UPHB 185 - Phlebotomy for Law Enforcement Refresher

Refresher for law enforcement who have previously completed phlebotomy training. Review of the theory and practice of basic phlebotomy techniques and procedures specific for use in law enforcement. Includes basic phlebotomy terminology and anatomy, blood collection procedures and required permissions, point of collection in the field, use of straight needle and butterfly needles, tube and field collection equipment, purpose of collection by law enforcement, rights andresponsibilities by law enforcement and subject, documentation and reporting, legal and ethical practices.

Course Learning Outcomes:

Demonstrate good specimen collection technique, appropriate equipment and safety practices used by law enforcement for blood draw in the field.
Demonstrate knowledge in legal practices, knowledge in anatomy, medical terminology, equipment, and regulations.
Demonstrate legal, ethical, and critical thinking practices through the application of appropriate legal procedures, documentation, and behaviors.

Outline:

Phlebotomy Skills Review
- Updates to general rules, guidelines and standards
  - HIPAA general rules
  - OSHA guidelines
  - Applicable CLSI venipuncture standards
- Pre-collection skills and requirements
  - Common medical terms
  - Basic anatomy of the circulatory system of the arm and hand
  - PPE and Infection control
  - Identification of subject
  - Pre-draw authorization and subject consent
  - Collection of medical history
  - Positioning subject for blood draw
- Collection of blood sample
  - Identifying puncture site
    - Application of tourniquet
    - Acceptable areas for performing puncture
    - Palpation of vein
    - Positioning of subject for blood draw
  - Cleansing puncture area
    - Acceptable cleaning agents
    - 2017 CLSA standards for cleansing area
      - Circular target (concentric) cleansing
      - Back and forth friction cleansing
    - Allow site to air dry
  - Collection equipment
    - Evacuated tube system (ETS)
      - Vacutainer (straight) needle and holder
      - Required tubes – Na fluoride + K oxalate
      - Verification of lot #s and expiration dates
    - Winged infusion set (butterfly)
    - Syringe adapters / blood transfer devices
- Post collection processes
  - Subject evaluation and care
  - Sharps disposal
  - Labeling specimens
  - Documentation and dept specific reports
  - Storage and transport of sample
  - Chain of custody
- Complications during the collection process
  - Restricted vascular access and problem sites
  - Contamination
  - Special needs subjects
  - Subject behaviors
- Proficiency and continuing education
  - Demonstration of ETS, butterfly and syringe sample transfer
  - One successful live venipuncture per officer
Legal Instruction
- Forensic specific draw considerations
  - Standards and indicators for law enforcement blood draws
  - Subject identification and pre-draw authorization and consent
  - Equipment examination for lot number and expiration dates
  - Required identifiers on the sample and report
  - Role of law enforcement compared to other settings
- Blood Evidence Submission
  - Regulatory Agencies
    - Federal
    - State
    - Local
  - Blood draw report - Agency-specific forms
  - Required storage for samples
  - Chain of custody - required documentation
- Courtroom Testimony
  - GOHS and Pima County Attorney’s office
  - Purpose of both tube additives (Na+ Fluoride and K+ Oxalate)
  - Examination of tubes, purpose of glass vs. plastic tubes
  - Relevant Case Law
  - Statutory Guidelines
- Miscellaneous Situations and Concerns
  - Failure to obtain specimen
  - Special needs subjects
    - Refused consent
    - Role of admin per se
    - Requesting a search warrant
    - Procedure for forcible blood draws and combative arrestees
  - Restricted vascular access and problem sites
  - Legal rights of the subject