A phlebotomy is an incision made in a vein to collect blood. This is what is more commonly called a “bloodletting”, a common practice in everyday life for blood donation or medical examinations. 

Phlebotomy refers to the operation of removing blood from a patient.

«Phlebo» = vein; “Take”= section.

An examination known to all

Almost everyone has had a blood sample before: for blood donation or during routine checks and blood tests. Phlebotomy is similar to this, except that blood is taken several times and in larger quantities.

The historical “bloodletting”

This practice was once known as the infamous “bloodletting”. It was thought at the time, between the XIth and the XVIIth century, that the “humors”, the diseases (one ignored the existence of the microbes), were contained in the blood. The logic of the time was therefore to withdraw blood to relieve the patient. This theory turned out to be devastating from all points of view: not only was it useless apart from rare diseases (cited here) but in addition it weakened the patient and made him vulnerable to infections (the knives used were not not sterilized).

Preparing for a phlebotomy

It is no longer necessary to deprive yourself before a blood sample, and to fast before the operation. On the contrary, it is better to be in good shape. 

A state of relaxation is recommended before the operation (to avoid bloodshot!)

Step by step phlebotomy

The operation requires day hospitalization in the case of several successive samples.

• We start with control blood pressure of the patient. It must be strong enough, without being too strong, for the operation to take place in good conditions.
• The patient is placed in sitting, his back against the back of an armchair. After applying a tourniquet, the patient’s arm is tilted downward before a vein is found large enough to prick it with a needle. The doctor or nurse then applies an antiseptic lotion, then introduces the needle connected to a collection bag and vial using what is called a catheter. 
• A phlebotomy lasts on average 15 to 20 minutes.
• A bandage is then applied to the area punctured by the needle, which is kept for two to three hours.

Risks of the operation

The patient may experience various reactions during a phlebotomy, the severity of which depends on the physical condition of the person. One can thus observe symptoms of sweats, fatigue, a state of discomfort, of the dizziness, or even a loss of consciousness. 

Le sample can also be painful if the tourniquet is too tight.

If they feel unwell, the patient will be lying down and monitored for a few minutes to control his reactions. 

Bleeding is interrupted if the patient is unwell.

Tip

In order to avoid discomfort, it is better to get up gradually and avoid excessive head movements, remain calm, and not look at the blood bag if you are afraid of it.

Decrease iron in the blood, in the case of hemochromatosis

Hemochromatosis is an excessive build-up of iron in the body. It is potentially fatal, but is fortunately curable. The condition can affect the whole body: excess iron in tissues, organs (the brain, liver, pancreas and even the heart). Often due to diabetes, it can take on the appearance of cirrhosis or severe fatigue, and occasionally makes the skin appear tanned.

The disease particularly affects people over 50, especially women after menopause. In fact, periods and their monthly blood loss are natural phlebotomies, a protection that disappears during menopause.

Phlebotomy, by removing blood and therefore iron from the body, relieves existing lesions but does not, however, repair them. The treatment will therefore be for life.

The methodology is to take one or two samples per week, of 500ml of blood maximum, until the iron level in the blood (ferritin) drops to a normal level below 50 μg / L.

Decrease the excess of red blood cells: essential polycythemia

La essential polycythemia is an excess of red blood cells in the bone marrow, where blood platelets are created.

It is treated with 400ml samples every other day, until the hematocrit (the proportion of red blood cells in the blood) drops to its normal level.

However, bleeding motivates the creation of new blood platelets, so we practice a phlebotomy coupled with the taking of drugs capable of reducing their production, such as hydroxyurea.

Just like after donating blood, it takes a while for the body to create red blood cells, platelets and blood fluid again. This is a long period of time during which the body is idling: the blood is not transported as quickly as usual to the organs.

Must therefore limit its activities. The physical activities will have to wait, otherwise you will quickly be out of breath.

It is also recommended to drink more water than usual in order to replace the water lost by the body.