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The first step a phlebotomy technician performs when drawing blood is to record the patient's medical history, temperature, and pulse, and match the physician's testing order with the amount of blood to be drawn. Next, the site of the withdrawal is located. Typically, the large vein that is visible on the underside of the arm near the elbow is used.
Finding a suitable vein, however, is not always easy because there are a great many anatomical differences among people. Once a suitable site is located, a tourniquet is wrapped high on the patient's upper arm. The phlebotomy technician checks the site for lesions, scar tissue, other needle marks, and any skin disorders that might interfere with the collection process. Then the site is cleansed by swabbing with a sterile solution. The technician positions the patient's arm in order to make a proper puncture. The needle is inserted almost parallel to the vein and as close to the skin as possible. Then the hub of the needle is raised and the angle toward the skin increased so that the needle can pierce the wall of the vein. After the needle is advanced slightly into the vein, blood may be withdrawn. Generally this is done by releasing a clamp attached to the blood collection device or to the tubing. When the required amount of blood is collected, the needle is removed and sealed, the site covered, and the tourniquet removed.
After collection, the phlebotomy technician labels the blood, coordinates its number with the worksheet order, and transports the blood to a storage facility or to another laboratory worker. The phlebotomy technician also checks to make sure that the patient is all right, notes any adverse reactions, and administers first aid or other medical assistance when necessary.