7 Examining the current practice of therapeutic phlebotomy. All you need to know as a healthcare provider... no leeches necessary!
Hello, I have assisted in a few Phlebotomy procedures, and from the patients perspective, it has significantly helped their health. This was on adults only. I find it funny tho that we do this procedure, usually only taking one bag, apx 300-400 Mls, and yet if you donate blood monthly is just called blood donation. Food for thought!
The blood letting is not done randomly. There are points used for cupping or hijama. Wet cupping involves using vaccum suction cups, so that only a certain amount of blood is drawn. This practice has historically helped with localized conditions such as gout without overburdening the kidneys or liver for metabolization of impurities. Cupping does not involve opening large veins, only micro circulatory vessels, and therefore is a safer procedure. Problem is, most practitioners are not healthcare providers and the bigges risk is infection.
Hello, I have assisted in a few Phlebotomy procedures, and from the patients perspective, it has significantly helped their health. This was on adults only. I find it funny tho that we do this procedure, usually only taking one bag, apx 300-400 Mls, and yet if you donate blood monthly is just called blood donation. Food for thought!
My hospital treats a lot of hematology patients and has it's own blood donation center. Some patients who are being treated for hemochromatosis or PCV and don't have any contraindications are just referred to our donor center on a routine cycle to donate blood.
That's funny. I (being an old nurse) was just talking to my young coworkers about this the other day. We had a patient whose RBC's were like way high! Of course, they'd never heard of anyone doing this. That's why it's so much fun to be a nurse from the dark ages! The experiences and on-the-job education we got!
My biological mother tracked me down when she was diagnosed with hemochromatosis. The treatment for that is basically controlled bloodletting. Ironically, I do not have it, but have the opposite problem: anemia and low iron.
We also do leech therapy on my unit, so old timey stuff does work :)
feelix said:The blood letting is not done randomly. There are points used for cupping or hijama. Wet cupping involves using vaccum suction cups, so that only a certain amount of blood is drawn. This practice has historically helped with localized conditions such as gout without overburdening the kidneys or liver for metabolization of impurities. Cupping does not involve opening large veins, only micro circulatory vessels, and therefore is a safer procedure. Problem is, most practitioners are not healthcare providers and the bigges risk is infection.
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Mmmm....more study, maybe? Some patients may feel better...others feel "dizzy," or worse. I like to keep an open mind, so I'll allow that in certain, tightly-circumscribed populations this may be an option. But in general it just feels a little, I dunno...creepy. Sorry. Thoughts of far-out pseudo-science pop up when you start talking about blood-letting--it just sounds so primitive.
Of course, the idea of eating nothing but what grows naturally is primitive, too, and the woods are full of people who would totally do exactly that if only they could. And I'm one of them. So, who's to say?
History
Blood letting or venesection was a practice used in many civilizations throughout history including the Egyptians and Romans. It involved the use of lancets, cupping or leeches. In most cases the patient did not experience many benefits but instead became weakened and facing sudden death. "A famous example is that of President George Washington who died in 1799 following the removal of approximately 1.7 litres of blood during a bloodletting procedure for acute epiglottitis." (Assi & Baz, 2014)
Current Practice
The practice of phlebotomy involves taking a small sample of blood (usually with a small butterfly needle) for laboratory testing. However, therapeutic phlebotomy refers to a less common procedure in which the patient needs a larger amount of blood removed. The specified volume is ordered by a physician/NP. This is done to remove excessive iron or red blood cells in the bloodstream. If left untreated, iron can build up in the heart, liver and joints. Iron overload can cause depression, joint pain, changes in skin color, and even cardiac arrest. Too many red blood cells can lead to thicker blood, potentially causing blood clots to form. The two most common diagnoses needing chronic therapeutic phlebotomy treatment are hemochromatosis (a metabolic disorder in which the body absorbs too much iron) and polycythemia vera (a bone marrow disease leading to excessive production of red blood cells).
Procedure & Supplies
Begin by checking the ordered volume of blood to be removed. In adult care, I have seen large collection bags placed below the patient's midline (using gravity for collection). In pediatric cases many nurses use empty syringes for blood collection. The blood can clot quickly during the process, occluding the IV catheter. Therefore, it is important to have all supplies ready and open to avoid any delay in collection. Here's a list of the supplies I frequently use when phlebotomizing a pediatric patient:
Tips & Tricks
Post Care
Medicine has clearly made significant strides since the time in which bloodletting was an accepted practice. Currently, therapeutic phlebotomy is certainly proven as an effective and precise practice for those who need it. With so many advances constantly happening in the world of medicine, is it possible that physicians years from now will look upon our current practices and consider them archaic as well?
References:
Assi, T. B., & Baz, E. (2014, January 12). Current applications of therapeutic phlebotomy. Retrieved May 18, 2017
What You Don't Know About Excess Iron Could Kill You. Retrieved May 18, 2017
What is Hemochromatosis?Retrieved May 18, 2017
Therapeutic Phlebotomy. Retrieved May 18, 2017
About Ashley Hay, BSN, RN, BSN, RN
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