AMYA

POLYTECHNIC COLLEGE MEDICAL LABORATORY

Bonum Est Sui Diffusivum SCIENCE PROGRAM

COURSE MODULE
Principles of Medical Laboratory Science 2
Course No.: MT 103
Course Title: Principles of Medical Laboratory Science 1
Unit: 3 Units (2 Units Lecture and 1 Unit Laboratory)
Pre-/Co-Requisite:
Year Level: 1st Year, 2nd Semester

Course Description:
This course deals with the basic principles of phlebotomy and laboratory assisting. It
emphasizes on the understanding of phlebotomy, from its evolution to the current practice. It
deals with infection control, blood collection equipment, different venipuncture procedures,
other body fluids and the different analytical phases of specimen collection.

Course Objectives:
At the end of the course, the learners are expected to:

COGNITIVE
1. Identify the different blood collection equipment
2. Discuss the steps in specimen collection, from proper patient identification to releasing
of results
3. Identify other body fluids, describe their nature, use and proper collection

PSYCHOMOTOR
4. Decide the appropriate method and equipment to use in different settings, test
requests and indications
5. Properly demonstrate the different procedures for specimen collection

AFFECTIVE
6. Appreciate the role of a phlebotomist in today’s healthcare setting
7. Embody the following values and traits of being a health care professional: Integrity,
Honesty, Critical Thinking, Empathy and Value for Life
Learning Module No. 1

Topic: Understanding Phlebotomy

Materials: Laptop and Internet Connection
Assessment: MCQ Post-Test via Infinit

Learning Outcomes:
At the end of the session, the students should be able to:
1.) explain the general concept of PMLS 2
2.) recall the general topics and activities done in PMLS 1
3.) describe the evolution of phlebotomy and the role of the phlebotomist in today’s
healthcare setting
4.) discuss the traits that form the professional image of the phlebotomist
6.) distinguish the different types of healthcare settings
7.) list the clinical analysis areas of the laboratory and the types of lab procedures
performed in the different areas

The evolution of phlebotomy and the role of the phlebotomist in today’s healthcare
setting

Phlebotomy was known as bloodletting when it was first used and dates back to the
ancient Egyptians, around 1000 BC. They believed that the process of releasing blood from the
body would cure various diseases, such as the plague and acne. Some even believed that it
could cast out evil spirits. In this case, the procedure would be performed by a priest, who was
also the official "physician" during that time.

In Greece, a prominent Greek physician known as Galen of Pergamon, discovered that

arteries as well as veins had blood. Previously it was thought that arteries were filled with air. It
was commonly believed at the time that blood didn't circulate through the body. Instead, they
thought that it stagnated in the extremities. During this time, treatment involved giving the
patient an emetic to encourage vomiting. Galen of Pergamon developed quite a complex
system for the quantity of blood which should be removed and from what specific areas of the
body. Interestingly, he believed that blood should be drained as close to the diseased area of
the body as possible, as this was the "diseased blood".

At some point during the 16th century, surgery started to become slightly more
sophisticated and the job of bloodletting went back to the physicians. By the 1800s the
popularity of bloodletting was reaching an all-time high. The physician would perform the
procedure by making an incision into the arteries or veins. In some cases, in an attempt to
"improve" their technique, they used a device called a fleam, which was a wooden stick that
drove a blade into the vein. The use of a 12 spring-driven blade that could make shallow cuts all
at once (known as a scarificator) was considered a more humane way to retrieve blood from a
human. In some cases they also used cupping as a method. This method blistered the skin so
that the blood could then be released via the blisters. At this time too, leeches were used to
soak up the blood. Bloodletting was used to "cure" diabetes, acne, cholera, asthma, cancer,
conclusions, coma, epilepsy and much more!
 In today's world, we now know that losing too much blood is definitely not helpful and
that, especially in historical circumstances such as the Plague, bloodletting actually only
contributed to the illness and made it much worse.

It's amazing to think that these practices were still being conducted in the early 1900s.
Thankfully, modern bloodletting is a completely different scene today. Phlebotomy in today's
medical sphere has a different use. It isn't used to simply release blood from the body, but
rather to take a sample of blood from a patient for diagnostic purposes which is under the direct
order of a physician. Thankfully, today the process of taking a blood sample is safe, quick and
pain-free when performed by a certified phlebotomist with the use of sterile tools in a healthcare
environment.

Today, a phlebotomist has a variety of roles including:

- Drawing blood from blood donors and patients

- Evaluate a patient's ability to withstand procedures
- Explain various blood-drawing procedures to patients and answer any questions they
may have
- Perform basic care testing, such as blood glucose levels
- Prepare urine, blood, and other specimens for testing
- Maintain medical equipment such as test tubes, needles, and blood vials

Traits that form the professional image of the phlebotomist

Compassion.

A Phlebotomist’s primary duty is drawing blood. Because some patients or clients are
afraid of having their blood drawn, it is especially important that Phlebotomists are caring and
understanding while performing their duties in order to make the patient feel as comfortable and
at ease as possible.

Detail oriented.
Phlebotomists must draw the correct vials of blood for the tests ordered, track vials of
blood, and enter data into a database. Attention to detail is a must; otherwise, specimens may
be misplaced or lost, or a patient may be injured. It is also especially important for
Phlebotomists to keep their work environment clean and organized in order to avoid confusion
or causing infection and other complications.

Hand–eye coordination.
Drawing blood is a complicated task that phlebotomist must do several times a day.
They are responsible for drawing blood from many patients, and they must perform their duties
successfully on the first attempt, or their patients will experience discomfort or pain.

Ability to Multitask.
Labs can be a very busy place. Doctors, nurses and patients often rely heavily on the
results from blood work in order to determine proper diagnosis and treatment for patients.
Because so many people rely on these results, Phlebotomists must have the ability to multitask
and oftentimes meet tight deadlines and requests.
Team Player.
Because any medical staff is essentially a big team, it’s important for a phlebotomist to
be able to work well with other people in order to deliver the highest standard of care possible to
patients.

Different types of healthcare settings

Hospital
Hospitals primarily provide diagnostic and treatment services to patients who require
intensive or immediate care. Most hospitals are in-patient facilities, requiring patients to stay
under the supervision of specialized health care professionals until discharged.

Hospitals are generally classified by the type of ownership, treatment, facility size, and
length of a patient’s stay. The majority of them are nonprofits, typically governed by a regional
health authority.
 Most people are familiar with a general hospital, which admits patients for all types of
medical conditions. Depending on a patient’s diagnosis, a general hospital may refer him or her
to an acute care hospital, such as a cancer treatment, children’s, or maternity hospital, or to a
member of the hospital’s outpatient facility network.

Outpatient Clinic
An outpatient clinic or facility is often for patients who need short-term care and can
recover at home. Hospitals refer discharged patients to a network of outpatient clinics that
specialize in services for ongoing conditions such as weight loss, drug or alcohol rehabilitation,
and physical therapy.

Outpatient clinics are typically more convenient and affordable for patients as well. Day
surgery centers, urgent care clinics, and specialty clinics are often in close proximity to a
patient’s home, providing easier access to high-quality, non-emergency care.

Long-Term Care Facility

Long-term care facilities support people with short-term recovery, ongoing health
conditions, or disabilities. They are designed to help patients complete daily activities as safely
and as independently as possible.

According to a recent survey by Genworth, 7 in 10 people will require long-term care in

their lifetime. Depending on their health, patients can receive in-home care through homemaker
services or a home health aide. Community and assisted living facilities care for seniors who are
still relatively independent, while nursing home facilities care for patients who need full-time
care.

Clinical Lab
A clinical laboratory, or lab, completes diagnostic tests ordered by physicians and
primary care providers. Using biological specimens, such as blood, urine, or saliva, medical
technicians run tests to help diagnose, treat, and monitor a patient’s health.

Clinical lab facilities can be organized by function or test specialization. General clinical
labs run common tests, while other labs, such as cancer clinics, run disease-specific tests. Test
specialization facilities run diagnostic tests for a certain field, such as public health or
hematology.

Hospice
Hospice is another type of health care facility. A hospice facility cares for the terminally ill
or people nearing the end of life. Typically, hospice care is for patients who have no more than
six months to live. A team of professionals, such as physicians, nurses, spiritual advisors, and
counselors, supports both the patient and the patient’s family during the transition.

Depending on the care required and cost, hospice services can be accessed in a
hospice facility, at the patient’s home, in long-term facilities, or in the hospital.
Clinical analysis areas of the laboratory and the types of lab procedures performed in the
different areas

Clinical laboratories are healthcare facilities providing a wide range of laboratory

procedures which aid the physicians in carrying out the diagnosis, treatment, and management
of patients. These laboratories are manned by medical technologists (clinical laboratory
scientists) who are trained to perform various tests to samples of biological specimens collected
from its patients. Most of the clinical laboratories are situated within or near hospital facilities to
provide access to both physicians and their patients. Classifications of clinical laboratories
indicated below reveal that these facilities can provide quality laboratory tests that are significant
for addressing medical and public health needs. The list below should not be used as a fixed
guide for classifying clinical laboratories because of new areas continually arising in the field of
laboratory medicine.

1. According to ownership - can be government-owned (public) which is usually part of

hospitals and medical centers under the department of pathology or laboratory medicine;
or can be a private facility as part of a privately-owned medical/healthcare institution
2. According to function - can be general clinical laboratories which provide common
diagnostic laboratory tests; or can be specialty laboratories that provide disease-specific
diagnostic and confirmatory tests
3. According to test specialization - facilities can provide tests on a particular field of
interest listed below:
a. Clinical Chemistry
b. Clinical Microbiology
c. Hematology
d. Blood banking and Serology (aka Immunohematology, Transfusion Medicine)
e. Clinical Microscopy
f. Histopathology and Cytopathology
g. Molecular Biology
h. Public Health - providing tests such as water analysis, testing for environmental
substances, among other tests concerning public and environmental health
4. As part of the laboratory network - these facilities operate in a coordinated manner which
is usually managed and supervised by authorities at different levels of the network
a. Peripheral laboratories - provide routine screening, diagnostic (e.g. conventional
and rapid diagnostic tests) and follow up tests for patients; usually situated in the
community where people can access its services
b. Intermediate-level laboratories - can be at the district, provincial and regional-
level facilities; may conduct additional tests than those provided in peripheral
laboratories and can serve as referral laboratories for special cases (district-
level); aside from performing tests, they carry out management and supervisory
tasks under specific areas of jurisdiction (particularly provincial and regional
laboratories)
c. National reference laboratories - also known as the central level, which performs
oversight and overall management of the laboratory network in terms of policy
and program implementation, training and development, monitoring and
evaluation and research; these facilities also provide a range of routine and
highly-specialized laboratory testing, including the introduction and phasing in of
new diagnostic tests
TESTS DONE IN EACH AREA OF THE LABORATORY THAT REQUIRES PHLEBOTOMY:
List at least 10 tests per clinical area and indicate its special phlebotomy instructions.

CLINICAL AREA TEST PHLEBOTOMY NOTES

Checked by: ____________________________

Instructor