Steps for Venipuncture

Procedure Preparation

• Always ask for the patient's name and date of birth, comparing them to the order sheet, prior to drawing blood. In the hospital, the patient identification bracelet may be used for identity. Often, those having outpatient testing are required to show identification prior to being drawn.
  
  Position the patient so that the arm is below the level of the heart. Make sure all equipment is within easy reach, including needles with hubs attached, tubes, tape, tourniquet, alcohol wipes or betadine swabs, cotton balls, band-aids, gloves, sharps container, and labels.
  
  

Site Preparation

• For most blood draws, the antecubital (or inside elbow) veins are used. However, the area should be examined for scarring and other complications (such as a running IV). Other possible areas to draw include the dorsal (top-side) forearm, hand and foot (only if no other place is available).
  
  Start by applying the tourniquet 3 to 4 inches above the drawing area. Remember that the tourniquet should not be on for longer than one minute. If it takes longer, remove the tourniquet and wait one to two minutes before restarting. Put on gloves and clean the area with either alcohol or betadine. Have the patient make a fist. Using the index finger of your dominant hand, palpate (or feel for) the vein.
  
  

Venipuncture and Collection

• Blood Collection
  
  Uncap the needle. With the bevel pointed upward, pierce the skin at a shallow angle and advance slowly until the vein is pierced. Engage the first vacuum tube. There should be blood flowing into the tube. If no blood is obtained, the procedure must be restarted from the beginning with a new needle.
  
  Once tube is full, use one hand to stabilize the needle in the vein and remove the tube with the other. Insert other tubes until all the test samples are obtained. Properly dispose of the needle and label the tubes immediately.
  
  

Tubes

• Vacuum tubes have color coded tops to indicate the type of test and any additives they may contain. Tubes with additives must be mixed by gently inverting the tube a number of times.
  
  Common test tubes include: red (chemistries, immunology and serology, and blood bank crossmatching; no additives), purple (CBC and crossmatching; EDTA additive), light blue (coagulation tests; sodium citrate additive), dark blue (trace elements and toxicology; EDTA additive), yellow (tissue typing, paternity testing and DNA testing; ACD additive), yellow/black (microbiology; broth mixture additive), and pink (molecular/viral load; potassium EDTA additive).