Skill Title :
Vene Puncture Status : I
Learning Objectives :
- Indications for Phlebotomy (K)
- Choice of Veins and Anatomy of the vein
- Equipment required
- Choosing appropriate Needle / Syringe
- Explanation to Patient of entire procedure
- Aseptic precautions during procedure and their impact
- Demonstrate correct method of of Vene Puncture in mannequin.
A procedure in which a needle is used to take blood from a vein. A peripheral IV cannulation involves inserting an IV cannula into a peripheral vein. Venepuncture involves inserting a needle into the peripheral veins, for the purpose of aspirating blood.
Indications for Phlebotomy :
- Usually for drawing blood for laboratory testing.
- Venipuncture may also be done to remove blood for any other purpose
- It may be done as a preliminary to set an Intravenous drip.
- It may be done to push intravenous drug.
Choice of Veins and Anatomy of the vein :
The first choice is the antecubital fossa area, starting with the median cubital vein, (The median cubital vein is the larger and more stable vein and is preferred for venepuncture.) then the cephalic vein, and the basilic vein. If none of these veins work, then one can use the dorsum of hand veins. Other draw sites, are rarely used like Wrist, Foot.
AnteCubital Fossa Vein.
Anatomy of a vein :
There are 3 layers of veins which will be pierced while doing a venepuncture for accessing the lumen f vein and draw blood. The vein wall consists of three layers: The tunica intima, the tunica media and tunica adventitia. The innermost layer of the vein is the tunica intima.
Equipment required :
- Alcholic cleanser solution.
- Sterile Gloves.
- An alcohol wipe.
- A disposable tourniquet.
- Sampling tubes if it is required for Lab. Investigations.
- Gauze, Cotton swab and Sticking Plaster.
Simulation Equipment :
Choosing appropriate needle / Syringe :
Normally a 20 to 23 guage needle is selected with 5 cc or 10 cc syringe attached to it for collecting blood.
Explanation to Patient of entire procedure
Aseptic precautions during procedure and their impact
Demonstration correct method of Venepuncture in mannequin
- Introduce yourself to the patient and confirm the identity.
- Explain what you are going to do and obtain consent.
- Give an idea about small amount of pain and some discomfort when the needle enters the vein.
- Wash and sanitise your hands using alcohol cleanser.
- Place the patient’s arm in a comfortable neutral position so that you can identify the veins and Select a vein
- Apply the tourniquet proximally.
- Ensure that the vein is engorged , dilated thro’ its course
- Put on your gloves. (Purpose is protect the patient but also yourself from any contact with blood should there be a spillage and also prevent a needle stick injury.)
- Clean the venepuncture site using the cotton swab and alcohol wipe .
- Remove the grey cap from the needle, attach the needle to the syringe .
- Retract the skin distally, alert the patient and insert the needle into the vein with bevel upwards and at an angle of 30 degrees.
- Ensure that there is negative pressure in syringe created in syringe with slight withdrawal of piston before needle enters the vein.
- Remove the tourniquet , Withdraw the needle, apply the gauze over the puncture site.
- Ask the patient to apply pressure with the gauze, keeping arm straight
- Carefully dispose of the needle in the sharps bin.
- Ensure that any bleeding has stopped and if so, apply the plaster. Remove and dispose of your gloves, along with the remaining equipment in the clinical waste bin.
- Thank the patient.