available for other BBVs.  These other infections are difficult to treat, the prophylaxis or treatment is unpleasant, may cause significant side effects, and there is no guarantee that treatment will be successful. As the prevalence or carriage rates of BBVs in the general UK population is generally low, therefore the risk of infection from needlestick injuries remains minimal.

Read More
TOP

Tourniquets

 Phlebotomists are required to become familiar with different types of tourniquets and how to correctly apply them to a patient. A tourniquet is used first to compress a limb, usually the upper arm, and to swell the veins. After a suitable vein is identified a needle is insertedand  a syringe or collection tube may be used to draw blood samples.  Often a medicine  may be injected and for intravenous infusion a cannula, a small plastic tube is inserted via the needle. After the first or second specimen blood has been withdrawn,  the tourniquet is usually loosened to allow the blood to flow frely until all specimens are collected and the cannula is then removed. The wound site is then covered and pressure applied to prevent any bleeding. The procedure is not usually painful however it may cause some patient discomfort.

There are currently two types of tourniquet in used in phlebotomy procedures. Disposable tourniquets are much preferred for reducing the risk of transferred infection and as they can be more freely available, however they are often of poor quality to keep costs low, and can be more of a challenge to learn to apply safely and effectively without using them with a knot. Disposable tourniquets like certain types of examination gloves have a high content of latex, and proteins in the structure which may cause an allergic reaction.

Reusable tourniquets have the advantage of being adjustable, and can provide very small increments of pressure through the use of quick release clips. Although more expensive they can allow more ease and speed of use, finer manipulation of pressure upon the veins, and may be more comfortable for individual patients. These tourniquets have an inside and outside dictated by the position of the release clip, and can be put on from the wrong side so that rather than abduct or draw the tape out and away from the patients centre, the phlebotomist may adduct, and draw a length of tourniquet across the face or chest of the patient. This increase the risk of an eye injury if the tourniquet snaps back, as it’s made of elastic material, and also the phlebotomists hand would be very close to a female patients breast which if contact were made may be misinterpreted as a sexual assault.

In all circumstances tourniquets should be placed 1-2 inches above the collection site and just tight enough to be able to place a single finger between the skin of the patient and the inside surface of the tourniquet. Tourniquets have been used for centuries by soldiers in battle and surgeons to slow down or stop the flow of blood. They can be potentially dangerous and result in serious injury if not applied correctly or left on for too longer period of time. For this reason tourniquets used in paediatrics are used only by specially trained clinicians.

Typically a tourniquet is only left in place in tension for two minutes. Left in place longer than this may cause hemolysis and additional edema within the surrounding tissues resulting in the collection of inaccurate blood samples. Once the blood collection has started the tourniquet should be released and then removed from the limb when finished. A correctly applied tourniquet will allow the phlebotomist to obtain the best possible sample of blood quickly, efficiently and with the minimum of stress and discomfort to the patient.

Read More
TOP

Reproductive System

12+ +sperm and egg Phlebotomists regulary collect bloods for DNA testing as paternity disputes can be quickly determined with simple and irrefutable DNA results. Blood tests can also identify genetic abnormalities which may affect fertility or to eliminate potential hereditary diseases and disorders. Bloods are routinely screened for sexually transmitted diseases (STD’s).

Read More
TOP

Lymphatic System

 Phlebotomists are

Read More
TOP

Urinary System

urine test 199x300 Phlebotomists are acutely aware of how critical blood pH levels are in maintaining life. Even a tiny deviation in the acid/base balance can have major consequences on the organs of the body, and often with fatal results.  The very narrow parameters

Read More
TOP

Digestive System

 Phlebotomists understand that blood tests can identify the causes of several gastrointestinal disorders. The digestive system functions to break down food physically and chemically into nutrients which can be more easily absorbed and utilised by the bodies cells and tissues. It also serves to elimiate the waste products of digestion.

The gastrointestinal (GI) tract consists of 21 seperate structures that includes the mouth, pharanx, stomach, intestines, and several accessory organs such as the salivary glands, liver, gall bladder, and pancreas.

The passage of food begins at the mouth and ends at the anus. This route is known as the alimentary canal and in the averages adult is around 8.2 meters in length, and a meal can take between 15 – 48 hours to complete the journey.  The digestive process begins in the mouth with teeth providing the cutting, chewing, and grinding force to reduce the food into appropriately sized pieces for ease of swallowing. This process is termed mastication.

Saliva secreted during mastication contains enzymes which facilitate the digestion and absorbtion of solid and liquid food. Phlebotomists may be required during blood collections to take swabs of patients mouths for various culture examinations.

Read More
TOP

Cardiovascular System

 Phlebotomists collect blood specimens for numerous laboratory tests done to assess the efficiency of the cardiovascular system. Haemostatic disorders are a serious threat to life. Overactive clotting can cause a thrombus, an embolus, or disseminated intravascular coagulation (DIC) disease. Anticoagulant drugs such as heparin or warfarin are used to suppress clotting factors. Conversely, if clotting factors are deficient, as in haemophilia, then excessive bleeding can occur following a simple injury.

Tests for blood typing and cross matching are typically done in a transfusion, blood bank or immunohaematology laboratory. Plasma and serum that are tested for repiratory gases, regulatory hormones, metabolic wastes, and nutrients are usually carried out in a chemical laboratory.

Read More
TOP

Respiratory System

 Phlebotomists have an important role in respiratory medicine. Respiration refers to the exchange of gases that take place between air and the blood. Oxygen makes up 20% of our atmosphere and the average person inhales and exhales between 12-15 times per minute, or around 20,000 times per day. As oxygen (O2) and carbon dioxide (CO2) enter the blood, the circulatory system transports them between the lungs and body tissues. The repiratory and circulatory system function together delivering O2 to the cells and removing CO2.  At the cellular level oxygen is require for burning nutrients and releasing energy.

The main structures of the respiratory system are located in the head, neck, and thorasic cavity. They consist of the nose, pharanx, larynx, trachea, bronchi, and lungs. As each breath is taken the air travels through the nasal and pharangeal air passages into the lungs. A major change of gases takes place in the lungs  where O2 is exchanged for CO2, and then the air is exhaled.

 Phlebotomists are actively involved in the education of their patient who have a history of smoking. Respiratory diseases directly caused by smoking kills over 100,000 people every year in the UK.  Around 20% the UK adult population still smoke. The government’s plans to further ban cigarette advertising through the restrictions on brand packaging is aimed at reducing the treatment costs to the NHS.

Read More
TOP

Endocrine System

tallest and shorte 1559059i Phlebotomists frequently encounter patients with disorders of the endocrine system. The most common being diabetes. The human body has two types of glandular tissue. Exocrine glands secrete fluids such as saliva, mucus, digestive juices, and sweat. These fluids are transported through a network of channels or ducts. Endocrine glands release their secretions (Hormones) directly into the bloodstream, and are therefore referred to as ductless glands.

The Pituitary, or Hypophisis is a pea sized endocrine gland weighing 0.5 g and situated at the base of the brain. The pituitary is functionally connected to the hypothalamus as a protrusion, a tube referred to as the infundibular stem or pituitary stalk, and secretes 9 hormones that regulate homeostasis.

The Posterior Pituitary or Neurohypophysis stores and releases 2 hormones:

ADH, the Antidiruetic hormone is also known as AVP, Arganine vasopressin although much of this is relesed by the supraoptic nucleus in the hypothalamus.

 Oxytocin,  is one of the few hormones that provide a positive feedback loop. During labour, this feedback loop continues throughout as uterine contractions stimulate the release of oxytocin, which in turn, further increase uterine contractions. To hasten a difficult labour oxytocin IM injections are often given.

Read More