Phlebotomist Rules and Regulations

Setting Blood Draw Standards in USA

The Clinical and Laboratory Standards Institute (CLSI) sets phlebotomy standards that apply to those who draw blood either as full and part-time phlebotomists, medical assistants, or other health care providers and personnel with blood collection responsibilities in the United States of America.

Blood Collection Rules

Most blood tests are performed on anticoagulants whole blood, plasma, or serum. Blood specimens must be collected in the proper collection tubes and containers and in the right order of draw. The collection tubes must also be correctly labeled, and promptly transported to the laboratory. Needless to say, blood specimens should be refrigerated until placed in the courier box for transport to the laboratory.

If coagulation testing is the only laboratory work that needs to be drawn the phlebotomist should first draw a plain red top tube to remove tissue fluid contamination. This tube is then discarded into the biohazard receptacle. The next step is to draw the blood sample into a sodium citrate collection tube which must be filled to the proper level (filled to complete vacuum volume) and is then gently inverted to mix.

If additional laboratory work is ordered, including coagulation testing, the second tube would be the sodium citrate collection tube. Remember that all of the processes involved in specimen collection, from ordering supplies, to selecting the proper collection devices, to proper collection site and technique, to adhering to all in-house and legal requirements when handling and shipping the specimens are all important steps of obtaining valid and timely laboratory test results.

Phlebotomists in California

Phlebotomists in California are licensed and heavily monitored. They have several levels of licensing! Those wishing to work in California must first complete an unpaid 40-hour internship where 50 successful blood draws on patients via venipuncture and 10 finger/heelsticks must be properly performed and logged. All this must be done before entering the phlebotomy career, because CA regulation mandates that you cannot work as a phlebotomist without a license. This rule also affect many medical assistants, and other staff with blood drawing responsibilities in the state of California.