VENIPUNCTURE SITES DIAGRAM SKIN
Make sure to continue to anchor the needle to the skin as you remove each bottle from the barrel by gently pulling and twisting. If no blood begins to flow into the bottles, try slightly withdrawing or adjusting the angle of the needle.ġ1. Lower and anchor the needle to the patient’s skin using the wings of the butterfly needle.ĩ. Attach each blood bottle, in the correct order of draw, to the barrel and allow them to fill to the appropriate level. Advance the needle a further 1-2 mm into the vein after flashback is noted to ensure you are within the lumen.Ĩ. You should see flashback into the needle’s chamber and feel a sudden decrease in resistance as the needle enters the vein.ħ. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. Warn the patient that they will experience a sharp scratch.Ħ. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site.ĥ.
Attach the needle to the barrel (some blood collection systems come pre-assembled, such as the butterfly needle with barrel shown in the video).Ĥ. Re-apply the tourniquet if removed previously.Ģ. DO NOT touch the cleaned site afterwards at any point, otherwise, the cleaning procedure will need to be repeated prior to venepuncture.Ĭlean the site for 30 seconds and allow to dryġ.You should start cleaning from the centre of the venepuncture site and work outwards to cover an area of 5cm or more.Clean the site with an alcohol swab for 30 seconds and then allow to dry completely for 30 seconds: Don gloves (gloves don’t need to be worn for cleaning the site, but they should always be donned prior to performing venepuncture itself).Ĩ. Once you have identified a suitable vein you may need to temporarily release the tourniquet, as it should not be left on for more than 1-2 minutes at a time.ħ. A vein that feels hard is likely sclerosed, thrombosed or phlebitic (inflamed) and should be avoided.ĥ. Tapping the vein and asking the patient to repeatedly clench their fist can make the vein easier to visualise and palpate.Palpate the vein you have identified to assess if it is suitable: Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site.Ĥ. Position the patient’s arm in a comfortable extended position that provides adequate access to the planned venepuncture site.ģ. Areas in which two veins join should be avoided where possible, as valves are often present.Ģ.Areas of broken, bruised or erythematous skin should be avoided.The median cubital vein in the antecubital fossa is commonly used for venepuncture.Inspect the patient’s arm for an appropriate venepuncture site: Do not perform venepuncture on an arm that has an intravenous infusion in progress as this may alter blood test results.Ģ.arterio-venous fistula, lymphoedema, a stroke affecting the movement of a limb). Pre-existing medical conditions may prevent particular limbs from being used (e.g.You should ask the patient if they have a preference.Choose an arm to perform venepuncture on: You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation.ġ.
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