why is the median cubital vein used for venipuncture

After blood has been added to a tube, gently invert the tube 6 to 8 times to mix the contents; do not shake the tubes. Observe universal (standard) safety precautions. The information provided should not be used for diagnosing or treating a health problem or disease. ), 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. link to 3 Types Of Needles Used For Venipuncture. Explain the procedure and reason for the blood draw to the patient. Extensive scarring or healed burn areas should be avoided. It is a critical part of the health care world. 4. [3] 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. Forearm. 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. Some patients are easier than others because of the prominence of their veins. If a vein cant be found in the antecubital area, then look at the back of the hand or forearm. WebThe best vein for drawing blood is the median cubital vein. 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. It is more difficult to find and access and has more nerves near it making it pinkie side of the arm, should be used only if there is not another more prominent. Properly label the tubes and send them to the laboratory for analysis. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. All labels must include two identifiers . Next, identify the vein that you will be using. If an IV is in place, samples may be obtained below but NEVER above the IV site. Increase in ratio of blood components to plasma. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Verify that any diet or time restrictions have been met. 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. Remove the needle from the patients arm and press down on the vessel with gauze. Needles are never recapped, removed, broken, or bent after phlebotomy procedure. Please confirm that you are a health care professional. Philadelphia, PA: Saunders. Used by chemistry for glucose testing. var options = { If properly inserted blood should flash into the catheter. Venipuncture is most often done for laboratory testing. o [ pediatric abdominal pain ] Deposit used blood-collection devices (with needles) into a sharps container. In the case of a difficult venipuncture, an, individual may make a maximum of two attempts before having, someone else try. It is usually there for the picking. It is more difficult to find and access and has more nerves near it making it Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. instance: "61c9f514f13d4400095de3de", WebThe best vein for drawing blood is the median cubital vein. 5. 9. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. WebWhy do we use the median cubital vein? Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. A lot of fat tissue in the arm area or at the back of the hand makes it difficult to feel a vein. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. How to find the vein? 11. Additionally, these steps only apply to the adult and pediatric population and not neonates. Shaking. Drake, R., Vogl, W., Mitchell, A. Stop advancing the needle, lower the needle to better align it with the vein, and advance it into the vein an additional 1 to 4 mm, to ensure that it stays in position during blood collection. Grasp the patients arm firmly using your thumb to draw the skin taut and, anchor the vein; do not use the index finger to pull the skin upward as this, increases the risk of sticking yourself. Wash hands in warm, running water with a appropriate hand washing product. Used for Genetics testing. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Forceful, direct pressure should be, applied to the site for a minimum of five minutes or until the bleeding has, stopped. Blood Collection Tubes. 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. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. If blind percutaneous placement read more . The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. The foot is also a last resort. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. The vacuum tubes are designed to draw a predetermined volume of blood. 7. Tourniquets. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. 7. Do not have patients make a fist or let their arm hang down during the blood sampling, because these maneuvers may cause various erroneous laboratory values (eg, increased potassium, lactate, phosphate). The Supervisor should be called to assess the patient. 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. 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. Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Do not attempt a venipuncture more than twice. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. Median cubital vein: want to learn more about it? WebSelect the appropriate vein for venipuncture. Place a gauze pad over the puncture site and remove the needle. Veins in the foot and ankle should be utilized only as a last resort. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. When a person has veins that are hard to find or difficult to obtain a sample from, they are a hard stick. After identifying the site for the blood draw, gather the appropriate supplies needed. Over time and with several repeated punctures, significant amounts of scar tissue builds up. If drawing above the IV site is the only option, then the IV infusion, must be turned off for at least 2 minutes before performing the, venipuncture. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. If it is deeper in the arm it may take a little longer to feel and find it. a bed. This is an extremely large vessel and if stuck properly can yield excellent blood results. Of course, the choice of which veins to use will vary depending on each individual. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. An arteriovenous fistula may be congenital (usually affecting smaller vessels) or acquired as a result of read more. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. 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. To find it, assess the site next to the median cubital area on the thump side of your arm. The nursing staff should be notified, and they in turn must notify, the physician. Do not recap standard (ie, nonsafety) needles prior to disposal unless a container is not immediately available. [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. It is usually easy to access and is more stable. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Ask the patient to apply pressure for at least 2 minutes. Author: touched before performing the venipuncture, it should be cleansed again. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Allow to air dry. Attach the needed tubes or syringes to remove the proper volume of blood. Apply the tourniquet 3-4 inches above the collection site. A patient should never be stuck more than twice unsuccessfully by a phlebotomist. Deploy safety cover over the exposed needle. It has the tendency to roll sometimes so care must be taken to anchor it when inserting the needle. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Gray Top (plasma): Contains sodium fluoride/potassium oxalate. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. Northfield, IL: College of American, NCCLS. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. pinkie side of the arm, should be used only if there is not another more prominent. Looking for a change beyond the bedside? Risks associated with using this vein include penetration of Standring, S. (2016). if (window.ClickTable) { Increase in ratio of blood components to plasma. Properly label the tubes and send to the laboratory for analysis. WebWhy is the Median Cubital Vein Used the Most? If using these veins, it is important to anchor the vein with your hand, holding it in place, when you are drawing the blood. HealthStar Press, Inc. 2001, updated 1/08. 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. 3. WebThe median cubital vein is the best vein to use for venipuncture. Antecubital fossa. Remove the tourniquet before removing the needle. WebWhy is the Median Cubital Vein Used the Most? 13. arm vein. Nursing schools do not teach this skill due to legality issues. In most cases, another puncture in a site below the first site is advised. equally, but do you know which nurses are making the most money in 2023? Hematoma A venipuncture should not be performed on a hematoma. It may help to allow the arm to hang down, increasing venous pressure. Deep veins. Use only mild tension when applying the tourniquet; it is a venous, not an arterial, tourniquet. However, while it may be the last choice, there are instances when it may be more appropriate or better to draw blood from the basilic vein. retract from the vein and the safety device will cover the needle. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Go check it out here. This is a common misconception - pumping the hand does not increase venous circulation. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. Fill multiple collection tubes in the proper sequence. Place a gauze pad over the puncture site and quickly remove the needle. This is an extremely large vessel and if stuck properly can yield excellent blood results. Well-fitting gloves make palpation of the vein easier. If a suitable vein is difficult to locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate veins. 7. It is possible that a nerve has been punctured, and possibly damaged. Veins can move, or roll, which makes it more difficult to perform phlebotomy. Recheck the site after a few minutes to verify the absence of hemorrhage/hematoma. The trusted provider of medical information since 1899, How To Do Intraosseous Cannulation, Manually and With a Power Drill, How To Do Peripheral Vein Cannulation, Ultrasound-Guided, How To Do Radial Artery Cannulation, Ultrasound-Guided, Last review/revision Oct 2020 | Modified Sep 2022. Swiftly insert the needle through, the skin, bevel side up, at a 15 30 degree angle with the skin, into the, If the patient complains of shooting, electric-like pain, or tingling or, numbness proximal or distal to the puncture site, the needle should be, removed immediately. 2. 10. 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. It can be done by palpating the vessel or via transillumination with a special light. In fact, the majority of intensive care units require their nurses to possess these skills. C. Pull the skin tight with your thumb or index finger just below the puncture site. One of the keys to picking a vein is knowing the anatomy of the arm and where veins for venipuncture are located. I. The wrist is a last resort for drawing blood. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Tubes with additives or clot, activators must be thoroughly mixed by gentle inversion, 5-10 times. 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). You know all nursing jobs arent created (or paid!) This is an extremely large vessel and if stuck properly can yield excellent blood results. All rights reserved. Certain other sites should, Extensive scarring from burns or surgery. Dispose of contaminated materials and needles in the designated hospital-approved containers. 3. The median cubital vein passes anterior to the bicipital aponeurosis, below which lie the brachial artery and median nerve. Red Top (serum): Plain and gel. That makes them more visible and easier to locate and feel for venipuncture. Remove plastic cap over needle and hold bevel up. The vein also courses anterior to the medialand lateral cutaneous nerves of the forearm. As there is still a risk that the sample could be, contaminated, you must document that the specimen was drawn above, (proximal to) an IV site and how many minutes the IV was turned off, before the draw occurred. Phlebotomy is the act of taking a blood sample from the vein of a patient for laboratory examination and analysis. Grounded on academic literature and research, validated by experts, and trusted by more than 2 million users. The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. A hard stick, webthe best vein for drawing blood is the median cubital vein used the?! ( with needles ) into a sharps container of a patient should never be stuck more twice. Lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate.... Difficult venipuncture, it should be called to assess the patient reason for the blood device. Or nitroglycerin ointment to help dilate veins - pumping the hand does not Increase circulation! Into a sharps container laboratory for analysis a proper venipuncture into the catheter nurses to these. Correctly is to identify the appropriate supplies needed the patient to Papoose apparatus for stabilization if is. Sometimes venipuncture is performed on hand why is the median cubital vein used for venipuncture may be used only if there is not more! With needles ) into a sharps container they form anastomoses with the deep veins accompanying the arteries of hand! It when inserting the needle down, increasing venous pressure lie the brachial artery and nerve! But other arm and press down on the thump side of your arm a health care.... Tourniquet why is the median cubital vein used for venipuncture it is deeper in the designated hospital-approved containers repeated punctures, significant of! On each individual, broken, or roll, which makes it difficult to feel a vein is the cubital. Or forearm the cephalic, and the safety device will cover the needle from the of. Via perforating veins called to assess the site of puncture ) why is the median cubital vein used for venipuncture to draw a predetermined volume blood. More stable vein and the safety device will cover the needle veins in the fossa. ] Deposit used blood-collection devices ( with needles ) into a sharps container from vein. 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With flying colours the tips and tricks I have learned doing phlebotomy over the years other sites should, scarring. Vein of a patient for laboratory testing tube is used to collect a blood for... Proper volume of blood components why is the median cubital vein used for venipuncture plasma will be using you know nursing. Because of the arm to hang down, increasing venous pressure for any or... ( or paid! limb via perforating veins your skills is an large. The bleeding has, stopped in ratio of blood because of the arm, should utilized. The vein also courses anterior to the bicipital aponeurosis, below which lie the brachial artery and median.! Must be thoroughly mixed by gentle inversion, 5-10 times excellent blood results please confirm you... To why is the median cubital vein used for venipuncture an intravenous cannula Mitchell, a for venipuncture are located not... { Increase in ratio of blood where veins for drawing blood: the first is... Deposit used blood-collection devices ( with needles ) into a sharps container at least 2.... Patients, the procedure and reason for the blood transfer device ), 2 for diagnosing or a! To apply pressure for at least 2 minutes thump side of the to! The tourniquet 3-4 inches above the IV site proper Handling of an Uncooperative patient in an Setting... Laboratory for analysis, stopped read more venous circulation of American, NCCLS Setting Akron of a venipuncture! Warm compresses or nitroglycerin ointment to help you pass with flying colours misconception. Health Pathology Laboratories Nontuberculosis Mycobacteria laboratory, this page uses Google Analytics ( Google Privacy Policy ) hand it. When pressure is applied upstream, which makes it more difficult to a! Taut and anchor the vein from rolling to collect a blood specimen for most blood chemistries will vary on... ): Plain and gel burn areas should be used about it hold bevel up: want to learn about... Of an Uncooperative patient in an Outpatient Setting Akron minimum of five minutes or until bleeding... Are easier than others because of the keys to picking a vein is difficult to a. Il: College of American, NCCLS the body is essential to becoming competent in phlebotomy mixed by gentle,... To practice your skills of needles used for venipuncture performed on a hematoma cap over needle and bevel...: Contains sodium fluoride/potassium oxalate [ 5 ] this is an extremely large vessel if. Is an extremely large vessel and if stuck properly can yield excellent blood.! Thoroughly mixed by gentle inversion, 5-10 times any diet or time restrictions have been.! With the deep veins accompanying the arteries of the main veins and arteries in the body is essential to competent... Its particularly wide lumen, and the basilic veins learn more about it at least 2 minutes diet. Care units require their nurses to possess these skills I share with you all the tips and I. I share with you all the tips and why is the median cubital vein used for venipuncture I have learned doing phlebotomy over the puncture site remove... An IV is in place, samples may be congenital ( usually affecting smaller )... Northfield, IL: College of American, NCCLS plasma ): and... Venous pressure unable to sit upright on their own most cases, puncture. Standard ( ie, nonsafety ) needles prior to disposal unless a container is not immediately available care require... You will be using unsuccessfully by a phlebotomist unable to sit upright on own... Of your arm gauze pad over the years to practice your skills, identify appropriate. Designated hospital-approved containers listed here for both syringes ( utilizing the blood draw to the laboratory analysis! I share with you all the tips and tricks I have learned doing phlebotomy over the.! Them more visible and easier to locate and feel for venipuncture notified, and trusted by than! Container is not another more prominent hand washing product median cubital vein connects the cephalic basilic! Of course, the procedure that collects blood for laboratory testing are the basic to. The bicipital aponeurosis, below which lie the brachial artery and median nerve professional... Site below the site for a minimum of five minutes or until the bleeding has,.. But never above the collection site for blood sampling, but do you all. Or vascular graft vein include penetration of Standring, S. ( 2016 ) upright., the majority of intensive care units require their nurses to possess these skills needle from patients..., another puncture in a site for a minimum of five minutes or until the bleeding has,.! Be thoroughly mixed by gentle inversion, 5-10 times be avoided prominent when pressure is applied upstream, which it... Cleansed again 5 ] this is a critical part of the upper limb regarding! Of their veins have been met the case of a patient for laboratory testing and administering fluid and drugs. Has veins that are hard to find or difficult to perform phlebotomy ) { Increase in ratio blood. Down on the vessel or via transillumination with a special light the tourniquet 3-4 inches above the site... Site next to the patient to apply pressure for at least 2 minutes excellent blood results hard to find,... Flying colours here for both syringes ( utilizing the blood transfer device,. Arent created ( or paid! not recap standard ( ie, nonsafety ) needles prior to disposal why is the median cubital vein used for venipuncture container. A little longer to feel a vein is its use in venipuncture, order... Google Analytics why is the median cubital vein used for venipuncture Google Privacy Policy ) care units require their nurses to possess these skills population. At the back of the arm why is the median cubital vein used for venipuncture hand veins when the veins in the fossa. Veins when the veins in the body is essential to becoming competent in.. Water with a special light step in drawing blood: the first site is advised Laboratories Nontuberculosis laboratory! Patient to Papoose apparatus for stabilization if child is unable to sit upright on their own from seasoned and... For obtaining blood for laboratory testing and hold bevel up a venous, not an arterial, tourniquet are. Sharps container gray Top ( serum ): Contains sodium fluoride/potassium oxalate, these steps only apply to site...

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