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Venipuncture procedure steps pdf

Figure 3-2a

Venipuncture Procedure. G. Remove tourniquet when blood flow is established. Do not allow the contents of the tube to contact the stopper as backflow of blood into the venous system can cause possible adverse patient reaction. H. Fill tube until vacuum is exhausted and blood flow ceases. All tubes should have a complete draw to ensure there is Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. When drawing a blood specimen, the trained phlebotomist must: 1). Prepare the accession order. 2). Identify the patient. 3). Verify patient's diet restrictions, as appropriate. 4). Assemble necessary supplies and don gloves. 5). Reassure the. MLT 112: Principles of Phlebotomy Learning Unit 3: Handout Page 1 of 8 Specimen Collection - Venipuncture Procedure I. Collecting and Processing of Specimens A. Blood 1. Venipuncture Procedure (arm + dorsal/hand) - vacutainer, syringe, butterfly a. Approaching the Patient Correct patient identification Wash hand

about 1- 2 below the venipuncture site. Hold skin tight through Step 10. 10. Insert the needle, bevel side up, into the vein. 11. Push the vacutainer tube completely onto the needle. Blood should begin to flow into the tube. 12. Release the tourniquet. 13. Fill the tube until it is full o transfusions or laboratory testing purposes. Venipuncture, the most common phlebotomist procedure, involves drawing blood directly from the veins for blood analysis. The step-by-step routine is as follows: Before any blood can be drawn, several criteria must be met. • First, phlebotomy technicians must confirm the identity of the patient STEPS IN DOING A VENIPUNCTURE •TUBES: •Check for expiration dates. •Must have a clear view of the contents unless test must be shielded from light. •No sharp edges •No surface roughness (capable of cutting skin) •Should be used to collect blood straight into the tube •Must retain vacuum 32 8.9. 4.9 Venipuncture Procedures.. 4-38 . 4.9.1 Preparation of the Puncture Site..... 4-39 . 4.9.2 Venipuncture Techn ique for the BD Saf-T EZ ® Blood Collection Set (19 Gauge).. 4-41 . 4.9.3 Venipuncture Technique for the BD Safety-Lok™ Blood. Phlebotomy Venipuncture Procedure POSTED-LIS PRINCIPLE: This policy establishes criteria for the correct collection of blood specimens by venipuncture. POLICY: By establishing a procedure for the correct collection of blood by venipuncture many pre-analytical errors and patient management complications can be avoided. Patient safety is the ultimat

Venipuncture Procedure Step 1 Label the tube with the patient's particulars Step 2 Put tourniquet on the patient about 3-4' above the venipuncture site Step 3 Ask patient to form a fist so veins are more prominent Step 4 After finding the vein, clean the venipuncture site with alcohol using circular motion The technical committee segment is the single most significant step in the curriculum Demonstrate skills and knowledge necessary to perform phlebotomy. 10. Practice accepted procedures of transporting, accessioning and processing specimens. 11. Practice quality assurance and safety The venipuncture procedure requires both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him. Several essential steps are required for every successful collection procedure: 1. Identify the patient. 2. Assess the patient's physical disposition (i.e. diet, exercise, stress, basa It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. Drawing blood, while routine, is a learned skill. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy technician SOP: EQUINE VENIPUNCTURE AND IV INJECTION !! 2! I. Procedure Summary and Goal Describes procedures for intravenous injections and venipuncture of the jugular veins. Considerations Having a basic knowledge of the animal's behavior is important in safe and humane handling. Whe

VENIPUNCTURE PROCEDURE USING A SYRINGE: 1. Place a sheathed needle or butterfly on the syringe. 2. Remove the cap and turn the bevel up. 3. Pull the skin tight with your thumb or index finger just below the puncture site. 4. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and vein in one motion Describe each step in the venipuncture procedure, list necessary information found on specimen tube labels, and list the acceptable reason s for inability to collect a specimen. 9. Describe collection procedures when using a butterfly or syringe and the proper way to safely dispense blood int Venipuncture Procedure Purpose: To ensure proper collection of venous blood specimens Principle: By establishing a procedure for the correct collection of blood by venipuncture, many pre- analytical errors and patient management complications may be avoided. Patient safety is the ultimate goal above all other considerations

Wiring And Diagram: Diagram Of Veins In Arm For Phlebotomy(PDF) Impact of the phlebotomy training based on CLSI

Step By Step Procedure for How a Phlebotomist Draws Bloo

  1. Venipuncture can be painful, and a patient may experience anxiety or fear before the procedure. In some cases, just the appearance of a needle is frightening. A calm approach and skilled technique may help limit a patient's aversion to venipuncture. Anxiety may b
  2. Instructions for Blood Culture Collection Revised 7/2019 Page 1 of 2 Step 1 - Collection Preparation Obtain BLOOD CULTURE COLLECTION KITS - (one kit for each venipuncture) - Central Supply stocks as follows: Lawson #127919 collection kit. Individual bottles are stocked as anaerobic bottle Lawson #70, and Aerobic bottle Lawson #71
  3. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. Have the patient ball up their hand (form a fist). Puncture the vein quickly and at a 30 degree angle or less
  4. Phlebotomy will be initiated after verification of subject ID, physician order and sample requirements of protocol. Sample vacutainer tubes to be filled shall be properly labeled prior to use with the subject ID number, date of birth and date of draw. PROCEDURE: A. Prior to initiation of phlebotomy for purpose of blood sampling 1
  5. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. 1.Bloodletting - standards. 2.Phlebotomy - standards. 3.Needlestick injuries - prevention an

View Venipunture procedure2015.pdf from COMM 111 at University of Alaska. Venipuncture Procedures Step 1: Test Requisitions • Test Requisition: form on which test is ordered • Manual • Ofte Lippincott Williams & Wilkin

FACTS zChildren receive 18 million needle sticks/year zIV placement and venipuncture are some of the most frequently performed interventions by nurses, yet the most distressing for patients zIV placement is the tone setter for the child's entire hospital experience zSuccess or failure of the venous access procedure can set the tone for a lifetime of interactions with the health care. View Homework Help - VENIPUNCTURE_PROCEDURE_worksheet.pdf from BIOLOGY 1101 at Normandale Community College. Name_ VENIPUNCTURE PROCEDURE (ETS) Place the following steps in the venipuncture procedure Step 3: Venipuncture. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients Venipuncture ppt 1. AHIMA ELIAZER SC NURSING 1ST YEAR TMCON 2. OBJECTIVE At the end of the class student will be able to Define Venipuncture Explain the purpose of venipuncture Enlist the indication of venipuncture What should be observed during the procedure Enlist the equipment used Explain the procedure of venipuncture Discuss the complication of venipuncture Explain the Nursing. Venipuncture Procedure 24 Order Form/Requisition Form 25 Labeling the Sample 27 Equipment 27 Order of Draw 28 Venipuncture Site Selection 31 Performance of a Venipuncture 31 Troubleshooting 33 Performance of a Fingerstick 39 Blood Collection on Infants 40.

Duhamel Procedure Steps - A New Technique For Redo

Phlebotomy should be performed only by CDH staff who have received phlebotomy instruction by competent CDH laboratory staff and have demonstrated competency to perform the procedure. Collection procedures are listed for both venous and capillary blood specimens, syringe and vacutainer methods, adult, pediatric and neonatal patient popula Venipuncture is the process of collecting or drawing blood from a vein and the most common way to collect blood specimens for laboratory testing. It is the most frequent procedure per-formed by a phlebotomist and the most important step in this procedure is patient identifi cation List the steps and identify potential pitfalls of the phlebotomy procedure. 3. Demonstrate proper terminology, handling, and use of supplies for IV phlebotomy. 4. Demonstrate proper insertion, stabilization, and discontinuation of a vacutainer needle or a butterfly catheter. II..

h. Precautions when performing the venipuncture: If swelling is noticed during venipuncture, immediately release tourniquet, remove needle and apply pressure using gauze pad. On patients with a bleeding disorder (Hemophilia or von Willebrand's Disease), use a 21 gauge butterfly needle or smaller. Do not probe if blood is not obtained immediately VENIPUNCTURE WHOLE BLOOD Step 1B - COLLECT † Using standard venous phlebotomy procedures, collect a whole blood sample using a tube containing any of the following anticoagulants: EDTA (lavender top), sodium/lithium heparin (green top), or sodium citrate (light blue top). Other anticoagulants have not been tested and may give an incorrect. SOP: VENIPUNCTURE IN DOGS AND CATS 1 I. Procedure Summary & Goals a. Venipuncture is an essential skill in veterinary medicine and is used to collect diagnostic samples as well as administer therapeutic agents. b. Common venipuncture sites in the dog i. External jugular vein ii. Cephalic vein iii. Lateral saphenous vein iv. Accessory cephalic vei

Blood Collection Process: Venipuncture » Pathology

  1. 5.0 Considerations When Undertaking the Venepuncture Procedure Venepuncture is one of the most common invasive procedures and can be traumatic for the child and family. It should only be ordered when necessary. A clinical assessment should be undertaken prior to the venepuncture procedure
  2. Proof of proper procedure will then be evidenced by the flow of infusion fluid from IV bag B. Control flow rate with clamp on IV set B. This fluid can be used over. If more realistic experience is desired with blood flashback instead of water when inserting butterfly into lumen of vein, use procedure C (next). C. Recommended Procedure
  3. Venipuncture Able to Perform Able to Perform with Assistance Unable to Perform Initials and Date General Guidelines for Specimen Collection. 1. Check the accuracy of participant's name and birthdate per identification policy before starting the procedure. 2. Check for allergies to any materials used, e.g., povidone-iodine. 3. Gather equipment.
  4. This procedure provides instruction for collecting patient blood samples by venipuncture, according to the current standard of care for phlebotomy as established by the Clinical and Laboratory Standards Institute (CLSI). When proper techniques for blood specimen collection are followed, the risks of preanalytic errors and injury to patients and/o
  5. Procedure Let's take a quick, high-level look at the venipuncture procedure. For a detailed breakdown of each step of the venipuncture test scroll down.The area where the blood is to be drawn from is first cleaned with a germ-killing solution.Then the medical technician or phlebotomist will wrap a flexible band on the upper part of the arm to appl

Venipuncture Procedure Purpos

  1. will be considered for training. Each person must receive training and annual competency on venipuncture. A copy of this authorization will be kept in the employee's file and reviewed annually. (B) Purpose of Policy To expedite the initiation of diagnostic procedures, and better utilize physician and allied health personnel time. (C) Procedure 1
  2. Skin Puncture Procedure POSTED-LIS PRINCIPLE: Although venipuncture is the most frequently performed phlebotomy procedure, it is appropriate in some circumstances to utilize a skin puncture method. Current laboratory instrumentation and procedures make it possible to perform laboratory tests on microsamples of blood obtained b
  3. 1. Evaluations will be given on the student's venipuncture and capillary procedures. 2. The student will proceed with each procedure in front of the instructor, who will be evaluating each step as S (satisfactory) or U (unsatisfactory). 3. The student must get all satisfactory evaluations in order to receive a Certificate of Completion. 4
  4. Procedure: 1. Select and organize equipment. 2. Approach, greet and properly identify the patient. 3. Select and prepare venipuncture site. 4. Prepare equipment. Remove the winged infusion needle from its packaging. 5. Attach the evacuated tube holder onto the adapter at the end of the tubing. 6. Apply the tourniquet and select the venipuncture.
  5. istration and blood.
  6. Centers for Disease Control and Preventio
  7. Step Detail Information 12. Choose venipuncture site: 12.1)Using your fingertips, feel for the vein. 12.2)Feel for the median cubital or median cephalic veins located in the ante-cubital fossa region of the upper arm. NOTE: The order of choice for anatomical site for venipuncture is the: Arm Hand Foot - only as a last resort

venipuncture. The QSEs are foundational building blocks that function effectively to support the laboratory's path of workflow. Although not all aspects of the QSEs may be mandatory to perform the venipuncture procedure, adherence to the QSEs ensures that the venipuncture is performed at a higher level of overall quality. Other changes include Blood Specimen Collection: Venipuncture Syringe Method (Home Health Care) - CE CHECKLIST S = Satisfactory U = Unsatisfactory NP = Not Performed Step S U NP Comments. Phlebotomy uses large, hollow needles to remove blood specimens for lab testing or blood donation. Each step in the process carries risks - both for patients and health workers. Patients may be bruised. Health workers may receive needle-stick injuries. Both can become infected with bloodborne organisms such as hepatitis B, HIV, syphilis or malaria

Venipuncture- the puncture of a vein for surgical or therapeutic purposes, or for collecting blood specimens for analysis. 1.3.3. Vascular Access Devices (VAD)-a device inserted temporarily or permanently into a vein and /or artery to allow access to the circulatory system for the administration of fluids or medications, or for various procedures Capillary Puncture Steps (cont 'd) • Step 7: Warm the Site if Applicable - Warming increases blood flow up to sevenfold - Wrap site for 3 to 5 min. with a warm, moist washcloth, towel, or diaper or warming device. Temp not to exceed 42 degrees C (108 F) • Step 8: Clean and Air-Dry Site - Cleanse site with an antiseptic (70%. pliance of phlebotomy procedures with the CLSI H3-A6 guideline was unacceptably low, and that patient identi-fication and tube labelling are amongst the most critical steps in need of immediate attention and improvement. The process of patient identification and tube labelling is an essential safety barrier to prevent patient identity mix-up Terminate the procedure: Remove the tourniquet and the needle and apply pressure to the puncture site with a gauze pad (a minute or 2 is usually adequate unless the patient has a coagulopathy). Keep the needle motionless. Begin to withdraw the blood sample and, when blood begins to flow, remove the tourniquet Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. hub. When using a syringe, make sure that you pull the plunger in and out to. assure free motion. Position the draw site for best visualization and/or palpation. Apply th

The Goals of the Phlebotomy Program are that the student: 1. Will be accountable as a phlebotomist for the procedures expected of an entry level phlebotomist. 2. Will apply for and take a certification exam in Phlebotomy by an accredited certification agency. 3 5.7 Venipuncture Procedure ALWAYS WEAR LATEX GLOVES AND LAB COAT Blood drawing is standardized for the sitting position. You may have participants clench their fists (moderately) during phlebotomy, for up to two minutes. Venipuncture is performed with a 21-gauge butterfly needle with 12 inches of plastic tubing between the venipuncture sit Step 1. Prepare your work area. Even before your patient arrives, you need to have the proper equipment and a clean and sterile environment. Make sure you have the appropriate venipuncture tools, along with the required tourniquets, vials, tubing, disinfectant, gloves, lab forms, and labels Approval Procedure: Complete this form as each step of the venipuncture training progresses. It is the responsibility of the technologist being trained to request observation approval from Radiologist or RN before independently performing venipuncture. 1) Prior venipuncture experience NO ____ YES ____ Where____

Venipuncture Procedure explained step by step. Venipuncture procedure is the collection of blood from a vein, usually for laboratory testing, is done through venipuncture and performed by a phlebotomist. Although most professionals in the medical field can draw blood, a phlebotomy tech specializes in the process encompasses all the steps involved in sample processing, beginning from test ordering to the final interpretation of results by the clinicians to reduce or eliminate the errors that may arise during the various steps. Promotion of ideal phlebotomy practices and sample transport procedures are a pre-requisite for the effective laboratory.

venipuncture. DO NOT ALLOW CONTENTS OF TUBE TO CONTACT THE STOPPER OR THE END OF THE NEEDLE DURING THE PROCEDURE. If no blood flows into the tube or if blood ceases to flow before an adequate sample (approximately 6.0 mL as minimum blood volume) is collected, the following steps are suggested to complete satisfactory collection: a Enforcement Phlebotomy Program (LEPP) that was only sixty (60) hours in length. Tankersley was co-author of the textbook used nationwide to teach phlebotomy and had extensive experience in the field as a subject matter expert and instructor. This program focused primarily on the requirements to conduct bloo PHLEBOTOMY: FUNDAMENTALS AND PRACTICE COURSE MANUAL 2021 - 2022 (4 Credits) The purpose of this manual is to give you information you will need throughout the Phlebotomy course. It is intended as a supplement to the College Catalogue and the Student Handbook and supplements, but does not negate the information they contain

Venepuncture is a routine invasive procedure that involves puncturing a vein with a needle to gain venous access, either for phlebotomy (the collection of blood) or the provision of intravenous therapy. Correct technique and safe practice are essential in preventing harm to patients and staff HAND-HELD ROBOTIC DEVICE FOR VENIPUNCTURE PROCEDURES by JOSHUA MALCOLM LEIPHEIMER Thesis Director: Dr. Martin L. Yarmush Venipuncture, obtaining venous access for clinical intervention, is an essential first step in patient healthcare. Consequently, it is the most prevalent medical procedure an

How To Draw Blood Phlebotomy Coac

WHO guidelines on drawing bloo

Specimen collection. Start with quality specimen collection to achieve better results. For more than 60 years, BD Life Sciences - Preanalytical Systems has advanced the science of specimen collection to help laboratory tests become the foundation for 70% of all medical decisions. 1 Today, the gold standard in sample collection is the BD Vacutainer ® product family, which U.S. hospitals rely. Wayne, Pennsylvania, USA—The Clinical and Laboratory Standards Institute has published two phlebotomy documents: Collection of Diagnostic Venous Blood Specimens and Essential Elements of a Phlebotomy Training Program ().. Collection of Diagnostic Venous Blood Specimens (GP41-Ed7) provides a process and procedures for diagnostic venous blood specimen collection CC BY by Rx-TN. (RX Tennessee)http://www.SUNSOARS.com Blood Collection TutorialSupplier:(Taiwan) SUNSOARS Company Limited Factories are located at Wenzhou ci.. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. See Collection Notes 1 at the end of the procedure if 2 sets of blood cultures are ordered. 1. Position the patient (See PHL -1) 2. Tie tourniquet. (See PHL-1) 3. Select a vein and release tourniquet. (See PHL-1) 4

Venipunture procedure2015

  1. Venipuncture Procedure Steps 1 Review requisition or electronic order for collection requirements/duplicate request(s) (e.g., fasting, timed testing, utilization rules). 11 Collect samples following the Blood Collection Order of Draw. Completely fill all tubes to vacuum capacity. Gently invert tubes immediately after collection as required
  2. 20 steps to successful venipuncture Any nurse who's being introduced to a new skill should have a skills checklist and be aware of the rationale supporting each step. Use the following as your guide. 1. Review the order It's best practice to check the provider's or-der before drawing the lab(s). If the lab tes
  3. g the test. Reimbursement for the venipuncture is included in the reimbursement for the lab test procedure code

VENIPUNCTURE_PROCEDURE_worksheet

procedure and the risks so that they understand what they are consenting to. Practitioners need to ensure all aspects of informed consent are discussed with the patient. (2) Informed consent can be easily established in a friendly and informative manner. The following points must be discussed: (3) • What is involved in the procedure Higher Education | Pearso

How To Draw Blood Like A Pro nurse

Venipuncture ppt - SlideShar

10 Steps for Proper Blood Culture Collection A Blood Culture is one of the most important laboratory tests because it is used to help determine if a patient has bacteremia/septicemia, a life-threatening condition. Blood is a sterile fluid, and a normal, healthy patient does not have bacteria in the blood. However, many bacteria do colonize the. A step-by-step guide to performing venepuncture (a.k.a. venipuncture) in an OSCE setting, with an included video demonstration. Clinical Examination A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes STEP 3: Position the Patient's Arm! Consider this: ♦ Dependent positions increase capillary refill and may increase the likelihood you will be successful in inserting the IV. ♦ For cold skin, warm it by rubbing or stroking the skin or applying warm packs for 5-10 minutes as needed. STEP 4: Apply the Tourniquet! 1 4.5.2 Skin Test Preparation Steps: Filling Syringes (May be done before venipuncture) 4-9 4.5.3 Skin Test Administration Steps..... 4-12 4.6 Appointments for Measurement of Skin Reactions.. 4-18 4.7 Entering Results in ISIS 4-2

(PDF) Complications of venepunctur

Venipuncture, using a needle and evacuated tube, is the most As an extra precautionary step, ask the patient to state the identifier, such as name or birthdate. make certain to follow procedures and label the evacuated tubes in the presence of the patient. n The vacuum in the collection tube allows the correct amount of blood to enter. venipuncture as outlined in Lippincott. • Demonstrates appropriate assessment and use of pre-procedure topical/intradermal anesthetic (upcoming nurse-driven protocol). • Demonstrates selection of appropriate catheter. • Demonstrates insertion with utilizing appropriate technique and safety precautions (securement) Phlebotomy Procedure Therapeutic phlebotomy is performed in a medically supervised environment. It is commonly performed in a blood donor center, apheresis unit, physician office, or at home by a well-trained phlebotomist, but home phlebotomy is rarely performed.8 The prescription for phlebotomy should contain the fol-lowing elements: 1.Patient. responsibilities, policies, processes, procedures, and resources established by the licensee to achieve the requirements of these rules. Therapeutic phlebotomy means the removal of whole blood from a donor for the purpose of medical treatment. 8:8-1.3 Licensure (a) Application for an initial license to conduct a bloo treatment/procedure(s) within the scope of their practice. One unit of blood: One unit of blood is approximately equal to 500 grams or 470 mls. Therapeutic phlebotomy: The removal of a specific amount (volume) of blood from a patient for treatmen

WHO guidelines on drawing blood : best practices in phlebotom

How To Do Venous Blood Sampling - Critical Care Medicine

To correctly perform a venipuncture, follow the steps below. 10. Insert the needle. Insert the needle at an angle that is between 15 and 30 degrees. This angle allows you room to work, reduces the risk of pushing the needle through. the back wall of the vein, and allows the best blood flow through the needle phlebotomy procedure, and the remaining three items were related to overall performance. All items were answerable with a yes or no except for three. These were: 1) duration the tourniquet was applied, which was expressed in minutes and seconds; 2) time taken to complete the procedure, also expressed in minutes an

Blood Transfusion-IV Therapy

Specimen Collection Procedure - PERFORMING A VENIPUNCTURE

The Quality Venipuncture Quick Guide is available in a larger 11/17 inch size to provide additional assistance in an accurate blood draw. The Quick Guide lists all of the steps of the venipuncture procedure, as well as special considerations, and the order of the tube draw Venipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Venipuncture is most often done for laboratory testing Policies and Procedures. There are other issues of safety that come into play. Hospitals, labs, and other medical facilities that employ phlebotomists usually have policies and procedures in place for dealing with a patient that faints or gets dizzy or light-headed during a venipuncture. Being aware of these procedures is vital to the safety of. STEP 5: Take the examination at the Pearson VUE Professional Center of your choice. Immediately after you complete the examination, you will see your preliminary pass/fail result on the computer screen. STEP 6: Receive email notification to and view your final examination score report. STEP 7: Receive your wall certificate in.

Video: 3.7.2 Collection, Processing, and Shipping of Blood Sample

A process could be as follows: staff will remove the tourniquet as soon as blood starts to flow and upon completion of the procedure; hold the needle cap, alcohol wipe, and tourniquet in the gloved hand; pull the glove down over the debris and discard all of these components together. 5 (See Figure 4 for an illustration of the process, or view. The following six (6) procedures are the minimal regulatory requirements for assessment of competency for all personnel performing laboratory testing: 1. Direct observations of routine patient test performance, including patient preparation, if applicable, specimen handling, processing and testing; 2 Use our free Phlebotomy practice tests (updated for 2021) to prepare for your upcoming exam. The Phlebotomy Certification Exam is an assessment taken by candidates who wish to become a Phlebotomy Technician. Phlebotomy Technicians work in places like hospitals, blood donation centers, and any other medical facility in which blood needs to be.