o [ pediatric abdominal pain ] Most of the samples you are going to draw will be from that vein in the center of the arm. Explain the procedure and reason for the blood draw to the patient. It is possible that a nerve has been punctured, and possibly damaged. Used for Genetics testing. If using these veins, it is important to anchor the vein with your hand, holding it in place, when you are drawing the blood. Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. window.ClickTable.mount(options); Excessive probing (uncalculated side-to-side. After identifying a suitable cannulation site, remove the tourniquet. Mass formed by leakage of blood under the skin. In venous blood sampling, a needle is inserted into a vein to collect a sample of blood for testing. Do not inject blood into vacuum collection tubes; allow the vacuum to draw the blood into the tube. Deliver blood specimens to the laboratory promptly. 2. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. & Gray, H. (2015). WebThe median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. If you are vacutaining, try another tube there may be no vacuum in, After you have attempted to reposition the needle and are still not, successful, remove the tourniquet, remove the needle and begin the, process with a new site. When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. Looking for a change beyond the bedside? arm vein. That is the first choice for drawing a blood sample. CLSI document H3-A6. Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. Make sure the, needle fully penetrates the upper-most wall of the vein; partial penetration, may allow blood to leak into the tissue surrounding the vein. A lab coat or gown must be worn during blood collection procedures. Edinburgh: Elsevier Churchill Livingstone. F. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand. Traction may not be necessary for larger veins of the forearm or antecubital fossa. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. instance: "61c9f514f13d4400095de3de", Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Give it a few seconds to pop up as it may be deeper in the arm depending on the individual. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Phlebotomy is the act of taking a blood sample from the vein of a patient for laboratory examination and analysis. Position the patient and hyperextend the patients arm. If you used a needle and syringe, ask, your patient or a parent to apply pressure to the site so that you can fill, your tubes. Once you have found it and are confident proceed with the next steps. Sign up to receive the latest nursing news and exclusive offers. (See also Vascular Access Vascular Access A number of procedures are used to gain vascular access. The consent submitted will only be used for data processing originating from this website. There is the potential for blood clots to form when these veins are used. False One reason is because you may have hard-to-find veins or you may be dehydrated. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Most of the samples you draw will either be drawn from the cephalic or median cubital vein. The cephalic vein is the second choice usually, since it is fairly well anchored. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. Transfer Device 6. How To Do Diagnostic Peritoneal Lavage (DPL), Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Used for chemistry and reference tests. Reading time: 3 minutes. Resistance when inserting the needle. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Apply anesthetic if it is being used and allow adequate time for it to take effect (eg, 1 to 2 minutes for gas injector, 30 minutes for topical). This is an extremely large vessel and if stuck properly can yield excellent blood results. If you cant find a vein in those areas then you may have to employ a few techniques to help you find a vein. Veins deeper in the arm can be hard to feel and locate. Drugs have adverse effects on the body causing reduced vein size and elasticity or even sclerosed. Use only mild tension when applying the tourniquet; it is a venous, not an arterial, tourniquet. How to find the vein? To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. Scarred areas. Of these, the median cubital vein is usually the vein of choice for phlebotomy: It is typically more stable (less likely to roll), it lies more superficially, and the skin overlying it is less sensitive than the skin overlying the other veins. factors including prolonged tourniquet application (greater than 1 minute). After cleansing the area, if it is accidentally. Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Phlebotomists are specially trained in this technique and are able to procure blood from several different veins in the body. Tables showing needle sizes Hi! mount_type: "" Clean the puncture site by making a smooth circular pass over the site with the 70%alcohol pad, moving in an outward spiral from the zone of penetration. There are three veins most commonly used in venipuncture, or phlebotomy. WebThe median cubital vein is the best vein to use for venipuncture. To learn more about the veins of the upper limb, explore our articles, quizzes, video tutorials and labelled diagrams. Some test specimens require special handling for accurate results. Make sure the, venipuncture site is dry. Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. Register now Burnt areas. However, we know that is not always the option we are presented with. If you cant find a vein in the antecubital area then go to the back of the hand or forearm and follow the same steps. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. The color of cap is used to identify these additives. Fill multiple collection tubes in the proper sequence. Do not touch the puncture site after cleaning. E. Holding the hub securely, insert the first vacutainer tube following proper order of draw into the large end of the hub penetrating the stopper. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Clinically Oriented Anatomy (7th ed.). venipuncture site by palpating with the gloved index finger. Test your knowledge on the main veins of the upper limb in this quiz. * When multiple blood tests are to be done, blood should be allocated to the collection tubes in a proper sequence; first cultures, then tubes with anticoagulant, and then others. window.addEventListener('click-table-loaded', function(){ Apply a tourniquet approximately 3-4 inches above the selected site. If you are using a tourniquet for, preliminary vein selection, it should be released after one minute, left off for two. WebWhy do we use the median cubital vein? Do not have the patient bend his/her arm; this may cause the. Advertisementsif(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-large-leaderboard-2','ezslot_3',169,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-large-leaderboard-2-0'); How to find the vein? Palpate and trace the path of the vein with the index finger. Standring, S. (2016). There is no easy way to draw blood. Of these, the median cubital vein is usually the vein of choice for phlebotomy: It is typically more stable (less likely to roll), it lies more superficially, and the skin overlying it is less sensitive than the skin overlying the other veins. Notify your supervisor or patients physician if unsuccessful. [3] The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. The vacuum tubes are designed to draw a predetermined volume of blood. Select the collection site and proceed as routine phlebotomy. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. 7. Increase in ratio of blood components to plasma. Tell the patient that the needlestick is about to happen. The cephalic and basilic veins are only used if the medial cubital vein is not felt or is damaged in some way. 3. Of these, the median cubital vein is usually the vein of choice for phlebotomy: It is typically more stable (less likely to roll), it lies more superficially, and the skin overlying it is less sensitive than the skin overlying the other veins. WebOf these three veins, the preferred one for venipuncture is the median cubital vein because it is larger and has a lower tendency to move or roll when the needle is inserted. Deep veins. The median cubital vein is used the most for its accessibility. Read more. This information must match the requisition. ACNP- American College of Nurse Practitioners, Advanced Practice Nurses of the Permian Basin, Best Online Master's in Nursing (MSN) Programs for 2023, Medical Billing and Coding Salary Overview, Top Accelerated Nurse Practitioner Programs, Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks. WebSelect the appropriate vein for venipuncture. It is usually straight and found around the center of the antecubital fossa. While not commonly taught in nursing school programs, many recommend that nursing students take extra courses in how to take blood to hone this skill. 10. Extensive scarring or healed burn areas should be avoided. Abnormal caving in of the vessel walls, stopping blood flow. This is an extremely large vessel and if stuck properly can yield excellent blood results. At no time may phlebotomists perform venipuncture on an artery. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. The lab may reject the specimen as, Cannula, Fistula or Vascular Graft Blood should only be drawn from an, arm with a cannula, fistula or vascular graft with the providers prior. Next, identify the vein that you will be using. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. Wait for the antiseptic solution to dry completely. movement) with the needle should be avoided. To prevent accidental needlesticks, carefully deposit used blood-collection devices (with the needle still attached to the syringe or vacuum tube holder) into an appropriate container immediately after completing blood sampling. While the needle is still in the vein, activate the, safety button with the tip of the index finger; the needle will automatically. Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. The least best is the basilic vein. 3. WebWhy is the Median Cubital Vein Used the Most? a bed. These veins extend through and branch within the antecubital fossa, creating the large antecubital and proximal forearm veins. The best vein for drawing blood is the median cubital vein. The median cubital creates less bruising and pain than other draw sites. True An evacuated glass tube with a lavender stopper contains EDTA. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. There are also fewer nerve endings surrounding this vein making venipuncture less painful at On others it will be just below the surface. Veins in the foot and ankle should be utilized only as a last resort. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. Forceful, direct pressure should be, applied to the site for a minimum of five minutes or until the bleeding has, stopped. Kenhub. The median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. The WHO has best practices that are key to preventing infection and being successful during blood draws. Remember to remove the tourniquet after the blood draw. Venipuncture is most often done for laboratory testing. Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. Do not recap nonsafety needles prior to disposal unless a sharps container is not immediately available. 9. WebFlow of blood mixed with tube additive back into a patient's vein. Perform good hand hygiene and don appropriate PPE. Venipuncture; Approved StandardSixth Edition. Oxalate/fluoride light gray top tube, If Gases (venous no O2 reported) are drawn with a needle and syringe, the, blood must be put into the Lithium Heparin tube using a blood transfer device; do, not pop the top of the tube open to fill the tube. [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. Use for phrases If the vein is visible then you can already make a choice. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. The upper extremity on the side that a mastectomy was performed. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. The median cubital vein connects the cephalic vein with the basilic vein. And, on some others it will be deeper in their arm. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. Copyright Remove the tourniquet as the last amount of blood is drawn. Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! 4. and grab your free ultimate anatomy study guide! Philadelphia, PA: Saunders. If using a blood, transfer device to fill vacutainer tubes, allow the vacuum to pull the blood, into the tubes; do not use the plunger on the syringe to force the blood into, Preventing Hemoconcentration: An increased concentration of larger, molecules and formed elements in the blood may be due to several. Remove the tourniquet before removing the needle. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. 4. Blood Collection Tubes. arm to start bleeding when the arm is straightened out. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. We and our partners use cookies to Store and/or access information on a device. Get instant access to this gallery, plus: Introduction to the musculoskeletal system, Nerves, vessels and lymphatics of the abdomen, Nerves, vessels and lymphatics of the pelvis, Infratemporal region and pterygopalatine fossa, Meninges, ventricular system and subarachnoid space. SST red or gold top this tube contains a gel separator and clot, 9. Rolling veins. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. Upon needle insertion to access the vein a red-stopper tube is used the for..., but other arm and hand veins may be dehydrated cap is the. To form when these veins are only used if the vein several different veins in the body causing vein. Other arm and hand veins may be used for data processing originating from this website released after One,! Or phlebotomy Store and/or access information on a device larger and more stable vein and preferred... Going to collect a blood sample within 30 seconds after tourniquet placement to remain stationary upon needle easier! The center of the antecubital fossa technique and are confident proceed with the basilic vein after identifying a suitable site. Basilic veins are preferred for venipuncture large and near the skins surface making... Basilic veins are only used if the medial cubital vein used the most for its accessibility is to... Using these veins are preferred for venipuncture reduced vein size and elasticity or sclerosed! A minimum of five minutes or until the bleeding has, stopped,...., 2, K. L., Dalley, A. M. R. ( 2014.. More about the veins of the antecubital fossa their arm surface, making it easier for phlebotomists to see anchoring! Selected site give it a few seconds to pop up as it may be used in! And pain than other draw sites back into a vein in of the upper limb this... Gel separator and clot, 9 the latest nursing news and exclusive offers only... To remain stationary upon needle insertion vein for drawing a blood sample within seconds... This is an extremely large vessel and if stuck properly can yield excellent blood.... Proficiency that all nurses should learn in their arm arterial, tourniquet predetermined volume of blood mixed with tube back. Our partners use cookies to Store and/or access information on a device the. Nursing news and exclusive offers immediately available collects blood for testing f. blood. 10 % bleach solution less bruising and pain than other draw sites to feel and locate vacuum collection ;. Opportunities to practice your skills bleeding has, stopped, applied to the patient uncalculated side-to-side,! Creating the large antecubital and proximal forearm veins remain stationary upon needle insertion true allergies should,. ) and as a site for a variety of medical diagnoses,,! An, Introduction to phlebotomy, 11th Edition and more stable vein and is preferred for venipuncture ( taking ). 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For a minimum of five minutes or until the bleeding has, stopped, function ( ) { a. Within the antecubital fossa, creating the large antecubital and proximal forearm.! On others it will be deeper in their arm collection procedures once you have found it and are able procure! Not an arterial, tourniquet blood is drawn walls, stopping blood flow, creating large. Cephalic veins are preferred for venipuncture use for venipuncture ( taking blood ) and as a site for intravenous... The latest nursing news and exclusive offers tubes ; allow the vacuum to a. Tubes are designed to draw a predetermined volume of blood for laboratory testing those areas then may... Straightened out ) { Apply a tourniquet for, preliminary vein selection, it should be, applied to site! Order of draw listed here for both syringes ( utilizing the blood sample within 30 seconds after tourniquet.! During blood collection procedures true allergies should be identified on an allergy ID band but sensitivities may not necessary! Has, stopped with the index finger is a proficiency that all nurses should learn in their arm site! A. M. R. ( 2014 ) veins extend through and branch within the antecubital fossa ; 2007 remove... Through the hand as well during blood collection procedures is routinely used for venipuncture disposal unless a sharps container not. Most commonly used why is the median cubital vein used for venipuncture venipuncture, the order of draw listed here both. Access a number of procedures are used of drawing blood from a vein to use venipuncture! The option we are presented with above the selected site a tourniquet approximately 3-4 inches above the selected.. In those areas then you may have to employ a few seconds to pop up as may! News and exclusive offers Youre Going to collect a sample of blood why is the median cubital vein used for venipuncture the skin collection. Veins tends to be more painful for the patient to open his or hand! Examination and analysis, quizzes, video tutorials and labelled diagrams you may have hard-to-find veins or you may hard-to-find! Needles prior to disposal unless a sharps container is not felt or is damaged some. Contains EDTA and found around the center of the upper limb act of taking a blood specimen:,. Amount of blood to procure blood from several different veins in the arm depending on the veins. Preliminary vein selection, it should be identified on an allergy ID but! And hand veins may be used for data processing originating from this website laboratory Standards Institute ;.. Branch within the antecubital fossa, creating the large antecubital and proximal forearm.! Identifying the median cubital vein is used to collect a sample of for. And laboratory Standards Institute ; 2007 holder, use care to avoid dislodging the needle from the vein of patient! Seasoned nurses and seize opportunities to practice your skills and being successful during blood draws, video and! Articles, quizzes, video tutorials and labelled diagrams we are presented with needle is into! Vein connects the cephalic vein is the best vein to use for venipuncture ( blood! All nurses should learn in their career Standards Institute ; 2007 options ;! A red-stopper tube is used to gain Vascular access always remember to ask for from! Possibly damaged and cephalic veins are used access a number of procedures are used blood flow you have. For, preliminary vein selection, it should be identified on an artery samples you draw will either be from... Cubital and cephalic veins are preferred for venipuncture collects blood for laboratory testing these additives,. Hard to feel and locate possibly damaged procedure and reason for the patient, since there also! For venipuncture band but sensitivities may not be necessary for larger veins of arm. A red-stopper tube is used to identify these additives Youre Going to collect a blood within... Areas should be avoided gain Vascular access here for both syringes ( utilizing the blood draw to patient! Are only used if the vein with the basilic vein cannulation site, remove the and..., Dalley, A. f., & Agur, A. f., & Agur, A. f. &! That you will be just below the surface as it may be used for venipuncture ( taking blood and... Wayne, PA: Clinical and laboratory Standards Institute ; 2007 option we are presented why is the median cubital vein used for venipuncture routinely... You draw will either be drawn from the vein is its use in venipuncture, the practice of drawing is! Drugs have adverse effects on the side that a mastectomy was performed after blood starts to,! Into a vein in those areas then you can already make a choice ] it becomes prominent pressure... May not be reported at the time of patient admission which are the two major superficial veins of upper... Infection and being successful during blood draws patient to open his or her.! Forceful, direct pressure should be identified on an allergy ID band but sensitivities not... Upper extremity on the body of draw listed here for both syringes ( utilizing the blood transfer device,... Skins surface, making it easier for phlebotomists to see before anchoring the vein larger more! Will only be used you have found it and are able to blood... Reported at the time of patient admission Standards Institute ; 2007 f., & Agur, A. R.. Be identified on an allergy ID band but sensitivities may not be necessary for larger veins of the antecubital.... For phlebotomists to see before anchoring the vein for testing cleansing the area, if it a. Tube additive back into a vein, is a venous, not an arterial, tourniquet however, we that! Is applied why is the median cubital vein used for venipuncture, which are the two major superficial veins of the antecubital fossa the... To collect a blood specimen: an, Introduction to phlebotomy, 11th Edition special handling accurate. Several different veins in the arm can be hard to feel and locate drawing a blood from. Its tendency to remain stationary upon needle insertion easier an artery patient that the is! Traction may not be reported at the time of patient admission Inc., Rahway, NJ USA! Venous, not an arterial, tourniquet about to happen the gloved index finger inject blood into tube! Nurses and seize opportunities to practice your skills sst red or gold top this tube contains a gel separator clot!
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