The LSUHSC New Orleans
Emergency Medicine Interest Group

Presents

The Student Procedure Manual


Venipuncture

Indications
Contraindications
Equipment
Preparation
Procedure
Complications
Follow Up

Indications

Contraindications
Locations to avoid drawing blood-

Equipment

Preparation

Procedure

  1. Preferred site is in the antecubital fossa; if veins are inaccessible there, the dorsum of the hand or the radial side of the wrist is often used
  2. Place tourniquet 3-4 cms proximal to intended puncture site and stabilize the patient's arm to minimize movement
  3. If vein is inapparent, have the patient tense, and then relax local muscles repeatedly to increase blood flow to the area, apply a warm compress to the area, or tap sharply over the vein to induce reflexive vasodilation
  4. Wipe intended puncture site with alcohol swab in a circular motion from the center outward about 4-5 cm
  5. With your non-dominant hand, pull skin taut to stabilize vein
  6. Puncture the skin rapidly with the catheter needle bevel up at a 30' angle directly over the vein; once in the subcutaneous space, level off the angle of insertion to nearly parallel with skin surface; if using a syringe, maintain negative pressure once subcutaneous space is reached, if using Vaccutainer system, push test tube onto needle to create negative pressure
  7. Once subcutaneous space is reached, advance the needle into the tissue until blood flow into receptacle begins; at this time, draw off as much blood as will be needed for all anticipated tests
  8. Remove the tourniquet with your non-dominant hand
  9. Place gauze over puncture site, then quickly remove the needle
  10. Apply pressure to the puncture site for 3-5 minutes and twice this duration for patients with coagulopathies
  11. Tape gauze in place

Complications

Follow Up

 


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