Are all modern astronauts at least passable phlebotomists?

Question

phlebotomists are (nearly always) highly skilled people who safely and relatively painlessly poke our veins with big needles, take blood samples, then ask us to "press here". The process is called a phlebotomy.

the surgical opening or puncture of a vein in order to withdraw blood, to introduce a fluid, or (historically) when letting blood.

This requires training, practice, a medical background and will often require certification.

It's normally done in a medical setting so if there are any unexpected challenges they can be dealt with.

Phlebotomy has no doubt been common in spaceflight, medical research on the health effects of spaceflight has been central from its beginnings and is highly active today as extended missions are considered.

Question: Are all modern astronauts at least passable phlebotomists?

This would be a real challenge to do on yourself because of both geometry and human nature, every crew member will need at least one other crew member to be able to do this, so in crews of 2 or more there needs to be at least two passable phlebotomists.

Is it something that most or all astronauts are capable of doing, or are there just a few "designated drivers" in each crew?

Do astronauts phlebotomize each other during ground training for practice?

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From the NASA.gov feature NASA Researchers Develop a Technique to Predict Radiation Risk on International Space Station Missions:

Japanese Aerospace Exploration Agency astronaut Akihiko Hoshide poses for a photo after undergoing a generic blood draw in the European Laboratory/Columbus Orbital Facility (COF).

Answer 1

By my count, the OP asks three questions. I'll anecdotally answer two of them ("Is it something that most or all astronauts are capable of doing, or are there just a few "designated drivers" in each crew?" and "Do astronauts phlebotomize each other during ground training for practice?").

I was the "backup" medical officer for STS-109 (the primary medical officer was a veterinarian!).

While training for said mission, I went to the medical clinic at the Johnson Space Center after hours for IV training. NASA had paid an unfortunate volunteer (someone who worked on site) to be my test dummy.

It took me about four pokes to succeed (those little catheters are hard to slide into the vein!). I felt bad for the stickee and did not enjoy the session. There was other medical-related training for me, but that was it as far as starting IV's.

Answer 2

Question: Are… astronauts… passable phlebotomists?”

Answer: No reason why they should be. Phlebotomy is passe. There is little potential need for venipuncture during spaceflight.

There are 2 reasons for needle access to veins:

Diagnostic. In hospitals, blood for diagnostics is usually collected by venipuncture using 5ml tubes. However, this volume is not required. Chemistry tests and hematologic tests can be performed on much smaller capillary samples from skin pricks. https://pubmed.ncbi.nlm.nih.gov/18070280 . This is standard practice in neonatal nurseries. Capillary samples are easily collected with no venipuncture skills. They can even be collected by the subject themselves. The ISS is equipped with a Bio-analyzer which requires only pinprick blood samples.https://www.asc-csa.gc.ca/eng/iss/bio-analyzer.asp

Therapeutics . Fluids and medications can be delivered through a number of non-oral routes:

1. Transcutanious (across intact skin), and sublingual (under the tongue). This works well for fat soluble medications such as Fentanyl, Lorazepam and Nitroglycerin.

2. Subcutaneous. A short, fine needle is used to deposit medication in the fat layer just under the surface of the skin. Administration is simple and requires no training. Medicine is slowly absorbed into the capillaries, then carried by the circulatory system. Local anesthetics and Morphine can be administered by this route.

3. Intramuscular. Medication is injected into a muscle (usually the shoulder) using a longer needle than for subcutaneous. Minimal training is required. Most antibiotics can be administered intramuscularly.

4. Intravenous (directly into a vein). This is required for medications which require dilution to avoid tissue irritation. An example is Vancomycin. It is also useful for replacing large fluid volumes such as in trauma resuscitation. Volume replacement is particularly urgent in hypovolemic shock (e.g.: massive blood loss) but IV access can be a significant problem due to peripheral vein collapse.

5. Fluid Replacement via Rectum (FRVR). This is an alternative to intravenous fluid replacement when IV access is not available. It is not routinely used in emergency departments due to availability of intraosseous (needle into bone marrow cavity) and peritoneal (tube into abdominal cavity) methods. Space medicine is a particularly good application for FRVR since it requires virtually no training and astronauts are on a perpetual low residue diet.

So phlebotomy is unlikely to be an essential procedure in space. It would be unreasonable to reject an otherwise qualified astronaut candidate for their poor phlebotomy skills.