1.Surface judgments, profound questions: A homosexual male's Phlebotomy experience
Chadwick Co Sy Su ; Paul Martin Anthony C. Cenizal ; Teresita E. Dumagay
Philippine Journal of Health Research and Development 2019;23(4):12-17
Background and Objectives:
Two of the authors, one heterosexual and one homosexual, both voluntarily donated blood to a well-known health institution in the Philippines. As they were filling out the paperwork, one of the authors' attention was called by one of the questions in the form: “Nakipagtalik ka na ba sa iyong kauri?,” which can be literally translated as “Have you had sex with your own kind?”. This erroneously phrased
question was the sole question interrogated and problematized in the study.
Methodology:
Reviews of Standpoint Theory and the methodology associated with it and, in effect, used in the
study, formed part of the critique, divided into individual narrations and interpretations by each author. A third co-author, a hematologist, lent her insight on the logistics and issues of phlebotomy. Institutional ethnography was brought to bear on the narratives
Results and Conclusion
This three-author collaboration is presented as a claim that an interdisciplinary approach may open new vistas to a phenomenon that has long existed but been ignored. Reviews of Standpoint Theory and curriculum planning for health professionals are recommended.
Phlebotomy
;
Communication
;
Homosexuality
;
Blood Donation
2.Infective Endocarditis and Phlebotomies May Have Killed Mozart.
Korean Circulation Journal 2010;40(12):611-613
Thirty-five year-old Amadeus Mozart died in Vienna after an acute illness that lasted only 15 days but no consensus has been reached on the cause of his death. From many letters written by his farther it is almost certain that he experienced at least three episodes of acute rheumatic fever attack in his childhood, and a relapse of rheumatic fever was suggested to have killed Mozart, although death from acute rheumatic fever is very rare in adults. His last illness was characterized by high fever, massive edema, vomiting and skin rash. His last illness can be explained by infectious endocarditis and heart failure. During his last hours, he was given phlebotomy, possibly for the third time in two weeks, and soon after he became unconscious and died. As such, phlebotomy performed on a man dehydrated by high fever and vomiting may have caused systemic shock. In summary, Mozart probably died from chronic rheumatic heart disease complicated by infective endocarditis and heart failure, and repeated phlebotomy-induced hypovolemic shock.
Adult
;
Bloodletting
;
Consensus
;
Edema
;
Endocarditis
;
Exanthema
;
Fever
;
Heart Failure
;
Humans
;
Phlebotomy
;
Recurrence
;
Rheumatic Fever
;
Rheumatic Heart Disease
;
Shock
;
Unconscious (Psychology)
;
Vomiting
3.Checking Perceived Blood Group of the Patient Upon Phlebotomy: Additional Approach for Accurate Patient Identification and ABO Testing.
Kyung Mi JO ; Yousun CHUNG ; Sue SHIN ; Eun Youn ROH ; Jong Hyun YOON ; Kyou Sup HAN
Korean Journal of Blood Transfusion 2014;25(1):10-17
BACKGROUND: Accurate patient identification is fundamental in transfusion medicine. Our hypothesis is that an open question about patients' ABO blood group would be helpful for accurate identification of the patient and for accurate laboratory testing. METHODS: We added some blanks, including the patient's ABO blood group on the tube label, which should be filled in by the phlebotomist on the spot. From Aug 1, 2012 to May 31, 2013, we analyzed the effect of the additional step for identification of a misidentification 'incident' in 31,454 tests of 14,864 patients. We surveyed on 21 phlebotomists with regard to whether the changed label reinforces patient identification. In addition, the discrepancy rate between the ABO blood group perceived by the patient and the test result was analyzed. RESULTS: Patient-misidentification error rate during this study was 0.022%, and 81.0% of the phlebotomists answered that the changed label reinforces patient identification. The total discrepancy rate was 1.93%. Patients without previous results showed a higher discrepancy rate (3.08%) than patients with previous results (0.35%). Males (2.48%) showed a higher discrepancy rate than females (1.38%). Patients older than 50 years showed a higher discrepancy rate (2.87%) than patients younger than 50 years (0.82%). According to ABO blood group, group O showed the lowest discrepancy rate (0.87%). CONCLUSION: Checking ABO blood group known by the patient helped phlebotomists to correctly identify the intended patient. Active corrective action by the transfusion laboratory when discrepancies exist could increase test reliability and pave the way for safe transfusion, which will ultimately improve the quality of transfusion medicine.
Female
;
Humans
;
Male
;
Phlebotomy*
;
Transfusion Medicine
4.Reducing the Reporting Time by Improving Laboratory Processing for Inpatient Routine Chemistry Tests.
Eun Jung CHO ; Kyoung Jin PARK ; Dae Hyun KO ; Hoon HONG ; Woochang LEE ; Sail CHUN ; Won Ki MIN
Laboratory Medicine Online 2018;8(2):52-55
BACKGROUND: The returning time of inpatient specimen analysis is usually slow because phlebotomists deliver all the collected specimens at the end of their work cycle. In addition, manual specimen reception further delays the reporting time and imposes a heavy workload on the technical staff, thus compromising effectiveness. Therefore, we have created an automated specimen reception system to tackle testing delays and enhance the efficiency and quality of specimen collection and handling. METHODS: In May 2015, the pre-analytical processing of inpatient samples was renovated. We automated the specimen reception in parallel with barcode printing and introduced pneumatic tubes to deliver samples for routine chemistry tests. We compared the reporting time of the automated system with that of the manual system and analyzed the distribution pattern of the specimens according to handling time. RESULTS: The median reporting time was advanced by 41 minutes, from 09:33 AM to 08:52 AM for the manual and automated reception, respectively. Moreover, with the reduction in hands-on time, the blood specimens reached the laboratory immediately after phlebotomy, thereby improving the processing efficiency by spreading out the interval during which the specimens arrived in the laboratory. Additionally, the new system allowed the identification of the phlebotomist who collected the specimens and tracking the specimens from collection to test result. CONCLUSIONS: With the introduction of our automatic reception system, the reporting time was considerably reduced. Therefore, the satisfaction of the clinician and the technical staff was improved.
Chemistry*
;
Humans
;
Inpatients*
;
Phlebotomy
;
Specimen Handling
5.Ultrasonographic Study of the Anatomical Relationship Between the Lateral Antebrachial Cutaneous Nerve and the Cephalic Vein.
Hyung Soon IM ; Jin Young IM ; Ki Hoon KIM ; Dong Hwee KIM ; Byung Kyu PARK
Annals of Rehabilitation Medicine 2017;41(3):421-425
OBJECTIVE: To define the anatomy of the lateral antebrachial cutaneous nerve (LABCN) and the cephalic vein (CV) in the anterior forearm region of living humans using ultrasonography for preventing LABCN injury during cephalic venipuncture. METHODS: Thirty forearms of 15 healthy volunteers were evaluated using ultrasonography to identify the point where the LABCN begins to contact with the CV, and the point where the LABCN separates from the CV. The LABCN pathway in the forearm in relation to a nerve conduction study was also evaluated. RESULTS: The LABCNs came in contact with the CV at a mean of 0.6±1.6 cm distal to the elbow crease, and separated from the CV at a mean of 7.0±3.4 cm distal to the elbow crease. The mean distance between the conventionally used recording points (point R) for the LABCN conduction study and the actual sonographic measured LABCN was 2.4±2.4 mm. LABCN usually presented laterally at the point R (83.3%). CONCLUSION: The LABCN had close proximity to the CV in the proximal first quarter of the forearm. Cephalic venipuncture in this area should be avoided, and performed with caution if needed.
Elbow
;
Forearm
;
Healthy Volunteers
;
Humans
;
Neural Conduction
;
Phlebotomy
;
Ultrasonography
;
Veins*
6.Optimal Number of Blood Cultures and Volume of Blood Needed to Detect Bacteremia in Children.
Jong Jae KIM ; Cheol Am KIM ; Sang Ho BAIK ; Eui Tak OH ; Hong Ja KANG ; Kil Seo KIM
Journal of the Korean Pediatric Society 1998;41(7):917-922
PURPOSE: We compared pathogen recovery rates by obtaining two blood cultures instead of one blood culture containing 1ml and collecting a larger volume, 1 to 3ml. METHODS: Total of 750 blood specimens from 250 patients with fever, a temperature higher than 39degrees C and suspected bacteremia were obtained. Each patient had two samples of blood, A (1ml) and B (4ml), obtained at 30-minute interval from separate sites of extremities and B was divided into B1 (1ml) and B2 (3ml). Each sample was inoculated into aerobic culture media. Patients were excluded if two samples of blood were not obtained or if the isolate represented a contaminant. RESULTS: A pathogen was isolated in 19 (7.6%) of 250 patients and 37 (4.9%) of 750 specimens. In 7 patients, the pathogen was isolated with all the culture methods and in 12 patients, one or more of the cultures yielded no growth. The pathogen recovery rates were 53% (10/19) in A and B1, 89% (17/19) in B2 and 68% (13/19) in A+B1. No difference was detected between A or B1 and A+B1 (P>0.05) and the pathogen recovery rate for B2 was significantly greater than that for A or B1 (P<0.05), but no significant differences were found in pathogen recovery when B2 was compared with A+B1. CONCLUSION: Increasing volume of blood from 1 to 3ml inoculated into blood culture bottles improves detection of bacteremia in pediatric patients and spares patients the cost and pain of an additional venipuncture.
Bacteremia*
;
Child*
;
Culture Media
;
Extremities
;
Fever
;
Humans
;
Phlebotomy
7.Optimal Number of Blood Cultures and Volume of Blood Needed to Detect Bacteremia in Children.
Jong Jae KIM ; Cheol Am KIM ; Sang Ho BAIK ; Eui Tak OH ; Hong Ja KANG ; Kil Seo KIM
Journal of the Korean Pediatric Society 1998;41(7):917-922
PURPOSE: We compared pathogen recovery rates by obtaining two blood cultures instead of one blood culture containing 1ml and collecting a larger volume, 1 to 3ml. METHODS: Total of 750 blood specimens from 250 patients with fever, a temperature higher than 39degrees C and suspected bacteremia were obtained. Each patient had two samples of blood, A (1ml) and B (4ml), obtained at 30-minute interval from separate sites of extremities and B was divided into B1 (1ml) and B2 (3ml). Each sample was inoculated into aerobic culture media. Patients were excluded if two samples of blood were not obtained or if the isolate represented a contaminant. RESULTS: A pathogen was isolated in 19 (7.6%) of 250 patients and 37 (4.9%) of 750 specimens. In 7 patients, the pathogen was isolated with all the culture methods and in 12 patients, one or more of the cultures yielded no growth. The pathogen recovery rates were 53% (10/19) in A and B1, 89% (17/19) in B2 and 68% (13/19) in A+B1. No difference was detected between A or B1 and A+B1 (P>0.05) and the pathogen recovery rate for B2 was significantly greater than that for A or B1 (P<0.05), but no significant differences were found in pathogen recovery when B2 was compared with A+B1. CONCLUSION: Increasing volume of blood from 1 to 3ml inoculated into blood culture bottles improves detection of bacteremia in pediatric patients and spares patients the cost and pain of an additional venipuncture.
Bacteremia*
;
Child*
;
Culture Media
;
Extremities
;
Fever
;
Humans
;
Phlebotomy
8.A Broken J-Guide Wire during Central Venous Catheterization : A case report.
Kun Moo LEE ; Dae Sik PARK ; Sang Eun LEE ; Young Hwan KIM ; Se Hun LIM ; Jeong Han LEE ; Soon Ho CHEONG ; Young Kyun CHOE ; Young Jae KIM ; Chee Mahn SHIN
Anesthesia and Pain Medicine 2007;2(4):266-269
J-guide wires have been widely used for central venous catheterization with the popularity of the Seldinger technique. However, many adverse sequelae of central venous catheterization have been reported. We report two cases of J-guide wire breakage during central venous catheterization. Venipuncture by a steel needle was easily achieved in each case. However, insertion of a J-guide wire was difficult to perform, and pulling out the guide wire from the steel needle was more difficult, which caused breakage of the core and the uncoiling of the spring coil of the guide wire. The tip of the guide wire was not cut off, and there were no complications. With the removal of the guide wire, weak resistance was felt that which was not supposed to be sufficient to cut off the guide wire. It was assumed that an inherent fault in the manufacturing process of the guide wire could lead to this type of breakage.
Catheterization, Central Venous*
;
Central Venous Catheters*
;
Needles
;
Phlebotomy
;
Steel
9.Pain reduction at venipuncture in newborn infants: oral glucose solution, EMLA cream(R) and pacifiers.
Korean Journal of Pediatrics 2006;49(4):388-393
PURPOSE: We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. METHODS: Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. RESULTS: There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A:12.5+/-2.5, B:10.1+/-2.6, C:9.4+/-2.0, D:6.5+/-2.1 and E:8.7+/-2.3; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A:100 percent, B:82 percent, C:56 percent, D:40 percent and E:70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A:72 percent, B:30 percent, C:22 percent, D:0 percent and E:14 percent; that of group D was clearly lowest. CONCLUSION: These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.
Glucose*
;
Humans
;
Infant
;
Infant, Newborn*
;
Infant, Premature
;
Pacifiers*
;
Phlebotomy*
;
Skin
10.Four Cases of Porphyria Cutanea Tarda.
Sung Hwa KIM ; Sang Lip CHUNG ; Sang Won KIM
Korean Journal of Dermatology 1983;21(4):421-427
Porphyria cutanea tarda(PCT) is a photocutaneous disorder due to excessive porphyrins in the skin. We experienced 4 male patients who showed typical clinical manifestations. Histologic findings revealed subepidermal bullae with festooned derrnal papi11ae, and typical porphyrin excretion pattern of PCT was detected. One case had on 500mg daily of chloroquine with r.linical and biochemical improvement 4 months later without any adverse effects. Other 2 cases had on 125mg of chloroquine twice a week and the other one had perforrned phlebotomy.
Chloroquine
;
Humans
;
Male
;
Phlebotomy
;
Porphyria Cutanea Tarda*
;
Porphyrias*
;
Porphyrins
;
Skin