Phlebotomy is usually by a phlebotomist, although medical practitioners, EMTs, paramedics, medical technologists, and nursing staff are also trained to take blood. Phlebotomists are also referred to as allied health professionals, and they draw blood for laboratory testing from patients. Nurses, medical technologists, and laboratory mangers supervise phlebotomists.

In addition, phlebotomists are also responsible for:

1. Providing proper explanation to the patients about the procedure being performed, patient considerations, and knowing the Patients Bill of Rights.

2. Basic record keeping for laboratory reports in patient files

3. Phlebotomists should know how to prepare laboratory reagents and stains

4. Maintaining lab equipment including sterilization and disinfection

5. Examining patients to take vital signs - temperature, blood pressure, and pulse and respiration rate

6. Sending urine and fecal samples for lab testing

In addition to all these, a professional phlebotomist has a basic knowledge of skills of drawing blood. The interface between the clinical laboratory and the patient is a phlebotomist. Phlebotomist uses the professional discretion for use of appropriate collection procedure like venipuncture, capillary blood, skin punctures, and collection of blood from neonates. Another special field for phlebotomists is drawing blood from indwelling lines.

In addition to specimen collection, phlebotomist should understand and practice the associated areas of handling, processing, and transportation. Appropriate methods of collection, preservation, and processing blood samples must be recognized by phlebotomist. Depending on the tests required, usually a 5 to 25mL sample of blood is enough for collection. Though phlebotomists do blood collection routinely, but medical practitioners, EMTs, paramedics, other nursing staff are also trained to take blood.

Due to the relative ease of obtaining blood samples, many studies are done on blood in diseased and normal states. Much valuable information is available to physicians in timely manner and low cost with least discomfort to the patients. Certain routine blood tests are part of new hospital admissions, in hematology and chemistry departments. Blood is also cultured in microbiology department. Immunological and serology tests are performed by detection of antibodies in patient blood serum. Majority of immunology tests are done on serum for which blood is collected in a plain tube and allowed to clot completely before being centrifuged.

Hospital or clinics depend on the workings of medical laboratories. About 85% of the patients clinical decisions are dependent on the information consequential from laboratory tests. A small error in pre-analytical procedure will magnify into a major parameter change and thus patient treatment would be affected. To determine prognosis of disease, diagnose disease, and manage therapy physicians depend on the quality of data produced by medical lab technicians.

Owing to high personnel turnover rates, lack of understanding about good laboratory practices, and inadequate training, there are several opportunities for making errors during phlebotomy, which mainly concern patient misidentification and collection of unsuitable specimens for testing due to unsuited venous accesses, venous stasis, inappropriate collection devices and containers. Improved standardization of phlebotomy techniques, continuous education, certification, and training of health care professionals involved in blood drawing responsibilities would help to obtain high quality specimens, with improved health care system and better service for the patients.

Though it is not required for the phlebotomist to get licensed in all the states, but certification is an asset for getting a job as a phlebotomist. Practicing phlebotomists requirements for certification are different in every state. It is mandatory to get licensed for "all persons who are not doctors, nurses or clinical lab scientists" in the states of California and Louisiana. In remaining states, phlebotomists can draw blood under proper supervision regardless of former experience or education. Phlebotomists need to be thoroughly trained in order to take blood irrespective of place of practice. Some vocational or technical schools offer phlebotomy diploma courses lasting for 2-3 months, while community colleges offer longer term associates degree programs. Phlebotomists should be compulsorily licensed and registered before starting actual work in some states. Respective states department of health and phlebotomy schools can give details regarding these regulations.

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