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What Is the Difference Between Venipuncture and Phlebotomy?

The terms “phlebotomy” and “venipuncture” are often used interchangeably, but for medical assistants, there’s a difference. All phlebotomy requires venipuncture, but not all venipuncture is phlebotomy. Let’s take a closer look at what medical assistants do and their role in each process.

What Does a Medical Assistant Do?

Medical assistants manage a broad range of clinical and clerical tasks in settings from private practices to hospitals. As indispensable members of the healthcare team, they bridge the gap between the office and exam room, serving as liaisons between patients and medical professionals. Administrative duties may include:

  • Managing the schedule
  • Triaging phone calls
  • Maintaining medical records
  • Helping with billing and insurance claims
  • Ordering supplies

Their clinical responsibilities are:

  • Greeting and rooming patients
  • Obtaining vital signs
  • Updating medication and allergy lists
  • Performing diagnostics tests
  • Collecting biological samples
  • Assisting with in-office procedures
  • Sterilizing instruments
  • Keeping exam rooms stocked
  • Patient education
  • Phlebotomy
  • Administering EKGs

Phlebotomy is an important skill because it helps doctors diagnose and treat disease.

What’s the Difference Between Venipuncture and Phlebotomy?

The difference between venipuncture and phlebotomy is their purpose. Venipuncture is the process of puncturing a vein with a needle for any medical purpose. Phlebotomy is venipuncture performed specifically to obtain blood samples for study.

Do Medical Assistants Perform Venipuncture?

Medical assistants perform venipuncture only for phlebotomy. But venipuncture can also be done to:

Administer Intravenous Drugs

Nurses start an intravenous line with venipuncture. An IV catheter, a thin plastic tube, is inserted into the vein using a needle where, with proper care, it can be used almost indefinitely to give patients IV medications and more. Between doses, the tube is “locked” with saline to prevent blood clots. This task is reserved for licensed medical professionals and is typically managed by nurses.

Collect Blood Donations

Similarly, gathering blood for infusions requires an IV line, however, because no medications are injected through it, it can be started by a certified phlebotomist.

What medical assistants can and can’t do is defined by each state. In NY state, medical assistants do not work with IVs.

Why Do Medical Assistants Perform Venipuncture?

Medical assistants perform venipuncture to obtain blood samples for testing. The levels of chemical substances in the body are a reflection of health, so when a component is above or below the normal range, it could signal an illness. Doctors use results to:

  • Verify good health
  • Determine a patient’s blood type
  • Identify risk factors for chronic conditions, such as diabetes
  • Diagnose disorders
  • Monitor the therapeutic effects of drugs, including blood thinners and antibiotics

Chemical analysis can detect many different health issues. Some include:

  • Anemia
  • Cancer
  • Diabetes
  • Electrolyte abnormalities
  • Autoimmune disorders
  • High cholesterol, a risk factor for heart disease
  • Hypothyroidism
  • Bacterial and viral infections
  • Nutritional deficiencies
  • Liver disease

Phlebotomy Equipment for Medical Assistants

To perform phlebotomy, you’ll need gloves, alcohol pads, tourniquet, needles, collection tubes, gauze and bandages.

Gloves – the safest approach to phlebotomy is to treat everyone’s blood as though it may be contaminated. Wearing gloves protects you from blood-borne pathogens.

Alcohol Pads – cleansing the skin with alcohol where the needle is inserted is a must for preventing infection. It doesn’t kill every microorganism, but it removes most bacteria.

Tourniquet – is applied to the limb above the vein to keep it full of blood. Plump veins are easier to see and have a firmer texture, so they’re less likely to collapse when punctured.

Needles – come in several sizes to accommodate different patients. Their diameter is measured in gauge from 12 to 30, the smaller the gauge, the larger the needle. A 22G is used for average adults, a 25G is ideal for kids and seniors with smaller veins. Lengths range from 0.5 – 1.5 inches. Use short needles for draws from the top of the hand and longer needles for drawing from the antecubital vein in the bend of the elbow.

Collection Tubes – blood is collected in sealed vacuum tubes. Color-coded, they may be plain or contain additives necessary for testing.

Gauze and Bandages – once the needle is withdrawn, blood may continue to flow. A medical assistant will apply gentle pressure with a clean gauze until the bleeding stops, and then cover the site with an adhesive bandage to help prevent infection and protect the patient’s clothes.

Phlebotomy: Step-by-Step

Phlebotomy is a technically demanding process that requires attention to detail. As a medical assistant, you will follow these steps:

Step #1: Review the Doctor’s Order

Lab orders contain all the information you need to draw a patient’s blood including their identity, the tests ordered and restrictions. Verifying the information is a vital safety measure.

Step #2: Screen the Patient

Before beginning, you’ll confirm the patient followed preparation instructions. For example, did they fast for the required time before the draw? You’ll also review their allergies to ensure they won’t react to the supplies you may use, such as latex gloves, disinfectants, and bandage adhesive.

Step #3: Obtain Consent

Venipuncture, like all healthcare procedures, requires informed consent. Being informed means knowing which tests were ordered and what to expect from the phlebotomy process, including adverse effects. A parent or guardian must give consent for children.

Step #4: Choose the Right Equipment

Venipuncture equipment varies, so you’ll need to assess a patient’s size and the health of their veins to make the best choices. The goal is a successful draw on the first attempt.

Step #5: Prepare Supplies

Preparation makes the phlebotomy process more efficient. Midway through a draw is not a good time to remember that you forgot the necessary supplies. Lay them all out in advance.

Step #6:  Position the Patient

A patient should always be in a safe position to have blood drawn with his or her arm placed so that it can’t slip. People prone to fainting should lay down.

Step #7:  Perform the Venipuncture

The steps in performing the venipuncture are:

  • Wash your hands and wear clean gloves
  • Place the tourniquet
  • Cleanse the venipuncture site with alcohol
  • Insert the needle and blood will begin to flow
  • Release the tourniquet
  • Fill and replace collection tubes as needed
  • Withdraw the needle
  • Compress the site with clean gauze until bleeding stops
  • Cover the site with an adhesive bandage
  • Dispose of all used supplies, including gloves, gauze, and needles, per OSHA standards.

Step #8:  Educate the Patient

Before the patient leaves, review post-procedure care and who to call with questions. If possible, let them know when and how they will receive results.

Step #9:  Label the Samples

Collection tubes should be labeled with the patient’s personal identifiers and the day and hour blood was collected. Tubes sent to outside labs may be rejected if the information isn’t legible and error-free.

Step #10:  Process the Sample

Whether you’re doing tests in-house or sending samples to private labs, many blood draws need to be processed immediately after they’re drawn. In some cases, serum needs to be separated from cells in a centrifuge. Tubes should also be properly stored, refrigeration or freezing can either destroy or preserve delicate samples.

How Do Medical Assistants Learn Phlebotomy?

Medical assistants are trained in phlebotomy as part of their vocational school program. They learn techniques in class and then practice them in the lab on peers. They may have an opportunity to take blood from patients during their supervised externship. Graduate medical assistants are well-prepared to practice routine phlebotomy in a doctor’s office without direct supervision.

Where Can Medical Assistants Use Their Phlebotomy Skills?

As demand for phlebotomy increases, so are the settings in which medical assistants can use their skills, including:

Private Practices

Most medical assistants work in doctor’s offices, many of which offer phlebotomy services. Though it was once done only in hospitals, phlebotomy is a convenience for patients and an added source of income for practices. Physicians could hire phlebotomists, but employing medical assistants is more practical because they have the broader skillset offices need.


Hospital phlebotomists serve both inpatients and outpatients. It’s fast-paced and challenging, but you’ll learn a lot by seeing cases rarely encountered in other settings. Most labs hire only certified phlebotomists, but your training as a medical assistant is an advantage when competing for jobs.


Clinics hire medical assistants as phlebotomists because of their versatility. Medical assistants can handle most responsibilities in a clinic from checking in patients to taking vital signs.

Insurance Companies

Certified phlebotomists can work for insurers, drawing blood for pre-coverage exams. It’s an ideal role for a medical assistant with phlebotomy certification because they have both the clinical and administrative skills necessary to work independently.

Final Thoughts

As private practices look for ways to improve patient convenience and speed up care, venipuncture is becoming an increasingly valuable skill for medical assistants. It’s one of many they’ll learn in vocational school and refine through experience.

Now that you know the difference between venipuncture and phlebotomy, ready for an exciting new career in the medical assisting field? The Medical Assistant program at Hunter Business School prepares competent, entry-level medical assistants in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains required for professional practice. The Medical Assistant program provides hands-on experience in a real medical setting where you can foster professional relationships with actual patients. Medical Assistant students spend 160 hours in an externship in an actual medical environment where they are supervised and taught in order to gain valuable on-the-job training.

Contact us today to find out more on how to become a medical assistant on Long Island.