They are also a bit larger and have a thicker lumen resulting in a faster blood flow. When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. 7. 2. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Transfer Device 6. The tube must be labeled before leaving the patient. Scarred areas. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. If a flash still does not appear, withdraw the needle almost to the skin surface, change direction, and try again to advance the needle into the vein. Properly label the tubes and send them to the laboratory for analysis. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. Leg veins (eg, dorsal digital veins and the greater saphenous vein inferoanterior to the medial malleolus) or external jugular veins may be used if upper extremity veins are inaccessible. Avoid drawing blood from a hematoma. It is possible that a nerve has been punctured, and possibly damaged. See below. There are several major veins that run through this area, close to the surface. Observe special handling requirements. 12. Observe all applicable isolation procedures. 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). After identifying the site for the blood draw, gather the appropriate supplies needed. Shaking. Apply the tourniquet 3-4 inches above the collection site. Veins in the foot and ankle should be utilized only as a last resort. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. True An evacuated glass tube with a lavender stopper contains EDTA. Venipuncture is most often done for laboratory testing. Good luck! 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. An OSHA acceptable, puncture proof containermarked Biohazardous. Enjoy :). At no time may phlebotomists perform venipuncture on an artery. I. [3] There are also fewer nerve endings surrounding this vein making venipuncture less painful at I wrote an entire article about best tips for difficult veins. Gray's anatomy for students. 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. For children, swab the site 3 times using only alcohol. Needles are never recapped, removed, broken, or bent after phlebotomy procedure. Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. An important tip - take extra supplies into the patients room in case you need to attempt a second venipuncture. WebFlow of blood mixed with tube additive back into a patient's vein. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. Apply the, tourniquet 3-4 inches above the selected puncture site. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. Apply a band-aid or CoFlex to, the site. 2. In the above situations, use another site (eg, the opposite arm) for venipuncture. The forearm and at the back of the hand are also other possible areas for drawing a sample. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. 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. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Adequate, pressure should be applied to stop the bleeding once the phlebotomy is, complete. Picking a vein is not difficult. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. }()); Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. When bleeding stops, apply a fresh bandage, gauze or tape. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Veins in the foot and ankle should be utilized only as a last resort. Copyright If applying povidone-iodine, wipe it off with alcohol and allow the alcohol to dry. In the case of a difficult venipuncture, an, individual may make a maximum of two attempts before having, someone else try. It is usually straight and found around the center of the antecubital fossa. Once found, be sure to anchor it when inserting the needle. False regardless of how small it may be. Large bruise caused by blood under the skin. Advertisementsif(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-large-leaderboard-2','ezslot_3',169,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-large-leaderboard-2-0'); How to find the vein? Drawing blood from a patient can be a daunting task but it also is a necessity for nurses. On others it will be just below the surface. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. 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. It is the best because its larger and rolls or moves less than other veins. There read more ). If the child is old enough, collect blood as in an adult. The blood is normally drawn from a vein on the top Remove the tourniquet if you did not do so earlier. Preventing dizziness or fainting and potential follow-up injuries due to a, fall: Be sure patient is seated in an appropriate draw chair and or lying in. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. This area is in the front of and below the bend of the arm at the elbow. Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. It can be difficult to find these veins in some patients, especially if the patient is dehydrated, obese, or undergoing chemotherapy. 8. To prevent accidental needlesticks, carefully deposit used blood-collection devices (with the needle still attached to the syringe or vacuum tube holder) into an appropriate container immediately after completing blood sampling. This article will discuss the anatomy and function of the median cubital vein. (2016). Do not attempt a venipuncture more than twice. 4. Individuals taking chemotherapy. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Green Top (plasma): With and without gel, contains lithium heparin. The information we provide is grounded on academic literature and peer-reviewed research. The median cubital vein is the first choice for venipuncture. The median cubital vein, the preferred one to use, is found close to the center, and the basilic vein is located on the inner, or medial part of the antecubital area. Standring, S. (2016). 4. Obese patients. Arteries pulsate, are, more elastic and have a thicker wall than a vein. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. All content published on Kenhub is reviewed by medical and anatomy experts. If an IV is in place, samples may be obtained below but NEVER above the IV site. The WHO has best practices that are key to preventing infection and being successful during blood draws. If the blood is flowing, slowly, gently adjust the angle to see if the needle is sitting up against the, wall of the vein. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Ask the patient to apply pressure to the gauze for at least 2 minutes. WebSelect the appropriate vein for venipuncture. The median cubital vein typically arises as a collateral branch from the cephalic vein which runs on the anterolateral aspect of the upper limb. The cephalic vein is the second choice usually, since it is fairly well anchored. Select the appropriate vein for venipuncture. 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. Increase in ratio of blood components to plasma. 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. window.addEventListener('click-table-loaded', function(){ Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Of course, the choice of which veins to use will vary depending on each individual. Most of the samples you are going to draw will be from that vein in the center of the arm. WebWhy is the Median Cubital Vein Used the Most? The nerves are also further away in the antecubital area making drawing blood less painful. Wrist. 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. 6. The antecubital fossa is the area of the arm near the elbow. An example of data being processed may be a unique identifier stored in a cookie. 13. 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. Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. 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. Please confirm that you are a health care professional. It is more difficult to find and access and has more nerves near it making it For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. The blood is normally drawn from a vein on the top The median cubital vein is used the most for its accessibility. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. While not commonly taught in nursing school programs, many recommend that nursing students take extra courses in how to take blood to hone this skill. New technology is being developed, Below is a needle gauge chart showing the sizes of needles used for the Evacuated Tube System, Syringe Method, and the Butterfly Needle when performing venipuncture. Next, locate the vein you will be using for the blood draw. Activate the safety device and properly dispose of the vacutainer holder with needle attached into a sharps container. Sign up to receive the latest nursing news and exclusive offers. That is the first choice for drawing a blood sample. The basilic vein basically runs from the palm of the hand and up your arm on the side of the ulna. Netter, F. (2019). Red Top (serum): Plain and gel. The least best is the basilic vein. While it is important to know the best veins to access its also important to know which areas to avoid. Use for phrases pinkie side of the arm, should be used only if there is not another more prominent. It is more difficult to find and access and has more nerves near it making it Dont be discouraged if at first, you dont access the vein. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. If blood is being obtained for blood cultures, vigorously cleanse the site with alcohol for 30 seconds, allow the alcohol to dry, and then swab in outwardly expanding, overlapping circles using chlorhexidine or povidone-iodine. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. 11. Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. [3] Atlas of Human Anatomy (7th ed.). It is usually easy to find as its near the surface of the skin and is usually larger than the basilic vein. This is an extremely large vessel and if stuck properly can yield excellent blood results. 5. 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. 8. 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. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. The label must include the patient first and last names, DOB,, collection date and time and collectors initials. o [ pediatric abdominal pain ] The information provided should not be used for diagnosing or treating a health problem or disease. 3. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. Patient should be seated with back supported or, if they are anxious or have a history of vasovagal reaction, supine. Wait for the antiseptic solution to dry completely. All surfaces are cleaned daily with bleach. It is more difficult to find and access and has more nerves near it making it Never leave the tourniquet on for over 1 minute. Most patients needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. 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. The cephalic vein, which runs up the thump side of your inner arm is the second choice of the 3. Insert the needle proximally (ie, in the direction of venous blood flow), with the bevel facing up, along the midline of the vein at a shallow angle (about 10 to 30 degrees) to the skin. If you used a syringe to collect the blood, now transfer samples to collection tubes and bottles;* either insert the needle directly into the tops of the vacuum tubes, or remove the needle and attach a vacuum tube holder to the syringe. How to find the vein? Draw the desired amount of blood by pulling back slowly on the syringe stopper. Hematoma A venipuncture should not be performed on a hematoma. The foot is also a last resort. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. If a tourniquet is used for preliminary vein selection, release it and reapply after two minutes. 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 median cubital vein connects the cephalic vein with the basilic vein. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. These superficial veins lie within the subcutaneous tissue. Use another tube as vacuum may have been lost. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. While the needle is still in the vein, activate the, safety button with the tip of the index finger; the needle will automatically. * When multiple blood tests are to be done, blood should be allocated to the collection tubes in a proper sequence; first cultures, then tubes with anticoagulant, and then others. The median cubital vein is used the most for its accessibility. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. If the needle had initially passed completely through the vein, a flash may now appear as you withdraw the needle tip back into the lumen. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. Veins on the underside of the wrist should be avoided. Tubbs, R. S., Shoja, M. M., Loukas, M., & Bergman, R. A. Large bruise caused by blood under the skin. arm vein. if (window.ClickTable) { and grab your free ultimate anatomy study guide! If you are not able to find the median cubital or cephalic veins, then try the basilic vein. Vein rolls when inserting the needle. It does hurt more, though, when inserting the needle there than in the center of the arm. Do not touch the puncture site after cleaning. touched before performing the venipuncture, it should be cleansed again. These tubes are used for coagulation tests and need to be completely filled to ensure the proper ratio of blood to anticoagulant. Have appropriate back up staff as available. Veins on the underside of the wrist should be avoided. 5. Along its course, the median cubital vein commonly gives off a perforating branch, the deep median vein. HealthStar Press, Inc. 2001, updated 1/08. The median cubital creates less bruising and pain than other draw sites. Do not recap standard (ie, nonsafety) needles prior to disposal unless a container is not immediately available. Verify that any diet or time restrictions have been met. 7. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Reassure the patient that the minimum amount of blood required for testing will be drawn. Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. These superficial veins lie within the subcutaneous tissue. Mastering Pediatric Phlebotomy. Center, for Phlebotomy Education, Inc. 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. 7. Small veins can be hard to locate and feel. Certain other sites should, Extensive scarring from burns or surgery. Some test specimens require special handling for accurate results. There are also fewer nerve endings surrounding this vein making venipuncture less painful at The basilic vein is kept as a last choice option. WebThe best vein for drawing blood is the median cubital vein. Tubes with different additives are used for collecting blood specimens for specific types of tests. WebWhy do we use the median cubital vein? Needles and hubs are single use and are disposed of in an appropriate sharps container as one unit. 5. Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. How To Do Diagnostic Peritoneal Lavage (DPL), Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Veins in the foot and ankle should be utilized only as a last resort. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. 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. 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. link to 3 Types Of Needles Used For Venipuncture. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Foot. 5. I am a full time phlebotomist and I enjoy my job. Confirm the ordered tests and fill out the appropriate forms and labels. Most of the samples you draw will either be drawn from the cephalic or median cubital vein. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. When using a syringe, pull back on the plunger gently to avoid damaging the blood cells or collapsing the vein. If properly inserted blood should flash into the catheter. Veins deeper in the arm can be hard to feel and locate. opposite arm, then blood should be drawn from BELOW (distal to) the IV. If you used a needle and syringe, ask, your patient or a parent to apply pressure to the site so that you can fill, your tubes. Blood should flow into the evacuated tube. The least best is the basilic vein. Muscular patients. In the case of an accidental needlestick, immediately wash the area with an antibacterial soap, express blood from the wound, and contact your supervisor. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. arm vein. Chlorhexidine hypersensitivity: Cleanse the skin using a different disinfectant. Mass formed by leakage of blood under the skin. 2. It can be done by palpating the vessel or via transillumination with a special light. Transfer blood drawn into the appropriate tubes as soon as possible using a Blood Transfer Device, as a delay could cause improper coagulation. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. All labels must include two identifiers . Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Northfield, IL: College of American, NCCLS. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Beth Celli is a native New Yorker who is now based in Delaware. 1. The basilic vein is the last choice for venipuncture. It courses superomedially across the roof of the cubital fossa, within the subcutaneous tissue and empties into the basilic vein on the anteromedial side of the upper limb. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Veins on the underside of the wrist should be avoided. NOTE: When using a winged blood collection set for venipuncture and a coagulation tube is the first tube needed, first draw a discard tube (plain red top or light blue top). This vein penetrates the fascial roof of the cubital fossa to anastomose with a brachial vein, forming a connection between the superficial and deep venous systems of the upper limb. (See also Vascular Access Vascular Access A number of procedures are used to gain vascular access. retract from the vein and the safety device will cover the needle. window.ClickTable.mount(options); To help distend and locate veins, tap a potential site with your fingertips. Use to remove results with certain terms Preventing injury from improper immobilization Immobilize the patient, with care. Each healthcare system has its own requirements prior to nurses performing blood draws. Go check it out here. Increase in ratio of blood components to plasma. Allow 10-15 minutes after a transfusion is completed before obtaining a blood sample. Venipuncture is most often done for laboratory testing. 1. Used primarily for hematology and blood bank testing. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Once you have found it, take care in anchoring the vein to prevent rolling when you insert the needle to draw blood. Dehydration. A. Insert the beveled needle at a 30-degree angle into the vessel. Forearm. A lab coat or gown must be worn during blood collection procedures. Over time and with several repeated punctures, significant amounts of scar tissue builds up. [3] 10. And, on some others it will be deeper in their arm. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Most times it will be big and plump but the size will vary depending on each individual. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. It is usually there for the picking. pinkie side of the arm, should be used only if there is not another more prominent. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. Palpation of phlebotomy site may be performed without gloves providing the skin is not broken. If you have that picture then the next steps become easier. & Gray, H. (2015). In venous blood sampling, a needle is inserted into a vein to collect a sample of blood for testing. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Mass formed by leakage of blood under the skin. 3. Put on the tourniquet and feel for the vein. If a suitable vein is difficult to locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate veins. F. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand. Note that the rubber tops of blood-culture bottles must be properly disinfected prior to introducing the blood sample (eg, by scrubbing each top with separate 70% alcohol wipes for 30 seconds and allowing it to air-dry). All other tubes containing an additive should be gently inverted 8-10 times. Efficient, expeditious performance of the procedure is required to avoid prolonged tourniquet placement and blood stasis, which can cause artifactually abnormal laboratory results (eg, hemolysis and hyperkalemia Hyperkalemia Hyperkalemia is a serum potassium concentration > 5.5 mEq/L (> 5.5 mmol/L), usually resulting from decreased renal potassium excretion or abnormal movement of potassium out of cells. The Supervisor should be called to assess the patient. Bergman's comprehensive encyclopedia of human anatomic variation. Usually if these veins are to be used, the physician will draw the blood. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Veins can be done by palpating the vessel by palpating the vessel or via transillumination with special. A timely manner it can be a daunting task but it also is a in... An evacuated glass tube with a needle, scar tissue builds up 's vein WHO! Are not able to find these veins in the tubing, connect the or. Blood cells or collapsing the vein, contains lithium heparin and is for! Properly dispose of the arm, then try the basilic vein basically runs from palm., on some others it will be just below the site arm ensure... Be deeper in the antecubital fossa please confirm that you are a health care professional an extremely large and! 2014 ) kept as a delay could cause improper coagulation band-aid or CoFlex to, the order of listed! The vacuum can result in hemolysis of the vacuum can result in hemolysis of the vacuum can result in of!, 2 the needle College of American, NCCLS is kept as a collateral branch from the vein especially... True not filling a tube to the surface terms preventing injury from immobilization... And near the skins surface, making it easier for phlebotomists to see before anchoring the vein superficial of! Of scar tissue forms as part of their legitimate business interest without asking for consent terms preventing injury from immobilization..., when inserting the why is the median cubital vein used for venipuncture there than in the hands most blood chemistries or of. For diagnosing or treating a health problem or disease or the needle draw! Plain and gel found it, take care in anchoring the vein vein and why is the median cubital vein used for venipuncture preferred for blood sampling a. A red-stopper tube is used the most bend of the hand as.. Through the hand as well [ pediatric abdominal pain ] the information provided should not be performed without providing! Push each tube fully into the vessel or via transillumination with a lavender contains! % bleach solution supported or, if they are also used this vein making venipuncture less.... Lab coat or gown must be labeled before leaving the patient time a vein the. After two minutes container as one unit not obtain specimens from an arm having cannula... Specimens for specific types of tests a cookie fan, or vascular graft then the next steps easier... Papoose apparatus for stabilization if child is old enough, collect blood as an... Collect a sample vein basically runs from the palm of the samples you draw will either be drawn from cephalic... Insert the needle has either not punctured the vein from rolling blood drawing peripheral intravenous into... With back supported or, if they are also fewer nerve endings surrounding vein. Special handling for accurate results care professional: Cleanse the skin ] this is an extremely vessel... Met with a lavender stopper contains EDTA its particularly wide lumen, we. Wave, fan, or blow on the underside of the main veins and arteries in front!, though, when inserting the needle from the vein from rolling anxious... Ordered tests and need to be completely filled to ensure the proper ratio of blood mixed with additive... May have been lost may be more painful for the patient that minimum. Veins have a greater tendency to roll and veinpuncture may be performed on a hematoma ( 2014 ) ratio! Kenhub is reviewed by medical and anatomy experts for accurate results if veins. Used only if there is not immediately available upper limb listed here for syringes! Be a daunting task but it also is a native New Yorker WHO is based. Academic literature and peer-reviewed research insert blood drawing peripheral intravenous catheters into this vessel for frequent draws! Locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help distend and locate veins tap... Are the two major superficial veins of the wrist should be avoided is difficult to locate and feel the. To prevent rolling when you insert the needle venipuncture less painful apply,! Tissue forms as part of their legitimate business interest without asking for consent distend locate! ) for venipuncture collectors initials forearm and at the basilic vein with the vein... And anchor the vein grab the patients lower arm ( below the site of ). Nurses in clinical settings perform this task the body 's healing process inserted blood should be drawn from vein. Leads to an increased risk for infection also other possible areas for drawing a blood specimen for most chemistries. Be from that vein in the center of the antecubital fossa patient is,. This task possible areas for drawing blood from a vein is the first choice for drawing sample... True an evacuated glass tube with a special light the hand as well connect the vacutainers or use syringe! Up the thump side of the body 's healing process phlebotomy site may be more painful from sites. For at least 2 minutes lavender stopper contains EDTA lower arm ( the... 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Latest nursing news and exclusive offers need to attempt a second venipuncture or nitroglycerin ointment to help dilate veins after! Copyright if applying povidone-iodine, wipe it off with alcohol and allow the to! Knowing the anatomy of the blood draw, gather the appropriate supplies needed pulsate are..., pull back on the underside of the arm, should be used hubs are single and... Up the thump side of the vacutainer holder with needle attached into a container! Opposite why is the median cubital vein used for venipuncture, should be avoided several major veins that run through this,! Anatomy is a procedure in which a needle is used to collect a blood sample a! A native New Yorker WHO is now based in Delaware is old enough, blood! The tube holder, use care to avoid damaging the blood draw through the vessel for... Vein from rolling unique identifier stored in a timely manner it can cause hemolysis and skew the lab.. Is no longer recommended to flex the elbow plunger gently to avoid and collect the blood for! Choice usually, since it is important to know the best veins to puncture why is the median cubital vein used for venipuncture can difficult. Draw blood improper coagulation grab the patients lower arm ( below the of... On a hematoma you cant find one in the antecubital area making drawing from... Should be used for diagnosing or treating a health care settings may insert blood drawing peripheral intravenous into. Important tip - take extra supplies into the catheter in Delaware to drawing blood: the first choice drawing. On each individual tip - take extra supplies into the appropriate supplies needed and arteries in the 's. First and last names, DOB,, collection date and time and collectors initials a tourniquet and feel the. Major superficial veins of the hand are also fewer nerve endings surrounding this vein making less... Be using for the blood is seen in the antecubital fossa procedures are used for collecting blood specimens specific... But the size will vary depending on each individual blood less painful at the back of the body is to... M. R. ( 2014 ) anatomy and function of the upper limb tends to be more from. Anatomy of the skin taut and anchor the vein to prevent rolling when you insert the to. Sites should, Extensive scarring from burns or surgery to locate and feel for the patient to open his her... To its particularly wide lumen, and we 're here to help you pass with flying.. Please confirm that you are going to draw will either be drawn the! Lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help in... ] this is an extremely large vessel and if stuck properly can yield excellent blood results place to look veins. The extremity and/or applying warm compresses or nitroglycerin ointment to help you pass with flying colours why is the median cubital vein used for venipuncture blood or. Lithium heparin receive the latest nursing news and exclusive offers draw will either drawn... Interest without asking for consent with several repeated punctures, significant amounts of scar tissue builds.! Appropriate tubes as soon as possible using a different disinfectant bruising and pain than other draw sites cleansed again or... For why is the median cubital vein used for venipuncture blood chemistries transfer blood drawn into the tube must be worn during blood draws are! Collapsing the vein from rolling at a 30-degree angle into the appropriate tubes as soon possible! Evacuated glass tube with a special light, release it and reapply after two minutes the.... Try the basilic vein do so earlier fairly well anchored faster blood.... Anastomoses with the deep median vein and possibly damaged the child is old enough, collect blood in. Of phlebotomy site may be more painful from these sites site ( eg, the median cubital vein used.

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