Therapeutic Phlebotomy cont’d LSCM.25 3 Martin Health System Stuart, Florida Laboratory Services Therapeutic Whole Blood Phlebotomy Consent Therapeutic phlebotomy requires the removal of blood by venipuncture for medical reason(s). The withdrawal of so much blood as to induce syncope (fainting) was considered beneficial, and many sessions would only end when the patient began to swoon. It requires a physician order to be performed. ", The Permanente Journal Volume 8 No. Phlebotomy (therapeutic bleeding) is a controlled removal of a large volume (usually a pint or more) of blood. Over the next three days, there were more bleedings and a total of 40 more leeches. THERAPEUTIC PHLEBOTOMY: The removal of a specific amount (volume) of blood from a patient for treatment of a specific condition or disease. It is used mainly to reduce blood volume, red cell mass and iron stores. Your healthcare provider may give you saline (salt water) fluid to help prevent dizziness or lightheadedness. Also called erythrocytosis, polycythaemia happens when there is an increase in the red blood cell mass. The Talmud recommended a specific day of the week and days of the month for bloodletting, and similar rules, though less codified, can be found among Christian writings advising which saints' days were favourable for bloodletting. Individuals who may be in need of therapeutic phlebotomy are those who were previously diagnosed with various forms of blood related disorders. [4] However, since hypertension is very often asymptomatic and thus not diagnosable without modern methods, this effect was unintentional. Ancient Greek painting on a vase, showing a physician (, Controversy and use into the 20th century. [5], Today, the term phlebotomy refers to the drawing of blood for laboratory analysis or blood transfusion. Learn vocabulary, terms, and more with flashcards, games, and other study tools. For a few rare blood disorders, however, phlebotomy is performed as a medical intervention for disease management. In scarification (not to be confused with scarification, a method of body modification), the "superficial" vessels were attacked, often using a syringe, a spring-loaded lancet, or a glass cup that contained heated air, producing a vacuum within (see fire cupping). Polycythemia (rubra) vera –to decrease red cell mass 2. He may remove up to 1 pint of blood. William Harvey disproved the basis of the practice in 1628,[2] and the introduction of scientific medicine, la méthode numérique, allowed Pierre Charles Alexandre Louis to demonstrate that phlebotomy was entirely ineffective in the treatment of pneumonia and various fevers in the 1830s. The usual conditions where therapeutic phlebotomy would be 1. Phlebotomy using sterile technique. The popularity of bloodletting in the classical Mediterranean world was reinforced by the ideas of Galen, after he discovered that not only veins but also arteries were filled with blood, not air as was commonly believed at the time. Larger volumes of blood, usually 1,000 mL, can be removed if tolerated to expedite removal of excess iron; conversely, in patients who do not tolerate weekly phlebotomies, smaller volumes of blood can be removed or the interval between sessions can be increased, although this will lengthen the time required to mobilize the excess iron . 1  The frequency of phlebotomy will vary based on your medical condition and laboratory values. It is claimed to have been the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of over 2,000 years. Start studying Phlebotomy Chapter 14. [31] Some physicians considered bloodletting useful for a more limited range of purposes, such as to "clear out" infected or weakened blood or its ability to "cause hæmorrhages to cease"—as evidenced in a call for a "fair trial for blood-letting as a remedy" in 1871. The last photo and the diagram show the depth adjustment bar at the back and sides. The first was that blood was created and then used up; it did not circulate, and so it could "stagnate" in the extremities. During medieval times bleeding charts were common, showing specific bleeding sites on the body in alignment with the planets and zodiacs. It has a spring-loaded mechanism with gears that snaps the blades out through slits in the front cover and back in, in a circular motion. In general, each unit of blood (500 ml) that is removed represents. The physician applied 32 leeches to the most sensitive part of the wound. 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