Clinical Skills: Venepuncture

  • Wash hands using soap and water
  • Introduce self
  • Check name with patient and on name band
  • Ask permission to take blood sample, offer to explain the procedure, and be prepared to answer their questions about what you're testing for

  • Don gloves
  • Gather and set up equipment (in a tray cleaned with an alcohol wipe from inside-out first)
    • Chlorhexidine swabs
    • Barrel
    • Needle/Butterfly (depending on Medical School/Hospital Trust policy)
    • Blood tubes (ensure you know the correct colors for the tests you need, and ensure you know the 'order of drawer' for the tests - this can vary so look it up locally)
    • Tourniquet
    • Gloves
    • Cotton wool/gauze
    • Tape

  • Return to patient
  • Expose the are up to 3 inches about the antecubital fossa
  • Reposition patient's forearm with palm facing upwards
  • Apply tourniquet and find suitable vein
  • Wash hands and don new pair of gloves
  • Wipe vein with alcohol swab - slowly and only once
  • Open the needle/butterfly and attach the barrel (you may need a converted attachment for butterfly needles)
  • Warn patient of a sharp scratch and insert needle
  • If you are in the vein (you may see flash-back in the tube), insert the ends of the tubes into the barrel and fill as appropriate
  • When all tubes filled, remove the tourniquet
  • Take out the needle and dispose of in sharps bin
  • Apply cotton wool/gauze and tape
  • Invert the tubes for a number of times to ensure that the blood mixes with the additives in the tubes
  • Label the tubes at the patient's bedside with at least 3 components of patient data
  • Thank patient and tidy area
  • Wash hands and send the samples

Top Tips for finding blood:
  1. Positioning: sit the patient upright with their arms hanging loose by their sides, and ensure that you are comfortable
  2. Patient factors: if they have difficult veins, then you can try to i) keep them well hydrated before the blood test, ii) keep them warm, iii) warm their hands with a sealed glove full of mildly warm water
  3. Know your anatomy (or at least where veins can be found!) - the best areas include: antecubital fossa, radial aspect of wrist, hand.
  4. Firmly tapping the vein can increase your chances, but warn the patient first and check that it's not uncomfortable for them
  5. If the patient has small veins then go for small needles
  6. Go for veins which you can feel are spongy. If you can see a vein but can't feel it then forget it
  7. If you have repeated attempts, make sure that the patient is happy for you to do so. If not, see if a colleague can help
  8. As the anaethetists say - your first attempt is your best chance!

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    written by: celine_lakra; joel_cunningham,
    first posted on: 1/03/12, 17:00


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