CONTINUING EDUCATION Phlebotomy is the surgical opening or puncture of a vein with the intention of drawing blood or introducing a fluid. This process allows the health care professional to sample the blood for diagnostic purposes, generate a biological surgical additive, or administer medications intravenously producing an almost instantaneous effect on the patient. Accessing a patient’s venous circulation is not new in medicine. The ancient Greeks, Romans, and Egyptians all practiced “bloodletting” as a means of therapy to rid the body of evil spirits & demons (so-called bad humor) which traveled in the blood. This practice continued for centuries until modern medicine realized draining the patient’s blood resulted in poorer patient outcomes. Phlebotomy is a fragmented industry in America. Only California, Louisiana, Nevada, and Washington require phlebotomists to be certified to work in a medical office or hospital. Until recently the drawing of blood by a dental assistant or dental hygienist was at the discretion of the supervising dentist. Phlebotomy in Dentistry One of the primary reasons phlebotomy is practiced in Dentistry is to generate Biological Surgical Additives (BSA). The most popular BSA is platelet Rich Fibrin (PRF). Platelet Rich Fibrin is used to improve and accelerate the healing of a surgical wound by providing an extremely high concentration of growth factors and cytokines at the site of the wound. Using the patient’s freshly drawn blood, tubes of blood are centrifuged according to specific protocols to generate a supernatant of fibrin, rich in growth factors and cytokines. The growth factors and cytokines contained in the fibrin matrix accelerate the wound healing process, attenuate inflammation and pain, as well as provide a biological barrier membrane superior to any commercial membrane the dentist may purchase. Proper Education The practice of phlebotomy is a specific skill which must be properly taught while the student gradually, by trial and error, develops the skills necessary for success. With proper instruction and patience, the dental professional may develop the skill set necessary for the repeated success of drawing blood from a patient. The safe drawing of blood from a patient by the dentist, dental assistant, or dental hygienist requires proper education, appropriate armamentarium, professional patient interaction, and OSHA-approved disposal of biomedical waste (BMW). Proper education can begin with a Georgia Board of Dentistry-approved course offered by the Georgia Dental Association. This course will serve as a primer to the continuing education of the dentist, dental assistant, and dental hygienist in the practice of phlebotomy on their patients. Appropriate armamentarium includes the centrifugation machine, blood collection tubes, correct instruments for manipulating the fibrin matrix, and the right instruments for drawing the blood. Phlebotomy in the Dental Office LEE M. WHITESIDES DMD, MMSC 46 | Nov 2024
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