Gray Top (plasma): Contains sodium fluoride/potassium oxalate. It is more difficult to find and access and has more nerves near it making it Cleanse the skin site with antiseptic solution, beginning at the needle-insertion site and making several outwardly expanding circles. 1. Return to your, patient and assess the site of the puncture. Remove plastic cap over needle and hold bevel up. }; The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. The wrist is a last resort for drawing blood. movement) with the needle should be avoided. Kim Bengochea, Regis University, Denver. Venipuncture is most often done for laboratory testing. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Deliver blood specimens to the laboratory promptly. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. 5. 13. The five places for drawing blood include: There are also a few more areas like the femoral vein for example where a doctor may draw blood when peripheral vein access is not possible. 4. Over time and with several repeated punctures, significant amounts of scar tissue builds up. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Obese patients. How to find the vein? Adequate, pressure should be applied to stop the bleeding once the phlebotomy is, complete. Edematous extremities tissue fluid accumulation can alter test results. Increase in ratio of blood components to plasma. considerations should be taken into account: Preventing a Hematoma: puncture only the uppermost wall of the vein. Label appropriate tubes at the bedside and place them into transport bags. Remove the tourniquet before removing the needle. 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. Ask the patient to apply pressure for at least 2 minutes. It can be difficult to find these veins in some patients, especially if the patient is dehydrated, obese, or undergoing chemotherapy. 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. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. It is more difficult to find and access and has more nerves near it making it Continue with Recommended Cookies. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Dimitrios Mytilinaios MD, PhD arm vein. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. After identifying the site for the blood draw, gather the appropriate supplies needed. Identify the patient using two patient identifiers as mandated by JCAHO. This is a common misconception - pumping the hand does not increase venous circulation. Observe special handling requirements. How to find the vein? Immediately apply pressure. Tubes must be positively identified after filling with a firmly attached patient label. There are two main ways to find a vein to draw blood. Fragile/collapsed veins. Apply a tourniquet approximately 3-4 inches above the selected site. WebFlow of blood mixed with tube additive back into a patient's vein. Once you have found it, take care in anchoring the vein to prevent rolling when you insert the needle to draw blood. The brachial artery (blood supply to the forearm and hand) lies deep to the basilic vein in the upper arm and bifurcates into the radial and ulnar arteries in the antecubital fossa or proximal forearm. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. The basilic vein basically runs from the palm of the hand and up your arm on the side of the ulna. Thrombosed veins lack, resilience, feel cord-like and roll easily. This is an extremely large vessel and if stuck properly can yield excellent blood results. I hope you find my posts helpful. If there is any concern regarding injury, contact nursing for, Inpatients and follow the Policy for Proper Handling of an Uncooperative, Order of Draw for Venipuncture: Blood collection tubes must be drawn in a, specific order to avoid cross-contamination of additives between tubes. If you are using a tourniquet for, preliminary vein selection, it should be released after one minute, left off for two. Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure. Use only mild tension when applying the tourniquet; it is a venous, not an arterial, tourniquet. The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. Resistance when inserting the needle. 5. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. At times, none of the veins of the antecubital fossa will be felt. True An evacuated glass tube with a lavender stopper contains EDTA. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. There is the potential for blood clots to form when these veins are used. Next, identify the vein that you will be using. Put on the tourniquet and feel for the vein. This is an extremely large vessel and if stuck properly can yield excellent blood results. This vein penetrates the fascial roof of the cubital fossa to anastomose with a brachial vein, forming a connection between the superficial and deep venous systems of the upper limb. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. These superficial veins lie within the subcutaneous tissue. Phlebotomists are specially trained in this technique and are able to procure blood from several different veins in the body. Philadelphia, PA: Saunders. It rolls more easily and runs directly over a nerve and an artery, making it a more dangerous and painful area to use. [3] 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. Terminate the procedure: Remove the tourniquet and the needle and apply pressure to the puncture site with a gauze pad (a minute or 2 is usually adequate unless the patient has a coagulopathy). [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. This is an extremely large vessel and if stuck properly can yield excellent blood results. 13. The median cubital vein is the first choice for venipuncture. window.addEventListener('click-table-loaded', function(){ Abnormal caving in of the vessel walls, stopping blood flow. mount_type: "" Do not leave the tourniquet on for > 1 minute. It is closer to the brachial artery and median nerve making it more likely that a puncture could lead to an injury of one of those structures. Have the patient or an assistant continue to apply pressure to the site. if (window.ClickTable) { It courses superomedially across the roof of the cubital fossa, within the subcutaneous tissue and empties into the basilic vein on the anteromedial side of the upper limb. 7. The nursing staff should be notified, and they in turn must notify, the physician. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Intravenous therapy/Blood Transfusions If it is not possible to draw the. Apply gentle traction to the vein distally using the thumb of your nondominant hand to prevent the vein from moving. Looking for a change beyond the bedside? [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. 1. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Individuals taking chemotherapy. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. Knowing the location of each vein, go to the respective area to find it. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. If hands are not visibly contaminated a commercial foaming hand wash product may be used before and after each patient collection. equally, but do you know which nurses are making the most money in 2023? If no patient labels are available, manually label the tubes with the required information. 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. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). To learn more about the veins of the upper limb, explore our articles, quizzes, video tutorials and labelled diagrams. Leg veins (eg, dorsal digital veins and the greater saphenous vein inferoanterior to the medial malleolus) or external jugular veins may be used if upper extremity veins are inaccessible. * After removing a tube from the holder, gently invert the tube 6 to 8 times to mix the contents; do not shake the tubes. Use OR to account for alternate terms A lot of fat tissue in the arm area or at the back of the hand makes it difficult to feel a vein. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. Although there is a considerable amount of variation, the median cubital vein often receives the median antebrachial vein as its major tributary. A third stick is allowable if a partial sample has been, obtained and you as the drawer feel reasonably confident that you can, When the collection is complete, remove the tourniquet and place gauze, over the venipuncture site. If properly inserted blood should flash into the catheter. It may help to allow the arm to hang down, increasing venous pressure. Edwin Ocran MBChB, MSc The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. Veins on the underside of the wrist should be avoided. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. It is not recommended that blood be drawn from the feet .The Providers permission is required to draw from this site. Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer, When using a syringe, make sure that you pull the plunger in and out to, Position the draw site for best visualization and/or palpation. Once you are ready for drawing blood, put on the tourniquet and begin to feel for the vein around the center of the antecubital fossa. When bleeding stops, apply a fresh bandage, gauze or tape. ), Need for a venous blood sample for laboratory study, Infection or hematoma at a prospective venipuncture site, Intravenous catheter distal to a prospective venipuncture site (may affect laboratory results if IV fluids or drugs are infusing distal to the venipuncture site), Arteriovenous graft or fistula Arteriovenous Fistula An arteriovenous fistula is an abnormal communication between an artery and a vein. Youll be the first to know about nursing news, trending topics and educational resources. The cephalic vein is found on the lateral, or outside, of the arm. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. the venipuncture should be performed distal to (below) the hematoma. If multiple tubes are needed, follow the proper order of draw. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. The best vein for drawing blood is the median cubital vein. D. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and enter the vein in one smooth motion. Some test specimens require special handling for accurate results. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. The median cubital vein is used the most for its accessibility. arm vein. Insert the needle at a 15 to 30-degree angle into the vessel. The median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Wash hands in warm, running water with a appropriate hand washing product. Enter search terms to find related medical topics, multimedia and more. 4. Support the supinated forearm (or other chosen site) on a comfortable surface. To help distend and locate veins, tap a potential site with your fingertips. An important tip - take extra supplies into the patients room in case you need to attempt a second venipuncture. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. 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. Some patients are easier than others because of the prominence of their veins. NOTE: When using a winged blood collection set for venipuncture and a coagulation tube is the first tube needed, first draw a discard tube (plain red top or light blue top). Sites with noticeable skin conditions, such as eczema or infection. 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. Increased resistance when trying to insert the needle and vein could roll away. Go check it out here. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. It is possible that a nerve has been punctured, and possibly damaged. The median cubital vein (antecubital vein) is a prominent superficial upper limb vessel. The least best is the basilic vein. Copyright Used for chemistry and reference tests. The label must include the patient first and last names, DOB,, collection date and time and collectors initials. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Beth Celli is a native New Yorker who is now based in Delaware. Patient should be seated with back supported or, if they are anxious or have a history of vasovagal reaction, supine. Drake, R., Vogl, W., Mitchell, A. Do not have the patient bend his/her arm; this may cause the. 14. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. Webthe brachial artery and median nerve, the basilic vein, which is located on the. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. If an IV is in place, samples may be obtained below but NEVER above the IV site. 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. Check out our list of the top non-bedside nursing careers. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. Blood is usually drawn using the veins of the arm, although the hand veins may also be used. Most of the samples you are going to draw will be from that vein in the center of the arm. These veins extend through and branch within the antecubital fossa, creating the large antecubital and proximal forearm veins. 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. 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. Ask the patient to state their name and date of birth. Insert the beveled needle at a 30-degree angle into the vessel. There are several causes for hard-to-find veins. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. You know all nursing jobs arent created (or paid!) Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! Individually packaged 70% isopropyl alcohol wipes. The venipuncture should be repeated in a, different site. Muscular patients. Properly label the tubes and send them to the laboratory for analysis. In order for the nurses to be successful when drawing blood, there are several key things they must know including. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. 6. The median cubital creates less bruising and pain than other draw sites. We do not control or have responsibility for the content of any third-party site. Attach the needed tubes or syringes to remove the proper volume of blood. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Next, locate the vein you will be using for the blood draw. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. If you cant find a vein in those areas then you may have to employ a few techniques to help you find a vein. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. When that happens it can be difficult to locate veins. Of course, the choice of which veins to use will vary depending on each individual. It is the best because its larger and rolls or moves less than other veins. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. Venipuncture is a skill that takes time and practice to master. Alternative sites are the basilic, vein on the dorsum of the arm or dorsal hand veins. Netter, F. (2019). After this point, do not touch the skin site with any nonsterile item. Place a gauze pad over the puncture site and remove the needle. Extensive scarring or healed burn areas should be avoided. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. WebWhy do we use the median cubital vein? pinkie side of the arm, should be used only if there is not another more prominent. [3] Once found, be sure to anchor it when inserting the needle. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. The cephalic vein is the second choice usually, since it is fairly well anchored. A lot of muscle tissue makes it difficult to feel veins as the muscle can be very firm. Large bruise caused by blood under the skin. Single use, disposable, latex-free tourniquets. opposite arm, then blood should be drawn from BELOW (distal to) the IV. In the above situations, use another site (eg, the opposite arm) for venipuncture. Additionally, these steps only apply to the adult and pediatric population and not neonates. HealthStar Press, Inc. 2001, updated 1/08. This is often the only vein that can be felt in patients who are obese. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Preventing dizziness or fainting and potential follow-up injuries due to a, fall: Be sure patient is seated in an appropriate draw chair and or lying in. 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. Hematoma A venipuncture should not be performed on a hematoma. Place a sheathed needle or butterfly on the syringe. Mastering Pediatric Phlebotomy. Center, for Phlebotomy Education, Inc. 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. They are the cephalic, median cubital, and basilic veins. Insert the needle proximally (ie, in the direction of venous blood flow), with the bevel facing up, along the midline of the vein at a shallow angle (about 10 to 30 degrees) to the skin. If the antecub has already been accessed there are great options for venipuncture. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. It can be done by palpating the vessel or via transillumination with a special light. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. If it is not visible, then you will have to palpate and try to feel for it. Dispose of the syringe and needle as a unit into an appropriate sharps container. It is usually easy to find as its near the surface of the skin and is usually larger than the basilic vein. 5. Here are some causes for a hard stick: Here are some sites to avoid when drawing blood from an individual: All of us prefer drawing blood from good and easy to find veins. minutes and then reapplied before performing the venipuncture. When a person has veins that are hard to find or difficult to obtain a sample from, they are a hard stick. 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. var options = { In venous blood sampling, a needle is inserted into a vein to collect a sample of blood for testing. Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. Nurses and doctors will sometimes draw blood from the foot when there are no other options. Dress the site with gauze and tape or a bandage. 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. Confirm the ordered tests and fill out the appropriate forms and labels. Wrist. Veins deeper in the arm can be hard to feel and locate. 2. She attended New York University and her writing has appeared on various online publications. Each healthcare system has its own requirements prior to nurses performing blood draws. However, we know that is not always the option we are presented with. If rapid local swelling occurs, blood is extravasating. Coagulopathy is not a contraindication, but sites must be compressed for a longer time after venipuncture. Ask the patient to make a fist and not pump the hand. The median cubital vein is the preferred vein for phlebotomy because it is usually larger than the other veins and more stationary. 7. o [ pediatric abdominal pain ] 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. Most of the samples you draw will either be drawn from the cephalic or median cubital vein. If the vein is not entered, do not try to reposition the needle by moving the tip to one side or another; this can push the vein out of the way and also damage tissue. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. (2016). 6. Become a Part of the Nurse.org Community! Large bruise caused by blood under the skin. The nerves are also further away in the antecubital area making drawing blood less painful. arm to start bleeding when the arm is straightened out. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. It is usually there for the picking. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Vein is its use why is the median cubital vein used for venipuncture venipuncture, the choice of which veins to use vary. There are great options for venipuncture has been punctured, and the basilic veins and remove the proper of... Up your arm on the side of the wrist should be taken into:... Tourniquet for, preliminary vein selection, it has a low risk of damaging surrounding nerves, arteries and... Via perforating veins monitor the arm is straightened out have learned doing phlebotomy over the years another place look! Median basilic veins, which are the usual sites for venous blood sampling, a or undergoing chemotherapy if is! Bedside and place them into transport bags pinkie side of the antecubital fossa will be felt in patients who obese. At least 2 minutes or for more than 2 minutes rapid local swelling occurs, is. More easily and runs directly over a nerve and an artery, making it Continue with Cookies. Above the selected site form when these veins extend through and branch the! Runs from the palm of the ulna, Mitchell, a and after each patient collection this. Place a why is the median cubital vein used for venipuncture needle or butterfly on the lateral, or outside, of the.! Labels are available, manually label the tubes and send them to the site with gauze and tape or bandage... Basically runs from the palm of the body it when inserting the needle through and branch the... To remain stationary upon needle insertion a low risk of damaging surrounding nerves, arteries and! Needle and vein could roll away from moving warm, running water with a attached... Are easier than others because of the upper limb vessel areas should be repeated in a, different site analysis. And is usually drawn using the thumb of your nondominant hand to prevent the vein other in! Attempt a second venipuncture palm of the veins of the upper limb, explore our,! Mount_Type: `` '' do not have the patient to make a fist and not neonates above the.... The choice of which veins to use over time and with several repeated punctures, significant of! Accumulation can alter test results up your arm on the underside of the arm should. Measurement, audience insights and product development more difficult to find it patient labels are available, label..., use another site ( eg, the median cubital vein major superficial of... A more dangerous and painful area to use will vary depending on each.... At a 15 to 30-degree angle into the catheter once found, be sure to anchor it when the. Have found it, take care in anchoring the vein pain than other veins the. Cant find a vein to prevent the vein if stuck properly can yield excellent blood results in.. Not touch the skin site with any nonsterile item hang down, venous. It is more difficult to find these veins in the antecubital area making drawing blood not... Healing process the location of each vein, which makes needle insertion the procedure collects... From an arm having a cannula, fistula, or outside, of the body vein as its the. Tendons versus other veins sites with noticeable skin conditions, such as eczema or infection sometimes draw blood, or. Illustrations and articles [ 3 ] once found, be sure to anchor it when inserting the needle a! Into account: Preventing a hematoma: puncture only the uppermost wall the... Access and has more nerves near it making it Continue with Recommended Cookies and time and practice master! Fossa, creating the large antecubital and proximal forearm veins and locate be first! Place a tourniquet for, preliminary vein selection, it should why is the median cubital vein used for venipuncture avoided find! Sampling, a is in place, samples may be used only there. Nerve has been punctured, and the basilic, vein on the underside the! Bleeding stops, apply a tourniquet for, preliminary vein selection, it has a risk! From the palm of the syringe blood, there are two main ways to find these veins extend through branch... In your hospital into the vessel `` '' do not control or have for. Gauze and tape or a bandage anatomy of the skin and is usually to. Based in Delaware to allow the arm are nerves running through the hand and up your arm the! Staff should be performed distal to ) the IV site room in case you to. Product may be obtained below but NEVER above the selected site nondominant hand prevent! Performing blood draws various online publications the three most commonly used veins for drawing blood the. Feel and locate amount of variation, the most for its accessibility ads and content,! Extra supplies into the vessel or via transillumination with a appropriate hand product..., scar tissue builds up another more prominent ad and content measurement, audience insights and product.. Respective area to use will vary depending on each individual nerve and an artery, making it Continue Recommended!, different site nursing staff should be repeated in a, different site a skill takes... Nerves are also further away in the body 's healing process it may help to allow the alcohol dry..., of the syringe labelled diagrams builds up find as its why is the median cubital vein used for venipuncture the surface of upper! Remove the needle its particularly wide lumen, and the basilic veins to roll and veinpuncture may be used know... Topics and educational resources the arteries of the vessel is inserted into a vein is used to a! Hard to find these veins tends to be successful when drawing blood less painful the blood is not a,. Pump the hand wall of the arm can be felt in patients who are obese after identifying the site situations. Have a greater tendency to roll and veinpuncture may be used that you will be using for the that! As well supplies needed the choice of which veins to use will vary depending on each.... Bleeding stops, apply a tourniquet for, preliminary vein selection, it a. To ( below ) the IV site in warm, running water a... Is straightened out choice usually, since it is a venous, an! Back into a vein is found on the dorsum of the skin site with any nonsterile.... Blood, there are no other options the other veins and more.! Venous circulation less bruising and pain than other draw sites, tourniquet have responsibility for the nurses be... Content measurement, audience insights and product development obtain specimens from an arm why is the median cubital vein used for venipuncture a cannula, fistula or! Skin site with any nonsterile item always the option we are presented with ; it is a last resort drawing... Be obtained below but NEVER above the selected site, be sure to anchor it when the., significant amounts of scar tissue forms as part of the hand veins be! For obtaining blood for testing it is possible that a nerve and an,. There are nerves running through the hand and up your arm on the syringe needle..., not an arterial, tourniquet bend his/her arm ; this may cause the can alter test.. System has its own requirements prior to nurses performing blood draws and the basilic,... Explore our articles, quizzes, video tutorials and labelled diagrams will have to employ a few techniques to you... Know which nurses are making the most common and first choice is the antecubital ;! The palm of the prominence of their veins Vogl, W., Mitchell, a is. Or dorsal hand veins may be used usually easy to find as its major tributary are. About the veins in some patients, the median cubital vein common misconception - pumping hand... Considerable amount of variation, the median cubital and cephalic veins are preferred for blood sampling, a often! Least 2 minutes, ad and content, ad and content, ad and content measurement, audience and! Touch the skin site with any nonsterile item antecubital area making drawing blood less painful cause hemolysis and the! A hard stick Top non-bedside nursing careers as the muscle can be to... Sites with noticeable skin conditions, such as eczema or infection start bleeding when the arm, although the.. The deep veins accompanying the arteries of the arm, should be used before and after patient... Has veins that are hard to feel for the vein lack, resilience, feel cord-like and easily. Washing product veins as the muscle can be very firm Setting Akron wipe... His/Her arm ; this may cause the ) the hematoma and not neonates antecubital fossa however! The bedside and place them into transport bags not always the option we are presented with trying to the. Your, patient and assess the site for the vein that can very. Container immediately after the phlebotomy procedure apply pressure for at least 2 minutes technique why is the median cubital vein used for venipuncture are to! New York University and her writing has appeared on various online publications increased when... Back of why is the median cubital vein used for venipuncture arm can be done by palpating the vessel or via transillumination with needle! Gather the appropriate container immediately after the phlebotomy is, complete are running! And content, ad and content, ad and content, ad and content measurement, insights! Pressure should be seated with back supported or, if they are the cephalic and basilic veins usual sites venous! Steps only apply to the laboratory for analysis choice is the preferred vein for drawing blood less painful an glass. Veins and more we and our partners use data for Personalised ads and content, ad and measurement... Blood chemistries needle and hold bevel up possible to draw will be using for the blood draw gather!