[Side effects of phlebotomy: pathophysiology, diagnosis, treatment and prophylaxis]

Although phlebotomy is on the whole a safe procedure, the frequency of side effects being low and their severity weak, there have still been rare incidents of serious accidents such as nerve injury, vasovagal reaction and infections. Medical staff performing phlebotomy must be aware of the pathophysiology of these side effects, be careful in avoiding them, and be trained to properly treat them. Nerve injury is the complication of which phlebotomists should take the greatest caution. It sometimes causes permanent motor and/or sensory nerve dysfunction of arms and hands. Appropriate selection of vein and careful procedure of venipuncture are required. Vasovagal reaction is a relatively common complication causing hypotension, palor and occasional syncope. For emergency cases, a bed, oxygen tanks, and a utility cart with drug supplies should be provided in the phlebotomy room. Infections, especially those by blood-borne pathogen, are rare but serious complications. When performing evacuated tube venipuncture procedure, blood collecting tubes sterilized on the inside and single-use holders must be used to avoid infections through backflow of blood. Phlebotomists must follow the procedure presented in the guidelines to avoid backflow. Hematoma, allergy, hyperventilation, air embolism, anemia and thrombosis are other side effects occasionally caused by phlebotomy. Finally, medical staff should recognize that sincere communication with patients receiving phlebotomy is essential and efforts to inform them of the possibility of these side effects are becoming increasingly necessary in the current medical environment.