Venepuncture

VENEPUNCTURE

EQUIPMENT NEEDED

  • Needle
    • 21 gauge needle for most adults
    • 23 for small children
  • Appropriate tubes for blood
  • Syringes:
    • 1 for blood (10mls usually adequate unless for blood cultures = 20mls)
    • 1 for flushing with saline
  • Persist Plus (chlorhexidine) swab
  • IV Pressure Pad
  • Dressings Kit / Gauze
  • Tourniquet

 PROCEDURE

  • Find appropriate vein
    • Keep Arm in dependent position
    • Apply tourniquet or blood pressure cuff inflated to 80-100mmHg for large arms
    • Apply tourniquet proximally over mid to distal humerus; there is a vein running between the radius and ulna so applying over forearm will not work)
    • Tapping veins can help to become more prominent
    • Can also use warm compress to initiate vasodilation
  • Using Persist Plus, swab over and around (using circular sweeps) area around the vein(s) you wish to use
  • Stabilise arm / skin distal to vein (ensure that hand / thumb NOT near needle)
  • Hold needle with bevel facing UP and needle pointing downwards on 30 degree angle, stab needle through skin into vein approximately 1-2mm. If no blood seen on plunger withdrawal, may need to stab again a little deeper (particularly if patient elderly / atherosclerotic. Might also need to jiggle slightly to ensure in vein)
  • Once happy with position of needle, stabilise the needle end with one hand to prevent movement. Withdraw plunger to draw blood.
  • Remove tourniquet after blood removed
  • Place “dot” over insertion point and remove needle. Ask pt to continue to apply pressure for 1 minute (or 2 minutes if on warfarin / blood thinners)