PHLEBOTOM

PRACTICE,
Y
DEFINITIO
N,
AND DUTY

Phlebotomy

the incision of vein for blood letting

Phlebotomist

blood collector; the individual who

performs phlebotomy

Primary function of a
phlebotomist:
to assist the healthcare team in the
accurate, safe and reliable collection and
transportation of specimens for clinical
laboratory analyses.

Three important clinical

purposes for laboratory
analyses of specimens:
1.

Diagnostic Testing:

to figure out what is wrong with the

patient. (tests that detect abnormalities)

2. Therapeutic Assessments:
to develop appropriate therapy or
treatment of the medical condition. (tests
that predict the most effective treatment
or the drug of choice)

3. Monitoring:
to make sure the therapy or treatment is
working to alleviate the disease or illness.
(tests to confirm that the abnormality has
returned to normal or that the drug is
reaching its effective dosage)

CLINICAL
DUTIES OF
THE
PHLEBOTOM

Identify
the
patient
correctly

Assess
the
patient
prior
to
blood
collection

Prepare
the
patient
correctly

Perform
the
puncture

Withdraw
blood
into
the
correct
container
s
/tubes

Assess
the
degree
of
bleeding
and pain

Assess
the
patient
after
the
phleboto
my
procedure

Technical duties

Manipulate small objects, tubes and needles

Select and use appropriate equipment
Perform quality control functions
Transport the specimens correctly
Prepare/process the samples for
testing/analysis
Assist in the laboratory testing procedure,
washing glassware and cleaning equipment

Clerical duties

Print/collate/distribute laboratory
requisitions and reports
Answer the telephone
Answer all queries as appropriate
Demonstrate courtesy in all patient
encounters
Respect privacy and confidentiality

ETHICAL
STANDARD
S

Do

NO HARM to

anyone
intentionally.

Perform according to

SOUND TECHNICAL
ABILITY and GOOD
JUDGMENT.

RESPECT
patients rights!
(confidentiality, privacy,
the right to know about
their treatment, and the
right to refuse treatment)

MEDICOLEGAL
ASPECTS

Laws - societal rules or regulations that are

advisable or obligatory to serve.

Ethics - moral standards of behavior or

conduct that govern an individuals action.

Bioethics - moral issues or problems that

have resulted because of modern medicine,
clinical research, and /or technology.

In the Philippines
everyone is considered

INNOCENT
until

PROVEN GUILTY
in a
court of law!

Types of Law

Constitutional Law
Based on Philippine Constitution

Administrative Law

Law governing administrative agencies (government)

Statutory Law
Written Law; enacted by legislative body

Common (Case) Law

Based on court decisions, doctrines, and customs & usage

Classification of Law

Criminal Law
Conduct offensive to society as a whole
Act prohibited by statutory or common law

called a crime
Punishment: Imprisonment & Fines

Civil Law
Legal rights and responsibilities (duties) of

private citizens
Punishment: Imprisonment & Fines

Legal Torts
Legal or civil wrong committed by one
person against the person or
property of another person

Two Types
Intentional
Negligence

Intentional Tort of Misconduct

Plaintiff must establish that the defendant

intended to commit the specific wrong that
has been alleged.

Must be conscious performance of act to

accomplish specific result, or where a
reasonable person would have known the
results of a particular act.
Deliberate action
Conscious action
Plaintiff must show

intent

Misconduct (types)

Assault & Battery

Assault threatening to touch in a harmful way
Battery touching in a harmful way

False Imprisonment
Conscious restraint of freedom of another without

proper authorization, privilege, or consent

In the healthcare setting, it must be limited to, and

in proportion with the procedure being performed.

Based on reasonableness

Misconduct (types)

Defamation of Character
Slander spoken

Libel written
Must be written or spoken, and made to a

person other than the plaintiff

Invasion of Privacy
Patients medical record (includes x-ray images)
Freedom of Information Act (pt. can access

records)

Standard of Care

Skill and learning commonly possessed

by members of a particular profession.

In healthcare known as

Standard of Reasonable Care

Depends on specifics of situation
Open to interpretation by judge & jury

Tort of Negligence
Doing something you should not have done
or
Not doing something that you should have
done.

Negligent behavior or actions that cause

harm to another person is known as

malpractice.

Hippocratic Oath:

Do no harm!

Medical Negligence = Malpractice

A breach from the standard practice that is
the proximate cause of a patients injury.

Elements of proof of negligence in a medical

malpractice case include a deviation, or
departure from acceptable practice

A negligent act committed by a professional person

constitutes malpractice only if it involves
negligence in the carrying out of his professional
duties

Malpractice classifications

Criminal Malpractice
Assault
Battery
Mercy Killing

(Angel of Death)

Civil Malpractice
Practice falls below

Standard of Care

Ethical Malpractice
Violations of professional ethics (e.g. RT Code

of Ethics)

Malpractice:
Plaintiff must
prove

Duty of responsibility to patient owed

2. Duty of responsibility is breached
(broken)
1.

3.

Damages

4.

Proximal (Direct) Cause

MEDICOLEGAL
DOCTRINES
A rule or principle of law, especially when
established by precedent

Can be invoked by either plaintiff or

defendant

Respondeat
Superior
Let the master
respond.

Employer is liable for negligent acts of

employees which occur when the
employee is acting as an instrument of
the employer.
Employee-Employer relationship must
exist
Does not relieve practitioner of negligent
behavior

Indemnification
Employer can recover awarded damages

from its employee

The Borrowed
Servant
The common law principle that the
employer of a borrowed employee,
rather than the employees regular
employer, is liable for the employees
actions that occur while the employee
is under the control of the temporary
employer.

Res ipsa loquitur

The thing speaks
for itself

Often invoked to cause the defendant to prove his

actions were not negligent
(accused my prove that he is innocent)

The outcome is so obvious that the

damages can only have been caused by the
defendant.

e.g. sponges & instruments left inside patients, surgical

outcomes (esp. plastic surgery) that didnt turn out right,
wrong medications administered to the patient.

Informed
Consent
Affirmation by patient to
consent to have procedure
performed

Patient must have:

Appropriate mental capacity

Accepted elements of consent

Who can sign?

Must be over age of majority
Spouse
Emancipated Minor

Informed
Consent must
contain:

Authorization Clause

Permits healthcare giver to perform

procedure

Disclosure Clause

Explanation of procedure
Risks to include possibility of death
Benefits of having procedure performed
Alternatives

Anesthesia Clause
(if anesthesia is to be given)

No guarantee clause
Tissue Disposal Clause
Patient Understanding Clause

Had all questions answered

Everything explained to patient

Signature Clause
Patient signature or mark
Witness

INFORMED
CONSENT FOR
RESEARCH
Requires a consent PURPOSES
document that:

Explains the nature of the research and any risks

and benefits to the participant;
Describes the level of confidentiality of the
research data;
Describes the measure that the researcher will
take to ensure that confidentiality is maintained.

Implied
Consent
Exists when immediate action is required
to save a patients life or to prevent
permanent impairment of the patients
health.

Statute of
Limitations

Law that defines how soon after an injury a

plaintiff must file the lawsuit or be forever
barred from doing so.

Prevent the threat of a lawsuit from hanging

over a possible defendants head forever and to
force legal action while memories are fresh,
records are available and witnesses are still
living.

Medical
Records

Vital
Neat, legible, accurate
Medical malpractice
Billing, utilization review,
quality improvement

4 BASIC
PURPOSES :
Allows continuity of care plan
2. Provides documentation of illness and
treatment
3. Documents communication between
physician and health care team
4. Provides legal document that can be
used by patients and health care team
for legalities
1.

If it is NOT WRITTEN
down,
it was NOT DONE!

CONCLUSION:
To safeguard against litigation,
the paramedic must be
knowledgeable about legal issues
and the effects they may have.