Venepuncture

Subject summary

Each hospital has its own policy on blood sampling, some use syringes, butterflies or the vacutainer system. However, for the purpose of this demonstration, we will be using the vacutainer system. Whichever method is used, there is little difference in the technique.

  1. Firstly, as with all stations, you need to introduce yourself to the patient, explain what you are going to do and obtain consent. As this is a potentially painful procedure, explain that they may feel some discomfort and answer any questions they may have.

  2. Next you need to prepare your equipment so that you are ready. You will need alcohol gel, gloves, an alcohol wipe, tourniquet, needle, needle holder, appropriate sample tubes, gauze, a plaster and a sharps bin.

    1. Venepuncture kit
      Venepuncture kit

  3. Wash your hands with alcohol gel.

    1. Hand washing
      Hand washing

  4. Place the arm in a comfortable position for the patient so that you can identify the veins. Select a vein, apply the tourniquet and re-check the vein making sure you are comfortable with its course.

    1. Applying the tourniquet
      Applying the tourniquet
    2. Re-check the vein
      Re-check the vein

  5. Put on your gloves. This not only helps protect the patient but also yourself from any contact with blood.

  6. Clean the venepuncture site using the alcohol wipe in downward strokes.

    1. Clean the venepuncture site
      Clean the venepuncture site

  7. Remove the grey cap from the needle, attach the needle to the needle holder and remove the other cap to reveal the needle.

    1. Remove the grey cap from the needle
      Remove the grey cap from the needle
    2. Attach the needle to the needle holder
      Attach the needle to the needle holder
    3. Remove the other cap to reveal the needle
      Remove the other cap to reveal the needle

  8. Retract the skin distally, prepare the patient for a ‘sharp scratch’ and insert the needle into the vein bevel upwards.

    1. Insert the needle into the vein bevel upwards
      Insert the needle into the vein bevel upwards

  9. Once in the vein, attach a bottle and let it fill, changing if more than one bottle is required. Whilst the last bottle is filling, loosen the tourniquet and when full, remove it from the needle holder.

    1. Attach a bottle and let it fill
      Attach a bottle and let it fill

  10. Withdraw the needle, applying the gauze over the puncture site. Ask the patient to apply pressure with the gauze, keeping their arm straight as bending the arm may increase any bruising.

    1. Withdraw the needle, applying the gauze over the puncture site
      Withdraw the needle, applying the gauze over the puncture site

  11. Carefully dispose of the needle in the sharps bin.

    1. Carefully dispose of the needle in the sharps bin
      Carefully dispose of the needle in the sharps bin

  12. At this point invert the tubes 3 times to ensure full mixing with any additives in the tubes such as heparin.

  13. Whilst still at the bedside, ensure that you complete all of the patient details required on the bottles.

    1. Complete all of the patient details required on the bottles
      Complete all of the patient details required on the bottles

  14. Ensure that any bleeding has stopped and if so, apply the plaster. Remove your gloves and thank the patient.