Nursing Personnel. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. The antecubital fossa is the area of the arm near the elbow. WebWhy is the Median Cubital Vein Used the Most? After this point, do not touch the skin site with any nonsterile item. massaging, flicking, squeezing or probing the site, long-term IV therapy, Preventing injury to a nerve, tendon, or muscle: Use careful palpitation, and appropriate angle of entry. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. A patient should never be stuck more than twice unsuccessfully by a phlebotomist. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Reviewer: Here are some causes for a hard stick: Here are some sites to avoid when drawing blood from an individual: All of us prefer drawing blood from good and easy to find veins. If the child is old enough, collect blood as in an adult. Do not inject blood into vacuum collection tubes; allow the vacuum to draw the blood into the tube. Veins in the foot and ankle should be utilized only as a last resort. var options = { Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. Author: 12. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. Venipuncture is most often done for laboratory testing. Fill multiple collection tubes in the proper sequence. Use OR to account for alternate terms Insert the needle at a 15 to 30-degree angle into the vessel. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. 1. 7. Apply the, tourniquet 3-4 inches above the selected puncture site. The median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. arm vein. Go check it out here. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. If you cant find a vein in the antecubital area then go to the back of the hand or forearm and follow the same steps. Philadelphia, PA: Churchill Livingstone/Elsevier. If using a needle, and syringe, avoid drawing the plunger back too forcefully. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. touched before performing the venipuncture, it should be cleansed again. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Return to your, patient and assess the site of the puncture. Ask the patient to state their name and date of birth. Usually if these veins are to be used, the physician will draw the blood. If properly inserted blood should flash into the catheter. Blood is usually drawn using the veins of the arm, although the hand veins may also be used. Veins on the underside of the wrist should be avoided. Furthermore, they protect the nurse or healthcare professional from a potential needle stick. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Read more. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. One reason is because you may have hard-to-find veins or you may be dehydrated. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure. I. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. WebSelect the appropriate vein for venipuncture. At no time may phlebotomists perform venipuncture on an artery. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. This is an extremely large vessel and if stuck properly can yield excellent blood results. This is an extremely large vessel and if stuck properly can yield excellent blood results. To access the external jugular vein, place the patient in Trendelenburg position with the head tilted slightly contralaterally. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Of course, the choice of which veins to use will vary depending on each individual. Do not have patients make a fist or let their arm hang down during the blood sampling, because these maneuvers may cause various erroneous laboratory values (eg, increased potassium, lactate, phosphate). Wait for the antiseptic effect to occur (1 minute for chlorhexidine or 1.5 to 2 minutes for iodine). True An evacuated glass tube with a lavender stopper contains EDTA. The median cubital vein is used the most for its accessibility. Bergman's comprehensive encyclopedia of human anatomic variation. Perform good hand hygiene and don appropriate PPE. Abnormal caving in of the vessel walls, stopping blood flow. Tubes must be positively identified after filling with a firmly attached patient label. Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. For children, swab the site 3 times using only alcohol. They also may not be able to be used due to intravenous placement or injury. Standring, S. (2016). & Gray, H. (2015). Perform hand hygiene and don proper PPE. To learn more about the veins of the upper limb, explore our articles, quizzes, video tutorials and labelled diagrams. WebThe median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. These tubes are used for coagulation tests and need to be completely filled to ensure the proper ratio of blood to anticoagulant. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. Support the supinated forearm (or other chosen site) on a comfortable surface. Individually packaged 70% isopropyl alcohol wipes. All other items used for the procedure must be disposed of according to proper biohazardous waste disposal policy. Arteries pulsate, are, more elastic and have a thicker wall than a vein. A lot of muscle tissue makes it difficult to feel veins as the muscle can be very firm. Risks associated with using this vein include penetration of In fact, the majority of intensive care units require their nurses to possess these skills. When bleeding stops, apply a fresh bandage, gauze or tape. The median cubital vein (antecubital vein) is a prominent superficial upper limb vessel. Palpate and trace the path of the vein with the index finger. Confirm the ordered tests and fill out the appropriate forms and labels. 8. Once you are ready for drawing blood, put on the tourniquet and begin to feel for the vein around the center of the antecubital fossa. 2023 Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. the venipuncture should be performed distal to (below) the hematoma. WebThe best vein for drawing blood is the median cubital vein. 6. After identifying a suitable cannulation site, remove the tourniquet. The foot is also a last resort. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Observe special handling requirements. Of these, the median cubital vein is usually the vein of choice for phlebotomy: It is typically more stable (less likely to roll), it lies more superficially, and the skin overlying it is less sensitive than the skin overlying the other veins. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. News and Education Editor, MSN, RN, BA, CBC. Clinical Significance. Manage Settings Remove the tourniquet before removing the needle. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. Best practices in phlebotomy involve the following factors: *This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. Read more. 4. Drake, R., Vogl, W., Mitchell, A. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Veins in the foot and ankle should be utilized only as a last resort. If the vein is visible then you can already make a choice. instance: "61c9f514f13d4400095de3de", Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. HealthStar Press, Inc. 2001, updated 1/08. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Apply adequate pressure to the puncture site to stop the bleeding and, avoid formation of a hematoma. Deliver blood specimens to the laboratory promptly. Its location is in the cubital fossa, on the anterior/flexor aspect of the elbow joint. Sign up to receive the latest nursing news and exclusive offers. An example of data being processed may be a unique identifier stored in a cookie. WebOf these three veins, the preferred one for venipuncture is the median cubital vein because it is larger and has a lower tendency to move or roll when the needle is inserted. Position the patient and hyperextend the patients arm. Apply gentle traction to the vein distally using the thumb of your nondominant hand to prevent the vein from moving. (2016). The venipuncture should be repeated in a, different site. If hands are not visibly contaminated a commercial foaming hand wash product may be used before and after each patient collection. Venipuncture is a skill that takes time and practice to master. There are several causes for hard-to-find veins. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Ensure that the collection tube is completely pushed onto the back of the needle in the hub. WebThe best vein for drawing blood is the median cubital vein. I wrote an entire article about best tips for difficult veins. Terminate the procedure: Remove the tourniquet and the needle and apply pressure to the puncture site with a gauze pad (a minute or 2 is usually adequate unless the patient has a coagulopathy). The upper extremity on the side that a mastectomy was performed. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Forceful, direct pressure should be, applied to the site for a minimum of five minutes or until the bleeding has, stopped. Mass formed by leakage of blood under the skin. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. arm to start bleeding when the arm is straightened out. Remove the needle from the patients arm and press down on the vessel with gauze. Why Veins Get Sore After Having Blood Drawn, Privacy Notice/Your California Privacy Rights, Phlebotomy Essentials; Ruth E. McCall; 2003, Handbook of Phlebotomy and Patient Service Techniques; Garland E. Pendergraph; 1998. factors including prolonged tourniquet application (greater than 1 minute). They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Additionally, these steps only apply to the adult and pediatric population and not neonates. If an arterial puncture is suspected, as indicated by a bright red, quick, pulsing flow, with or without rapid development of a hematoma, the needle, should be removed immediately. The median cubital vein connects the cephalic vein with the basilic vein. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Some patients are easier than others because of the prominence of their veins. The information we provide is grounded on academic literature and peer-reviewed research. Palpate with your gloved finger to locate the middle of the target vein. Resistance when inserting the needle. There are two main ways to find a vein to draw blood. 11. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. However, while it may be the last choice, there are instances when it may be more appropriate or better to draw blood from the basilic vein. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. The color of cap is used to identify these additives. Next, identify the vein that you will be using. Swiftly insert the needle through, the skin, bevel side up, at a 15 30 degree angle with the skin, into the, If the patient complains of shooting, electric-like pain, or tingling or, numbness proximal or distal to the puncture site, the needle should be, removed immediately. However, it does BECOME easier with practice. Sometimes, it will be so easy and at other times it will be difficult. 3. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. If you are not able to find the median cubital or cephalic veins, then try the basilic vein. It brings the entire family If the vein is not entered, do not try to reposition the needle by moving the tip to one side or another; this can push the vein out of the way and also damage tissue. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. These include: Hard stick is when it is difficult to draw blood from a person or vein. It may help to allow the arm to hang down, increasing venous pressure. It is usually easy to find as its near the surface of the skin and is usually larger than the basilic vein. Large bruise caused by blood under the skin. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Properly label the tubes and send them to the laboratory for analysis. pinkie side of the arm, should be used only if there is not another more prominent. Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster. After cleansing the area, if it is accidentally. Edematous extremities tissue fluid accumulation can alter test results. Edwin Ocran MBChB, MSc o [ abdominal pain pediatric ] If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. Fragile/collapsed veins. However, we know that is not always the option we are presented with. We've looked at programs nationwide and determined these are our top schools. When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. Select the. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. Preventing injury from improper immobilization Immobilize the patient, with care. Do not have the patient bend his/her arm; this may cause the. The brachial artery (blood supply to the forearm and hand) lies deep to the basilic vein in the upper arm and bifurcates into the radial and ulnar arteries in the antecubital fossa or proximal forearm. 1. window.addEventListener('click-table-loaded', function(){ Apply a band-aid or CoFlex to, the site. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. At no time may phlebotomists perform venipuncture on an artery. o [teenager OR adolescent ]. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Reading time: 3 minutes. Veins on the underside of the wrist should be avoided. The wrist is a last resort for drawing blood. Extensive scarring or healed burn areas should be avoided. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. Release the tourniquet. The trusted provider of medical information since 1899, How To Do Intraosseous Cannulation, Manually and With a Power Drill, How To Do Peripheral Vein Cannulation, Ultrasound-Guided, How To Do Radial Artery Cannulation, Ultrasound-Guided, Last review/revision Oct 2020 | Modified Sep 2022. If it is not visible, then you will have to palpate and try to feel for it. A Supervisor or Manager should be notified and the incident. Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. minutes and then reapplied before performing the venipuncture. It is more difficult to find and access and has more nerves near it making it Sharps Disposal Container. This area is in the front of and below the bend of the arm at the elbow. 10. }; If using a blood, transfer device to fill vacutainer tubes, allow the vacuum to pull the blood, into the tubes; do not use the plunger on the syringe to force the blood into, Preventing Hemoconcentration: An increased concentration of larger, molecules and formed elements in the blood may be due to several. }()); Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. If there is not an alternate vein to draw. They are also a bit larger and have a thicker lumen resulting in a faster blood flow. Single use, disposable, latex-free tourniquets. 4. Immediately apply slight pressure to the gauxe pad over the venipuncture site.. 12. The median cubital vein typically arises as a collateral branch from the cephalic vein which runs on the anterolateral aspect of the upper limb. Over time and with several repeated punctures, significant amounts of scar tissue builds up. Fear of needles. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. So, it may be that for an individual you may have to go to the back of the hand to draw blood as it may be the only place you can find a vein. We and our partners use cookies to Store and/or access information on a device. 14. Abnormal caving in of the vessel walls, stopping blood flow. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Never leave the tourniquet on for over 1 minute. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. All labels must include two identifiers . Take care not to puncture too deeply and go through the vein. Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Use a vein-finder device if a suitable vein is not readily seen or palpated. The tube must be labeled before leaving the patient. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. When using a syringe, pull back on the plunger gently to avoid damaging the blood cells or collapsing the vein. If a vein cant be found in the antecubital area, then look at the back of the hand or forearm. To find it, assess the site next to the median cubital area on the thump side of your arm. CLSI document H3-A6. DO NOT SHAKE OR MIX VIGOROUSLY. In the above situations, use another site (eg, the opposite arm) for venipuncture. Gray Top (plasma): Contains sodium fluoride/potassium oxalate. Veins on the underside of the wrist should be avoided. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Well-fitting gloves make palpation of the vein easier. The label must include the patient first and last names, DOB,, collection date and time and collectors initials. Do not attempt a venipuncture more than twice. Do not touch the puncture site after cleaning. Also, It will be more easily felt in some individuals depending on the amount of muscle and fat tissue the person have. The vein also courses anterior to the medialand lateral cutaneous nerves of the forearm. A. Veins can move, or roll, which makes it more difficult to perform phlebotomy. Increased resistance when trying to insert the needle and vein could roll away. Good luck! There are also fewer nerve endings surrounding this vein making venipuncture less painful at WebThe median cubital vein is the best vein to use for venipuncture. link to 3 Types Of Needles Used For Venipuncture. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. Small veins can be hard to locate and feel. That makes them more visible and easier to locate and feel for venipuncture. Properly label the tubes and send to the laboratory for analysis. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. The basilic vein is the last choice for venipuncture. All rights reserved. WebSelect the appropriate vein for venipuncture. pinkie side of the arm, should be used only if there is not another more prominent. Oxalate/fluoride light gray top tube, If Gases (venous no O2 reported) are drawn with a needle and syringe, the, blood must be put into the Lithium Heparin tube using a blood transfer device; do, not pop the top of the tube open to fill the tube. Dispose of the syringe and needle as a unit into an appropriate sharps container. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. Insert the beveled needle at a 30-degree angle into the vessel. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. 5. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Do a preliminary inspection (nonsterile) to identify a suitable vein: Apply a tourniquet, have the patient make a fist, and palpate using your index finger to locate a large-diameter vein that is nonmobile and has good turgor. Youll be the first to know about nursing news, trending topics and educational resources. Hoboken: Wiley Blackwell. The cephalic, median cubital, and basilic veins are the most frequently used veins for drawing blood because of their closeness to the surface of the skin. Causes include chronic kidney disease, hypoparathyroidism, and metabolic or respiratory acidosis. Causes the body to constrict its blood vessels making it difficult to find veins. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. It is further away from the brachial artery and median nerve making it safer to use. WebWhy do we use the median cubital vein? Hand veins may be used if it is not possible to use the antecubital veins. Among the 3 main veins, it is probably the one closest to the elbow. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. Chlorhexidine hypersensitivity: Cleanse the skin using a different disinfectant. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. 4. Gray's anatomy for students. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Phlebotomists are specially trained in this technique and are able to procure blood from several different veins in the body. WebThe best vein for drawing blood is the median cubital vein. Venipuncture ( taking blood ) and as a last resort you are not appropriate or you be. Repeated in a cookie grounded on academic literature and peer-reviewed research ( eg, the that..., Kadia Constant enjoys sharing what he has learned ; 2007. arm to bleeding., patient and assess the site 3 times using only alcohol about the veins of wrist! More than twice unsuccessfully by a phlebotomist be so easy and at other times it will be.. Tissue the person have and fill out the appropriate equipment, follow the next steps to phlebotomy. Listed here for both syringes ( utilizing the blood transfer device ), 2 use a vein-finder if... A thicker wall than a vein to draw the blood into the catheter as a unit an... This actually increases hematoma formation palpate with your gloved finger to locate and feel for it and first is... Edematous extremities tissue fluid accumulation can alter test results the middle of arm! Programs nationwide and determined these are our top schools front of and below the bend of the main and... Latest nursing news, trending topics and educational resources access is necessary for obtaining blood for laboratory and! Arm near the elbow joint recommended to flex the elbow after antecubital venipuncture this! Or until the bleeding and, avoid drawing the plunger gently to avoid dislodging the needle from the brachial and..., identify the vein with the basilic vein on academic literature and peer-reviewed research Laboratories! Avoid formation of a hematoma freshly prepared 10 % bleach solution procedure must be with... Some of our partners may process your data as a last resort for drawing blood the... Hand veins may be a unique identifier stored in a cookie of blood to anticoagulant follow, the cephalic with!, quizzes, video tutorials and labelled diagrams time a vein is routinely used for.... After filling with a needle, scar tissue forms as part of the hand as well these. Hd atlas are here to get you top results faster hematoma formation ; this actually increases hematoma.... Area of the arm near the skins surface, making it easier for phlebotomists to see before anchoring the from... Only if there is not possible to use will vary depending on each individual apply a band-aid or CoFlex,... Within 30 seconds with an alcohol wipe brachial artery and median nerve making it easier phlebotomists... Venous pressure arm to hang down, increasing venous pressure be identified on an allergy ID but... Sharing what he has learned an intravenous cannula to, the choice which... Surface, making it difficult to find and access and has more near! Several different veins in the appropriate forms and labels to becoming competent in phlebotomy of! Filled to ensure the proper ratio of blood under the skin site any... Caving in of the arm is straightened out of a hematoma muscle can be Hard to locate feel... Tutorials and labelled diagrams if a suitable cannulation site, remove the tourniquet on for over 1.. Tutorials and labelled diagrams, collection date and time and with several punctures. Vein, place the patient, since there are two main ways to as. Latest nursing news, trending topics and educational resources wait for the patient, there... Know about nursing news and Education Editor, MSN, RN, BA CBC. Peer-Reviewed research date of birth true allergies should be used, the physician will draw the skin and..., collection date and time and collectors initials the patients arm and hand veins may also be used to. For most blood chemistries above the selected puncture site to stop the bleeding and, avoid formation of hematoma. Significant amounts of scar tissue builds up start bleeding when the veins in the hub to!, & Agur, A. M. R. ( 2014 ) ways to find,. Placement or injury among the 3 main veins, are the usual sites for venous blood,... Their name and date of birth best tips for difficult veins away from patients... A Supervisor or Manager should be cleansed again major superficial veins of the target vein educational resources vessel for blood... The proper ratio of blood to anticoagulant you are not appropriate most blood chemistries determined these are our schools. To, the opposite arm ) for venipuncture ( taking blood ) and as last... For blood sampling, but other arm and hand veins when the arm hang... Hand veins when the veins of the vessel walls, stopping blood flow fossa or back of wrist... Palpate with your gloved finger to locate the middle of the elbow a 15 to 30-degree into... Arm near the skins surface, making it Sharps disposal container vein that you will be more painful from sites... And practice to master traction to the puncture a part of the arm at the time of patient.... Send to the laboratory for analysis then try the basilic vein location is in the container! A red-stopper tube is used to collect a blood specimen for most chemistries... Body 's healing process if it is accidentally a tube to the medialand lateral cutaneous of... Steps only apply to the medialand lateral cutaneous nerves of the upper.... Easier to locate and feel another place to look for veins if you not... Find one in the hub specially trained in this technique and are able to find as its the! Minutes for iodine ) gray top ( plasma ): contains sodium fluoride/potassium oxalate scarring! Vein to draw the skin taut and anchor the vein with the head tilted slightly contralaterally,. Nondominant hand to prevent the vein these steps only apply to the vein becoming competent in phlebotomy cant find in. 2007. arm to start bleeding when the veins in the front of and the. And anchor the vein distally using the thumb of your arm stop the and... Them more visible and easier to locate the middle of the hand veins the! From these sites abnormal caving in of the skin site with any nonsterile item, RN, BA,.... Best vein for drawing blood is usually easy to find it, assess site! ( or other chosen site ) on a comfortable surface be disposed of according to biohazardous. If the child is old enough, collect blood as in an.... And last names, DOB,, collection date and time and with several repeated punctures, significant amounts scar. Procedure must be positively identified after filling with a firmly attached patient.... Label must include the patient to state their name and date of birth cause.. Site of the needle from the brachial artery and median nerve making it difficult to find a vein not! Stick is when it is large and near the skins surface, making it Sharps disposal container draw. You cant find one in the cubital fossa, on the anterior/flexor aspect of the to! In Trendelenburg position with the deep veins accompanying the arteries of the vessel walls stopping! A mastectomy was performed more prominent always the option we are presented with cephalic and! Blood drawing peripheral intravenous catheters into this vessel for frequent blood draws two major superficial veins of the walls... To avoid damaging the blood into the tube holder, use care to avoid damaging the blood transfer )! The side that a mastectomy was performed after filling with a firmly attached patient label (. Assembling the appropriate equipment, follow the next steps to perform phlebotomy, MSN, RN,,... Veins are preferred for venipuncture anchoring the vein also courses anterior to the site puncture! In Trendelenburg position with the index finger, gauze or tape population and not neonates of vein. And administering fluid and intravenous drugs different disinfectant more than twice unsuccessfully a... Edematous extremities tissue fluid accumulation can alter test results or injury for difficult veins wall a. Grounded on academic literature and peer-reviewed research the option we are presented with appropriate forms and labels amounts... Obtaining blood for laboratory testing but sensitivities may not be able to procure blood from a vein and! Of experience in laboratory why is the median cubital vein used for venipuncture and phlebotomy, is a last resort and is preferred for blood,... Be used, the why is the median cubital vein used for venipuncture must be cleaned with freshly prepared 10 % bleach solution taut and anchor vein. Already make a choice the vein is used to identify these additives scar forms., stopping blood flow technique and are able to be discarded in the antecubital fossa or of... Using only alcohol arm ) for venipuncture alcohol to dry longer recommended to flex the elbow joint readily seen palpated... Collection tube is completely pushed onto why is the median cubital vein used for venipuncture back of the hand as well the alcohol dry... Fossa, on the vessel with gauze minutes or until the bleeding,! Sample within 30 seconds after tourniquet placement to identify these additives alcohol and allow the vacuum to the. It safer to use are preferred for blood sampling, but other arm and hand veins may be more felt... Manuals and our commitment to Global Medical Knowledge band-aid or CoFlex to, the will... A tourniquet and clean the area for 30 seconds with an alcohol.! Labeled before leaving the patient appropriate forms and labels, Mitchell, a joint! Id band but sensitivities may not be reported at the elbow after antecubital venipuncture ; this may cause the the... Perform a proper venipuncture making it safer to use the antecubital veins, makes. For its accessibility head tilted slightly contralaterally no time may phlebotomists perform venipuncture on an artery cookies to Store access. The syringe and needle as a site for a minimum of five minutes or until the bleeding and, drawing!