April, 2009

Copyright 2009 Center for Phlebotomy Education, Inc.
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Center Seeks Phlebotomy Program Coordinator
Patient Awarded $3 Million for Venipuncture Injury
Just Write for Lab Week
Center Declares Global War on Preanalytical Errors
Showing Phlebotomists Appreciation During Lab Week
Featured Product: Arterial Blood Gas Collection DVD
This Month in Phlebotomy Today
Featured FAQ: Tissue Thromboplastin and the Order of Draw
Spring Break

Center Seeks Phlebotomy Program Coordinator

The Center for Phlebotomy Education is recruiting a full-time coordinator for its newly opened School of Phlebotomy in Corydon, Indiana. The successful applicant will possess a comprehensive understanding of phlebotomy procedures according to the CLSI specimen collection and processing standards, as well as classroom teaching experience, computer and communication skills, and  polished professionalism. Responsibilities include classroom teaching, development of material, maintaining relationships with clinical sites, administering and grading exams, counseling students, new student recruitment, marketing, and other duties to assist the program administrator.

The position requires relocation to Corydon, Indiana, a charming rural community in southern Indiana 2 hours south of Indianapolis and 30 minutes west of Louisville, Kentucky. Corydon is a vintage mid-American farming community with historical significance as Indiana’s first state capital and the site of the only Civil War battle besides Gettysburg to occur on northern soil. Nestled in gently rolling countryside in a county that has the Ohio River as its southern border, Corydon is home to Cousin Willie’s Popcorn, Butt Drug Store, the Corydon Jamboree, and, of course, the Center for Phlebotomy Education.

The School of Phlebotomy serves the southern Indiana and Louisville, Kentucky metropolitan area, and is currently moving its second and third sets of students through the 96-hour curriculum. Interested educators should contact the Center for Phlebotomy Education at 812-738-5700.

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Patient Awarded $3 Million for Venipuncture Injury

On February 5, 2003, Sharon Jenkins went to the hospital for chest pains. Last month she was awarded $3 million for injuries sustained while getting her blood drawn during her stay.

According to the Montgomery Advertiser, employees repeatedly probed for a vein during the draw, eventually rupturing Jenkins' brachial artery. A severe hematoma developed and lead to compartment syndrome, i.e., increased pressure within a confined space, such as between muscle fascia. The condition required surgical intervention in which the arm was opened from the elbow to the wrist to relieve the pressure. According to Jenkins’ attorney, the procedure rendered the arm useless, and the patient faces long-term pain and the possible amputation of the arm.

Christine Presley, Clinical Laboratory Supervisor at The Phlebotomy School at The Medical Center of Central Georgia, served as the plaintiff’s expert witness. Jenkins’ husband was awarded an additional $500,000. A spokesman for the hospital said it will appeal the verdict.

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Just Write for Lab Week

Order of Draw Pens

Managers and trainers looking for an inexpensive but uniquely educational gift for their students and staff can keep the recommended order of tube collection right at their fingertips. Just in time for National Medical Laboratory Professionals Week (April 19-25), the Order of Draw pen is comfortable and attractive with the order of draw illustrated in full color on the barrel for easy reference.

Many studies have proven that when blood collection tubes are filled in the wrong order, test results can vary, sometimes wildly, from the patient’s actual condition. Those who follow the prescribed order of draw collect specimens that are less likely to yield misleading test results that impact how the patient is diagnosed, medicated, and managed.

Reinforce the importance of the order of draw with phlebotomists, nursing personnel, medical assistants, the ED staff, and all those who draw blood specimens in your facility by putting this constant reminder in every pocket. The pens are available for immediate delivery in packs of 12 for $19.95.

For more information or to order, click here.

Center Declares Global War on Preanalytical Errors

In a speech before Norwegian biomedical scientists in Oslo, Norway last month, the Center for Phlebotomy Education declared global war against preanalytical errors.

In his opening remarks at the annual conference of NITO Norwegian Institute of Biomedical Science, the Center’s Director, Dennis J. Ernst MT(ASCP), announced, “Let it be known that on this day, at this conference, and in this city, we are declaring a global war on preanalytical errors.” Ernst cited statistics that show 11 percent of all transfusion-related deaths are caused by phlebotomists who misidentify patients or mislabel specimens, and a CAP estimate that 160,000 adverse patient events occur annually in the US alone due to labeling and identification errors. He recruited all who perform, teach or manage specimen collection procedures as “foot soldiers in the global campaign.”
“Until we eliminate preanalytical errors, people will be overmedicated, undermedicated, misdiagnosed, mismanaged, and yes, people will die,” said Ernst. “It’s not enough to simply ‘manage’ preanalytical errors. If we are serious about the laboratory’s contribution to patient care, we must eradicate them from the face of the Earth.” The event was attended by over 160 laboratory professionals representing every hospital in Norway.

To win the war, Ernst stressed the importance of knowing the enemy, including 30 of the greatest preanalytical threats to patient care. “Imagine a world without preanalytical errors,” he said. “There is no hemolysis, no underfilled tubes, no clotted EDTAs, no mislabeled specimens, no patient identification errors, and every patient is treated according to test results that accurately reflect his or her physiology. We can do this. We must do this!”

Attendees were urged to establish the frequency in which the most common errors are committed in their facilities, and instructed how to eradicate them by establishing benchmarks, setting goals, monitoring progress and rewarding those who have contributed to successful campaigns.

“You have three weapons,” Ernst told the assembly. “Education, education, and education. Every patient is someone’s loved one. We must be ready for every patient’s encounter with healthcare. When someone’s need intersects with our expertise, it is imperative that every laboratory test result we put into the hands of every patient’s physician is devoid of the catastrophic impact of even one preanalytical error.”

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Showing Phlebotomists Appreciation During Lab Week

Laboratories throughout the US will be celebrating their own during the week of April 19-25, not the least among them being phlebotomists.

“We encourage laboratories everywhere to designate Tuesday of National Medical Laboratory Professionals Week as “Phlebotomist Appreciation Day,” says Phlebotomy Today editor, Dennis J. Ernst MT(ASCP). “Results from a poorly collected specimen threaten the laboratory’s integrity, are useless to the physician, and pose a threat to the patient’s well being. Just like anyone else, phlebotomists must feel appreciated to do good work.”

Physicians rely on laboratory test results to provide at least seventy percent of the objective information they receive on their patients’ health status. Appreciating those who draw, transport, and process blood specimens---not just during this week of recognition but all year long---is critical to keeping the stream of information labs extract from specimens flowing swiftly and accurately.

“Too often phlebotomists feel like the neglected orphans of the laboratory,” says Ernst. “Lab Week is an excellent time to remove any shadow of doubt that those who collect specimens are appreciated.”

Featured Product:
Arterial Blood Gas Collection DVD

The Center for Phlebotomy Education releases part 5 of the Applied Phlebotomy Video Series training DVDs, Arterial Blood Gas Collection. Over a year in the making, the DVD is highly researched and authoritatively scripted to demonstrate proper technique according to the prevailing standard of care, and was subjected to the scrutiny of a rigorous peer review process to ensure accuracy.

Features include:

  • Detailed step-by-step instructions for collecting blood gases byarterial puncture, arterial line draw, and capillary puncture;
  • Highly researched to be consistent with the AARC Clinical Practice Guidelines and the Clinical and Laboratory Standards Institute’s arterial blood gas collection standard (H11);
  • Written, directed, edited and published by the world’s foremost authority on blood specimen collection procedures;
  • Graphic animation detailing the anatomy of the wrist, hematoma formation, nerve injury, and the acceptable sites for arterial fingerstick punctures;
  • Peer reviewed;

Each copy shipped with CE questions for trainers/users to measure comprehension;

Running time: 29 minutes.

For more information, visit www.phlebotomy.com/Videos.html or call the Center toll free at 866-657-9857.

Skin Puncture Procedure Template


This Month in Phlebotomy Today

Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 9th year of publication, are reading about this month:

  • Feature Article: The Geriatric Touch
  • Phlebotomy in the News: a round-up of articles on phlebotomy and phlebotomists who made Internet headlines in March
  • According to the Standards: Hemolysis and IV Draws
  • Tip of the Month: Red Light, Green Light
  • CEU questions (institutional version only).

Buy this issue for only $9.95. (after April 9th)

For subscription rates and to subscribe to Phlebotomy Today, visit www.phlebotomy.com/PhlebotomyToday.html. The current month’s issue will be emailed to you immediately upon subscribing.


Featured FAQ: Tissue Thromboplastin and the Order of Draw

Q: It is my understanding that if a blue top is the only tube to be drawn, it no longer needs a waste tube unless it is being drawn with a butterfly. This is contrary to several things I had read in the past, i.e., that the clot-activator tubes should not be drawn before anticoagulant tubes because of possible contamination, and also that tissue thromboplastin in the needle could interfere with a blue top drawn by itself. Can you help clarify this for me please?

A: No study has ever proven that tissue thromboplastin interferes with coagulation studies. It’s always been speculation until the late 1990s when studies proved that drawing a discard tube before the citrate tube made no difference in protime and aPTT results. Therefore, CLSI discontinued their recommendation for a discard tube in 1998 when drawing a protime or aPTT.
      However, studies have not been conducted on any affect of tissue thromboplastin on special factor assays. CLSI guidelines and standards, therefore, state that evidence of tissue thromboplastin contamination is consequential at best, and that facilities should establish their own policy in regards to special factor assays.
      There is certainly no harm done when drawing a discard tube, it's just not necessary when testing for protimes and aPTTs. Of course, discard tubes are still recommended when drawing with a butterfly set and the blue top is the first or only tube drawn. This is to prevent short sampling when the air in the tubing enters the citrate tube. The discard tube need not be filled, but only applied long enough to prime the line of the winged collection set. The discard tube can be another citrate tube or a plain, non-additive tube. As far as the clot activator contaminating an anticoagulant tube, there is no evidence in the literature that this occurs or that it affects results.

Each month, PT--STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's web site. For information on joining Phlebotomy Central, visit www.phlebotomy.com/PhlebotomyCentral.html.

Spring Break

Both the “What Would You Do?” column and the “Survey Says” column are on spring break. Both will return next month.

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Copyright 2009, Center for Phlebotomy Education, Inc. All rights reserved. Newsletters may contain links to sites on the Internet owned and operated by third parties. The Center for Phlebotomy Education, Inc. is not responsible for the availability of, or the content located on or through, any such third-party site. Information in this document is provided "as is," without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose and freedom from infringement. The user assumes the entire risk as to the accuracy and the use of this document. We will not be liable for any damages of any kind arising from the use of this information, including, but not limited to direct, indirect, incidental, punitive, and consequential damages.