Name of the Procedure:

Phlebotomy, Therapeutic (also known as therapeutic blood draw or venesection)

Summary:

Phlebotomy, therapeutic is a medical procedure that involves drawing blood from a patient's vein to treat certain health conditions. Unlike diagnostic blood draws, this procedure aims to remove a specific amount of blood to achieve a therapeutic benefit.

Purpose:

Phlebotomy is performed to manage conditions where there is too much iron or too many red blood cells in the bloodstream. The primary goals are to decrease iron levels, reduce blood volume, and lower the number of red blood cells.

Indications:

• Hemochromatosis (excess iron in the body)
• Polycythemia vera (too many red blood cells)
• Porphyria cutanea tarda (a disorder causing blistering of the skin)
• Chronic liver disease (when associated with iron overload)

Preparation:

• No fasting generally required.
• Patients may need to stay hydrated by drinking plenty of fluids.
• Review of current medications to determine if any adjustments are needed.
• A complete blood count (CBC) and iron studies may be ordered beforehand.

Procedure Description:

1. The patient is seated comfortably, usually in a reclining chair.
2. A tourniquet is applied to the upper arm to engorge the veins.
3. An antiseptic is used to clean the selected venipuncture site.
4. A needle attached to a sterile blood collection bag is inserted into the vein.
5. A prescribed amount of blood (approximately 500 ml) is drawn.
6. The needle and tourniquet are removed, and pressure is applied to the site to stop any bleeding.
7. A bandage is placed over the venipuncture site.

Tools and equipment: Sterile needle, blood collection bag, tourniquet, antiseptic, bandage.

Anesthesia or sedation: Generally not required, though local anesthesia may be used in specific cases.

Duration:

The procedure typically takes about 10 to 20 minutes.

Setting:

Phlebotomy, therapeutic is usually performed in an outpatient clinic or a hospital's phlebotomy lab.

Personnel:

• Phlebotomist or nurse
• Physician (may oversee the procedure)

Risks and Complications:

• Common: Minor bruising, slight dizziness, discomfort at the venipuncture site.
• Rare: Infection, excessive bleeding, fainting.

Benefits:

• Reduction in symptoms and prevention of disease progression related to iron overload or high red blood cell count.
• Patients may feel relief from symptoms like fatigue, abdominal pain, or blood clotting issues soon after the procedure.

Recovery:

• Rest for a short period after the procedure.
• Maintain hydration to replace fluids lost.
• Avoid strenuous activities for at least 24 hours.
• Follow-up appointments typically scheduled as needed.

Alternatives:

• Iron chelation therapy (for removing excess iron).
• Medications like hydroxyurea (for reducing blood cells in specific conditions).
• Pros and cons: Medication may be less invasive but could have systemic side effects.

Patient Experience:

During the procedure, patients might feel a slight pinch when the needle is inserted and some pressure as blood is drawn. Post-procedure, mild fatigue or dizziness can be managed with rest and hydration. Patients are encouraged to inform the healthcare provider if they experience significant discomfort or any unusual symptoms.