Routine venipuncture is the process of drawing blood from a vein during phlebotomy. Standard operating procedures (SOPs) should be adhered to when collecting blood samples.
There are multiple reasons for drawing blood from a vein. These include laboratory testing, getting rid of excess blood, treatment, and for blood transfusion.
Veins are preferred over arteries because they are easily accessible from the skin. Capillaries are too small to provide sufficient blood.
Essential notes on routine venipuncture
Blood collection from the legs and feet is hazardous because the sites are highly susceptible to infection and clot formation in diabetic patients. Phlebotomists should conduct such procedures only with the physician’s approval.
You should never apply a tourniquet on the same side of the body that has had a stroke or mastectomy.
If a patient receives an intravenous (IV) drip, collect blood from the other arm. The vein of choice should be beneath the IV on a different vein. If it’s impossible to draw blood from another arm, draw blood from the arm after IV is closed for an hour.
Blood collection from an artery is beyond the scope of a phlebotomist. A licensed physician should carry out the procedure. A failed attempt can result in paralysis of the hand, hematoma, blood clot (thrombosis), bleeding, infection, or nerve damage.
Avoid venipuncture sites with skin irregularities like scars and moles.
Do not prick the same puncture hole more than once; pick a different puncture site.
Routine venipuncture procedure
- Confirm the Name of the patient and the tests requested on the request form.
- Check for exceptional specimen handling instructions before drawing, such as cooling in ice, and have the requirements ready before proceeding.
- Explain the procedure to the patient and obtain consent. If a child, get permission from the parent or guardian.
- Hyper-extend the patient’s arm.
- Apply a tourniquet 3-4 inches above the selected puncture site.
- Ask the patient to make a fist.
- Grab the client’s lower arm and locate the puncture site, usually the median cubital vein within the antecubital fossa.
- Apply the tourniquet; you should only apply the tourniquet for 2 minutes at maximum.
- Clean the puncture site with an alcohol swab using an outward motion, then allow it to dry, do not blow.
- Inject the needle at a 15-30° angle.
- Adequately inserted, blood will flush through the needle.
- Draw the required amount of blood and remove the tourniquet.
- Gently remove the needle from the client’s arm, and press down the vein with dry gauze for about 4 minutes.
- Dispose of the contaminated material in the proper biohazard bin.
- Correctly label the specimen for accession.
- Thank the patient and direct them to the next station
