Dear Colleagues:



I am currently in the midst of a small policy debate regarding the allowance of

"non-

medical" personnel (a registered nurse or physician) to perform phlebotomy, the

placement of venous catheters and the ability to perform biopsy studies.



Currently, I have managed to clear the phlebotomy and catheter hurdle, but not

the biopsy

hurdle.



With an underlying assumption that any personnel performing these techniques

should be

adequately trained, would you mind sharing either privately or on the list your

institutions

policies regarding the performance of these laboratory techniques.



I would also be curious to know that when performing the muscle biopsy

technique, how

often are "side effects" encountered. Though I can easily anticipate soreness

and bruising,

I am more curious about the incidence/rate of infection or nerve damage.



Thanks for your time – Please feel free to respond to the list or privately.



Happy holidays,



Conrad

_________________

Conrad Earnest, PhD

Director: Exercise Biology Laboratory

Pennington Biomedical Research Center

6400 Perkins Road Baton Rouge, LA 70808-4124

Tel. (225) 763-2923

Fax: (225) 763-0905

EM. Conrad.Earnest@...

Dear Conrad,



At Massey University there is no formal policy, but the ethics committee

effectively mandates that it is OK for anyone who has attended phlebotomy

training course and is certified, and is mentored by an experienced phlebotomist

to place venous (not arterial) catheters and to take blood.



We have little problem getting ethics applications through for medics to perform

biopsies. However, allowance for non-medical personal is untested in New Zealand

far as I have been able to ascertain, but I am at the stage where I will try

within the next year, so are very interested in your outcome. It is difficult to

arrange for medics to come and take the samples - the main reason is they are

too busy.



I know of at least 5 PhDs who in UK, Canada, Australia, and USA who take their

own biopsies, and there is no evidence that the safety and outcomes are any

different to if a medic were taking the samples.



The concern and issues are competency and appropriate training and medical

supervision, and liability insurance for the day when something does go wrong.



Here is one reference summarizing risk factors.



Highstead RG, Tipton KD, Creson DL, Wolfe RR, Ferrando AA. Incidence of

associated events during the performance of invasive procedures in healthy human

volunteers. J Appl Physiol 2005;98:1202-6.



Would be grateful if you could write a summary when you are sufficiently

advanced.



With kind regards



David





David S. Rowlands PhD

Institute of Food Nutrition and Human Health

Massey University

Pvt Box 756, 63 Wallace St

Wellington 6021

New Zealand

P +64 4 801 5799 ext 6940

C 027 2099 383

H +64 4 499 0352