1. Therapeutic Phlebotomy Department. THERAPEUTIC PHLEBOTOMY Who will Perform the Procedure? Proehl, JA. THE PROCEDURE IS PERFORMED IN SUCH A MANNER AS TO MAINTAIN SAFETY OF THE PATIENT AND THE PHLEBOTOMIST. Email:[email protected] Policy: PRINCIPLE: The veins are the primary source of blood for laboratory testing. UPDATED PHLEBOTOMY PROCEDURES Presented by: Helen Maxwell Executive Director, ASPT 1 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard—Sixth Edition December, 2010 It’s also called a blood draw or venipuncture. A Therapeutic Phlebotomy Procedure. Phlebotomy, Therapeutic Title: Phlebotomy, Therapeutic - Lippincott Procedure Patient Age Group: ( ) N/A ( ) All Ages ( ) Newborns ( ) Pediatric (X) Adult Applies To: UNM Hospitals, UNMCC Lippincott® Procedures is your online source for instant, evidence-based procedure guidance at the point of care. 1. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. The World Health Organization has issued practice guidelines for nurses who draw blood, which is referred to as phlebotomy. Therapeutic Phlebotomy is a procedure performed in an outpatient setting (Clinic or Physicians Office) to remove red blood cells (RBCs) from the body. THERASAFE is the only FDA approved device specifically designed for Therapeutic Phlebotomy procedures. Parker, D., Deel, P., Arner, S. (2004) Iron out the Details of Therapeutic Phlebotomy. … A nurse checks your child’s blood pressure, heart rate, breathing, temperature, and oxygen level before, during, and after the procedure. WebMD explains the process, risks, and side effects. … The procedure is ordered as a treatment for hereditary hemochromatosis, polycythemia vera, and secondary polycythemia. code 99195 ‒ Phlebotomy, therapeutic (separate procedure) to revenue code 940 ‒ Other Therapeutic Services – General, and will assign maximum fee pricing in the amount of $105.04. Advise your patient to eat a good meal and drink plenty of fluids before undergoing phlebotomy. There is a $150 fee per therapeutic phlebotomy for all patients other than those with a diagnosis of hereditary hemochromatosis or secondary polycythemia due to testosterone replacement therapy, since these units may be used in some cases for transfusion to patients. It makes it easier to control the pressure. Nursing 2004, vol 34, number 2. This procedure is done under the supervision of the medical director of the laboratory. Tell him to move slowly afterward when changing positions or standing, to prevent light-headedness, faintness, and a rapid drop in blood pressure. 1.Bloodletting – standards. Scope: All personnel drawing blood specimens, i.e., by direct phlebotomy or venous/arterial lines. THERAPEUTIC PHLEBOTOMY FLOWSHEET Time Time Amount Time Time Amount Time left Infusion. If you are on any medications, you may take them at your usual time unless your doctor instructs you otherwise. Polycythemia (rubra) vera –to decrease red cell mass 2. Procedure: The following chart outlines the guidelines for blood drawing that is practiced at Tourniquet. “System” means the organizational structure, responsibilities, policies, processes, procedures, and resources established by the licensee to achieve the requirements of these rules. Utilizing Red Cross therapeutic apheresis services enables hospitals to provide these services to their patients without investing in equipment and the training of specialized staff. Phlebotomy is when someone uses a needle to take blood from your vein. They also check to see if your child is anxious, irritable, dizzy, pale, or thirsty. One common procedure nurses perform is therapeutic phlebotomy, where about 500 ml of blood is removed through a large-bore needle over 15–30 minutes. This is possible once the blood pressure cuff is inflated. We use a BP cuff as a tourniquet. Your blood will be drawn by Medical Technol-ogists or Medical Laboratory Technicians who have special training in this process. Once the vein of interest is located, the blood pressure cuff is deflated. Therapeutic Phlebotomy, retrieved Aug 20/08 from Mosby’s Nursing Skills: You will sit in a chair in the treatment area for your procedure. #3 Medications to lower the number of blood cells Guidelines for Blood Bank . 2.Phlebotomy – standards. Therapeutic Phlebotomy is the same as donating whole blood. PURPOSE  To safely remove a specific amount of blood from a patient with a clinical indication as ordered. After the right amount of blood is drawn, the nurse will remove the needle and place a pressure bandage (bandage that wraps around your arm) over the needle site (the place on your arm where the needle was). Hereditary hemochromatosis is an inherited condition that causes increased absorption of iron from the diet resulting in iron overload. Therapeutic phlebotomy cuts down the number of blood cells and reduces the blood volume. Therapeutic Phlebotomy Policies and Procedures for Infusion Nursing. Therapeutic phlebotomy is done through an IV (by vein) or central line if your child has one. Therapeutic phlebotomy is a blood draw procedure usually prescribed by a physician as part of a treatment of various medical conditions associated with accumulation of excess iron in the body. A phlebotomy of one pint of blood will generally lower hematocrit by about 3 percent. Informed Consent for Therapeutic Phlebotomy for Polycythemia Vera. The phlebotomy procedure must be performed to preserve venous integrity. Eat a light meal before you go to the infusion center. The removal of blood via therapeutic phlebotomy can improve symptoms and reduce the risk of developing clots. A blood pressure cuff is used as a tourniquet in order to increase the blood flow into the the median cubital vein. THERAPEUTIC PHLEBOTOMY: The removal of a specific amount (volume) of blood from a patient for treatment of a specific condition or disease. Blood transfusions are the most common procedure performed during hospitalizations and undoubtedly help patients. WHO … The patient should have a written request from the physician which specifies the amount to be drawn, the frequency of bleeding, and/or a Hgb or Hct level at which the patient should be bled. Your institutions should have policies and procedures regarding phlebotomy for nursing, including training classes on the proper procedures for blood draw, you should review these procedures prior to performing any blood draws. (800) 266-4033 or (425) 453-5098 Fax (425) 251-1977. 4th Edition pp 144-145. Therapeutic phlebotomy is very similar to what happens when donating blood, but this procedure is prescribed by physicians as a way to bring down blood hematocrit and viscosity. Time Square, 660 SW 39thStreet, Suite 245, Renton, WA 98057. The treatment of hemochromatosis, polycythemia, and porphyrias. MATERIALS: Nitrile gloves. By William Henderson. How frequent you’ll need therapeutic phlebotomy is determined by the seriousness of the condition. The Therapeutic Phlebotomy (TP) Procedure Described: The process varies slightly depending on the treatment site; following is a general step by step of what takes place. This means it tends to make it simpler for the blood to perform its functions effectively. Page 1 of 1 Please see links below for Therapeutic Phlebotomy procedure, which is now located in Lippincott. “Therapeutic phlebotomy” means the removal of whole blood from a donor for the purpose of medical treatment. One or two peripheral intravenous lines (PIVs) are started to perform the procedure if you do not have any other type of vascular access device (CVL or portacath). Infusion Nurses Society (2011). Appropriate Maximum Phlebotomy Volumes Purpose: To provide a guideline for performing safe phlebotomy procedures on our neonate, infant and pediatric population. After the preliminary tests for hemoglobin and hematocrit are finished, a phlebotomist prepares you for the procedure. You will have a mini-physical examination The linkage and maximum fee rate will apply retroactively to outpatient fee-for-service (FFS) claims with dates of service (DOS) on or after February 13, 2017. Definition Therapeutic phlebotomy is the removal of blood from your body to treat a medical condition. During your therapeutic phlebotomy procedure, a nurse will use a needle connected to a blood collection bag to draw a certain amount of your blood. 8:8-1.3 Licensure Procedure:Therapeutic Phlebotomy consists of inserting a needle … As a result, oncology nurses often are required to care for these patients. A signed IRB approved consent and a physician’s order are necessary for the initiation of phlebotomy and for blood sampling. Traditional methods for performing the therapeutic phlebotomy procedure utilized 500ml glass vacuum bottles, blood bags or modified blood bags, each method having its own clinical precautions. The vein is palpated to ensure its visibility and location. Useful For. Therapeutic Phlebotomy Guidelines . (2008). Pump it up to 60mmHg to find a vein and/or perform venipuncture, then lower pressure to 30 to 40mmHg for the procedure. 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