Venepuncture

Venepuncture is a frequently carried out procedure of entering a vein with a needle, usually to obtain a sample of blood.

To know the anatomy and physiology of the forearm.
To be able to palpate for and select a suitable vein. To withdraw a sample of blood with minimum discomfort to the patient and show an understanding of the potential dangers involved, including health and safety issues.
Ensure correct labelling of forms and samples and be able to discuss the reasons and possible outcomes of results with the patient.

Welcome patient, check identity and confirm reason for patient's appointment.
Seat comfortably and be aware of possible nervousness or fears. Reassure.
Explain procedure (if child, earlier use of EMLA cream).
Informed consent.
Identify tests required and associated requirements e.g. fasting status, timing of medication.
Select correct tubes and forms, fill in form accurately and clearly.
Support patient's arm comfortably
Inspect both arms if necessary - and take patient's advice of which arm is best into consideration, but not gospel!
Prepare needle holder and needle
Apply tourniquet, put on gloves
Palpate antecubital area carefully as most likely site of suitable vein. Select best vein.
Cleansing of skin optional
Remove needle from holder, may bend needle slightly with bevel edge upwards.
Steady vein with left hand and palpate above point of entry as guide. Insert needle under skin - keeping angle low and bevelled edge uppermost.
Attach vacuum tube and advance needle into vein. Wait for tube to fill up and change to next tube, as necessary.
Release tourniquet before removing final tube, cover needle site with swab and remove needle, apply gentle pressure.
Discard needle holder and attached needle in a sharps bin. Do not re-sheath.
Ask patient to apply pressure, while labelling tubes and completing forms.
Check puncture site and apply dressing.
Discuss arrangements for patients to receive results.
Ensure safe transport of specimens and update computer.