Venipuncture

Question 1

Before starting

Answer 1

Check its right patient: on extraction tube and chart
Check there are no contraindication:
arm not paralyzed, no thrombosis, no dialysis shunt, no dissection history
Ask coagulant of patient: need extra care
Wash hands
Get Material:
Sharps container
Tourniquet
Kidney dish/emesis basin** (for collecting materials to be used and later for collecting waste)
Vacuum extraction tubes
Vacutainer holder with needle
Non sterile gloves
Gauze pads
Disinfectant
Chux protective underpad
Bandage
Make sure everything is sealed, dry and date is good.
Patient sits or lie down. Prioritize non dominant arm.

Question 2

Venipuncture

Answer 2

If not already done:
Connect the Vacutainer needle holder and needle.
Apply the tourniquet around the upper arm, about 10 cm above the antecubital fossa, and tighten it.
Make sure that the release strap is on the side of your non-dominant hand
Look for a suitable vein: cephalic vein, median cubital vein, and basilic vein ( avoid: brachial artery and median nerve run here (although more deeply) and could be hit.)
oosen the tourniquet once you have found a suitable vein.
Disinfect the skin, put on non-sterile gloves and make sure that all needed materials are ready for use.
Apply the tourniquet once again
Hold the vacutainer needle holder between the thumb and index finger of your dominant hand, with the bevel of the needle facing upward
Ask the patient to extend the arm, and support the arm if necessary with your non-dominant hand. Pull the skin taunt with your non-dominant hand if necessary.
Enter the vein at an angel of about 45˚, reduce this angel to about 30˚ once the needle has penetrated the skin
upport your dominant hand on the patient’s arm, so that the needle is held steady. The vacutainer needle holder is held in the dominant hand; do not switch it to the other hand as this puts the needle at risk for getting displaced.
Use your non-dominant hand to pick up a vacuum extraction tube and slide it into the vacutainer holder. The middle and index finger are placed at the wings of the vacutainer holder, and the thumb pushes the vacuum tube up into the vacutainer holder
As soon as the first vacuum tube starts to fill with blood, release the tourniquet (use your non-dominant hand to do this)
Remove the last vacuum tube and then remove the needle from the vein. Immediately apply pressure to the puncture site using gauze.
Deposit the needle immediately in the sharps container
Ask how the patient is doing