1. Obtain and Label Blood Specimens

2. Introduction
Venipuncture is a technique that permits access to a vein so that a needle or catheter can be inserted, usually to withdraw a blood specimen or initiate an intravenous infusion
Venipuncture is a sterile procedure since the integrity of the skin is broken

3. Terms and Definitions Venipuncture Palpate Antecubital fossa
Anticoagulant
Hematoma

4. Veins Used for Drawing Blood
Antecubital Area Vessels
Cephalic Vein
Median Cubital Vein
Basilic Vein

5. Venipuncture Procedure
Universal precautions - hand wash & gloves
Strict adherence to the sharps policy
Verify the request to obtain specimen
Check the physician's orders
Select the proper specimen tube/s
Prepare label(s)
Perform a patient care hand wash/don gloves

6. Stamp Label With Patient’s Addresograph Plate
DP A1401TMC
GAVIN, JAMES
07DEC55 M USA AD ENL
SFC HHC 2/505th PIR
TMC-OUTPATIENT RECORDS, FBNC

7. Gather Equipment Constricting band Vacutainer holder or Syringe
Sterile disposable double-ended needle or Butterfly or Hypodermic needle
Betadine or alcohol wipe or sponge
Protective pad (chux)
Sterile 2 x 2-inch gauze sponge(s)
Band-Aid

8. Venipuncture Equipment

9. Assemble Holder & Needle
Put short end of needle into threaded hole in vacutainer holder
Screw tightly using clockwise motion

10. Insert the Tube into the Holder
Insert stoppered end of the tube into holder
Do not push tube beyond the guideline
Inspect the needle for barbs, corrosion

11. Identify Patient Explain the procedure and purpose
Ask patient about allergies (i.e., iodine or alcohol).
Position the patient - sitting or lying
Never draw blood from a standing patient.
Position protective pad

12. Apply Constricting Band
Apply with enough pressure to stop venous return
A radial pulse should be felt
Place latex tubing around limb about 2 inches above venipuncture site
If a commercial band is used, wrap it around limb and secure by overlapping velcro ends

13. Apply Constricting Band
Instruct patient to clench and unclench his fist several times to trap blood and distend veins
Avoid veins that are infected, injured, irritated, or have an IV running distally.

14. Palpate Selected Vein Palpate along length of vein with index finger
Vein should have a spongy feel
Clean the skin
Do not re-palpate the vein after cleansing the skin.

15. Prepare the Puncture Site
Cleanse area with betadine or alcohol using a circular motion
Do not touch the area once cleansed

16. Prepare to Puncture the Vein
Remove protective cover from needle
Position needle in line with vein and grasp patient's arm below entry point with free hand
Place thumb of free hand 1 inch below entry site and pull skin taut toward hand

17. Puncture the Vein Align needle bevel up
Pierce skin at a 15° to 30 ° angle
Decrease angle until parallel to skin surface, then pierce vein
If needle is withdrawn above skin surface, do not attempt venipuncture again with the same needle
15 ° to 30 °

18. Puncture Vein If unsuccessful Release the constricting band
Place 2 x 2 gauze sponge over site
Quickly withdraw the needle and instruct the patient to elevate arm slightly and keeping the arm fully extended apply pressure to the site for 2 to 3 minutes.
Notify supervisor before attempting another venipuncture

19. Single Tube Collections
When the tube is nearly full release the tourniquet
Remove the tube from the holder
DO NOT withdraw the needle before the constricting band is released

20. Multiple Tube Collections
When the Tube Stops Filling Pull It Out of the holder
After the last tube stops filling remove from the holder
Release the tourniquet
DO NOT withdraw the needle before the tourniquet is released

21. Complete the Procedure
Place 2 x 2 sponge over venipuncture site
Withdraw the needle smoothly and quickly
Immediately apply pressure to the site
Have patient elevate arm and apply pressure to site

22. Complete the Procedure
If tube contains an anticoagulant or other additive, gently invert tube several times to mix with blood
Apply a Band-Aid to the venipuncture site
DO NOT unscrew needle from sleeve with hands
DO NOT recap needle
Dispose of needle into sharps

23. Patient Comfort and Safety
Remove protective pad
Roll down patient's sleeve
If patient is in bed reposition and raise side rails
Remove all the equipment from area
Dispose of used supplies
Store reusable equipment and dispose of needle IAW local sharps SOP
Remove gloves and wash hands

24. Dispose of the Needle in a Sharps Container

25. Administrative Duties
Check and complete laboratory form IAW local SOP
Apply prepared label(s)
Document procedure IAW local SOP

26. Summary
If venipuncture is done smoothly and properly, there should be little pain for the patient and little risk to medical personnel
The procedural steps are designed to ensure a properly drawn specimen
With practice, obtaining a blood specimen can become a smooth routine