Never perform a venipuncture with the
patient standing up. If patients should faint,
they could seriously injure themselves.
Also, safeguards should be in place to
prevent patients from falling forward when
they are seated.
To perform venipuncture, follow the steps given
1. Explain the procedure to the patient.
2. Apply tourniquet around the arm approximately
2 to 3 inches above the antecubital fossa (the
depression in the anterior region of the elbow,
see figure 7-4) with enough tension so that the
VEIN is compressed, but not the ARTERY. A
BP cuff (sphygmomanometer) may be used
instead of a tourniquet if a patient is difficult to
3. Position the patients arm extended with little or
no flexion at the elbow.
4. Locate a prominent vein by palpation (feeling).
If the vein is difficult to find, it may be made
more prominent by massaging the arm with an
upward motion to force blood into the vein.
5. Cleanse the puncture site with a 70% alcohol
pad or povidone-iodine solution and allow to
CAUTION: After cleaning the puncture
site, only the sterile needle should be allowed
to touch it.
6. Fix or hold the vein taut.
This is best
accomplished by placing the thumb under the
puncture site and exerting a slight downward
pressure on the skin or placing the thumb to the
side of the site and pulling the skin taut laterally
7. Using a smooth continuous motion, introduce
the needle, bevel side up, into the side of the vein
at about a 15-degree angle with the skin
8. Holding the vacutainer barrel with one hand,
push the tube into the holder with the other hand
and watch for the flow of blood into the tube
until filling is completed.
9. Once all the specimens have been collected,
hold the vacutainer with one hand and release
the tourniquet with the other.
10. Place a sterile gauze over the puncture site and
remove the needle with a quick, smooth motion.
11. Apply pressure to the puncture site and instruct
the patient to keep the arm in a straight position.
Have the patient hold pressure for at least 3
12. Take this time to invert any tubes that need to
have anticoagulant mixed with the blood.
13. Label specimens.
14. Reinspect the puncture site to make sure
bleeding has stopped, and apply a bandage.
NEEDLE BEVEL UP