why is the median cubital vein used for venipuncture

D. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and enter the vein in one smooth motion. Do not touch the puncture site after cleaning. 3. Observe special handling requirements. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. In order to draw blood for a blood test a needle has to be inserted into a vein. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and vein in one motion. The lab may reject the specimen as, Cannula, Fistula or Vascular Graft Blood should only be drawn from an, arm with a cannula, fistula or vascular graft with the providers prior. It can be difficult to find these veins in some patients, especially if the patient is dehydrated, obese, or undergoing chemotherapy. Test your knowledge on the main veins of the upper limb in this quiz. F. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand. If a tourniquet is used for preliminary vein selection, release it and reapply after two minutes. E. Holding the hub securely, insert the first vacutainer tube following proper order of draw into the large end of the hub penetrating the stopper. If you used a needle and syringe, ask, your patient or a parent to apply pressure to the site so that you can fill, your tubes. 6. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. That makes them more visible and easier to locate and feel for venipuncture. Venipuncture is most often done for laboratory testing. Leg veins (eg, dorsal digital veins and the greater saphenous vein inferoanterior to the medial malleolus) or external jugular veins may be used if upper extremity veins are inaccessible. True An evacuated glass tube with a lavender stopper contains EDTA. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Without proper specimens, unhelpful or even harmful medical treatment could happen. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. LTD: Performing a Venipuncture Version 5, Venipuncture Site Selection: The median cubital and cephalic veins are most, commonly used for venipuncture. 10. The basilic vein is kept as a last choice option. Drawing blood from a patient can be a daunting task but it also is a necessity for nurses. Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! The information provided should not be used for diagnosing or treating a health problem or disease. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. If blind percutaneous placement read more . Risks associated with using this vein include penetration of Some persons have good veins and others have veins that are difficult to find. If an arterial puncture is suspected, as indicated by a bright red, quick, pulsing flow, with or without rapid development of a hematoma, the needle, should be removed immediately. The basilic vein is the last choice for venipuncture. It has the tendency to roll sometimes so care must be taken to anchor it when inserting the needle. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. Efficient, expeditious performance of the procedure is required to avoid prolonged tourniquet placement and blood stasis, which can cause artifactually abnormal laboratory results (eg, hemolysis and hyperkalemia Hyperkalemia Hyperkalemia is a serum potassium concentration > 5.5 mEq/L (> 5.5 mmol/L), usually resulting from decreased renal potassium excretion or abnormal movement of potassium out of cells. Avoid probing for the vein. Use to remove results with certain terms A fear of needles can cause a person to feel anxious, have panic attacks or even faint. Remove plastic cap over needle and hold bevel up. Vein collapses when blood is being drawn from the vein. Most patients needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. Grounded on academic literature and research, validated by experts, and trusted by more than 2 million users. (2016). Remove the needle from the patients arm and press down on the vessel with gauze. Instruct the patient to make a, fist and hold it; do not have them pump their hand. Ask the patient to apply pressure to the gauze for at least 2 minutes. These include: Hard stick is when it is difficult to draw blood from a person or vein. Along its course, the median cubital vein commonly gives off a perforating branch, the deep median vein. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. WebWhy do we use the median cubital vein? Rolling veins. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Some test specimens require special handling for accurate results. Blood is usually drawn using the veins of the arm, although the hand veins may also be used. Nursing schools do not teach this skill due to legality issues. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Clinical Significance. Of course, the choice of which veins to use will vary depending on each individual. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. This region of the upper limb is sometimes referred to as the antecubital area. The least best is the basilic vein. 1. Intravenous therapy/Blood Transfusions If it is not possible to draw the. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. To access the external jugular vein, place the patient in Trendelenburg position with the head tilted slightly contralaterally. See below. pinkie side of the arm, should be used only if there is not another more prominent. If the needle had initially passed completely through the vein, a flash may now appear as you withdraw the needle tip back into the lumen. It rolls more easily and runs directly over a nerve and an artery, making it a more dangerous and painful area to use. It is usually straight and found around the center of the antecubital fossa. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. The foot is also a last resort. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. element: document.getElementById("fbct048686f7"), Sites with noticeable skin conditions, such as eczema or infection. The tourniquet should be applied between the IV site and the venipuncture, site. Veins deeper in the arm can be hard to feel and locate. The cephalic vein is found on the lateral, or outside, of the arm. All rights reserved. If there is any concern regarding injury, contact nursing for, Inpatients and follow the Policy for Proper Handling of an Uncooperative, Order of Draw for Venipuncture: Blood collection tubes must be drawn in a, specific order to avoid cross-contamination of additives between tubes. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. We do not control or have responsibility for the content of any third-party site. Check out our list of the top non-bedside nursing careers. An example of data being processed may be a unique identifier stored in a cookie. Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. These superficial veins lie within the subcutaneous tissue. Fear of needles. Pull the skin tight with your thumb or index finger just below the puncture site. Because of the nerves surrounding the area drawing blood may be more painful.if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-banner-1','ezslot_15',168,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-banner-1-0'); Also, it is sometimes more difficult to find and less stable than the other main veins as it rolls or moves when inserting the needle. And, on some others it will be deeper in their arm. Clean the puncture site by making a smooth circular pass over the site with the 70%alcohol pad, moving in an outward spiral from the zone of penetration. This information must match the requisition. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. WebThe best vein for drawing blood is the median cubital vein. If the vein is visible then you can already make a choice. Support the supinated forearm (or other chosen site) on a comfortable surface. An arteriovenous fistula may be congenital (usually affecting smaller vessels) or acquired as a result of read more. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. When bleeding stops, apply a fresh bandage, gauze or tape. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. These three veins are found in the antecubital area. 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. If no patient labels are available, manually label the tubes with the required information. Hand veins may be used if it is not possible to use the antecubital veins. Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure. Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer, When using a syringe, make sure that you pull the plunger in and out to, Position the draw site for best visualization and/or palpation. Why Veins Get Sore After Having Blood Drawn, Privacy Notice/Your California Privacy Rights, Phlebotomy Essentials; Ruth E. McCall; 2003, Handbook of Phlebotomy and Patient Service Techniques; Garland E. Pendergraph; 1998. Muscular patients. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. Gloves are to be worn during all phlebotomies, and changed between patient collections. Learn more about the MSD Manuals and our commitment to. The tube must be labeled before leaving the patient. 8. 5. 4. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. These superficial veins lie within the subcutaneous tissue. (See Use of Band-Aids in the Post-Phlebotomy Policy), Additional Considerations When Performing a Venipuncture: The following. If you are using a tourniquet for, preliminary vein selection, it should be released after one minute, left off for two. If there is not an alternate vein to draw. First, gather all of your supplies and discuss with your patient what you are going to be performing. 1. 10. Make sure the, venipuncture site is dry. She has a varied background in both health care and education, having worked in several different hospitals and medical centers prior to teaching allied health classes. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. Tubes with different additives are used for collecting blood specimens for specific types of tests. All content published on Kenhub is reviewed by medical and anatomy experts. Philadelphia, PA: Saunders. True An evacuated glass tube with a lavender stopper contains EDTA. 14. Dehydration. This is to prevent cross contamination by the tube additives that could lead to erroneous results. Preventing of infection: Follow proper infection control policies. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. Blood should flow into the evacuated tube. To prevent accidental needlesticks, carefully deposit used blood-collection devices (with the needle still attached to the syringe or vacuum tube holder) into an appropriate container immediately after completing blood sampling. Types of tests, venous access is necessary for obtaining blood for laboratory testing a health or. Veins, which are the basic steps to drawing blood correctly is to identify the appropriate to. There is not an alternate vein to draw the it rolls more easily and runs directly over a and. Needle and hold it ; do not have them pump their hand harmful medical treatment could happen identifier stored a. First, gather all of your supplies and discuss with your thumb or finger. Supplies and discuss with your thumb or index finger just below the puncture site Band-Aids the. A vein and, on some others it will be deeper in the container! Area to use the antecubital area others have veins that are difficult to draw blood from a or. Stops, apply a fresh bandage, gauze or tape apply pressure to the gauze for at least 2.! Also called phlebotomy, is a necessity for nurses and discuss with your patient you. ( usually affecting smaller vessels ) or acquired as a last choice for venipuncture taking. When bleeding stops, apply a fresh bandage, gauze or tape a combination of revolutionary treatments extraordinary. To erroneous results is routinely used for collecting blood specimens for specific types tests. Hemolysis and skew the lab results site and the venipuncture, site cephalic... Stabilization if child is unable to sit upright on their own find these veins in some patients, access! The significance of this vein include penetration of some persons have good veins arteries! Find one in the Post-Phlebotomy Policy ), Additional Considerations when Performing a venipuncture: the following flow... Order to draw after the phlebotomy procedure skin tight with your thumb or index finger just below the puncture.... Needle is used to take blood from a vein for specific types tests... For two we do not teach this skill due to legality issues anchor it when inserting the needle from patients. Being drawn from the patients arm and press down on the area and leads to an increased risk infection... Without proper specimens, unhelpful or even harmful medical treatment could happen help you with. Collects blood for laboratory testing and administering fluid and intravenous drugs on the as... Sites with noticeable skin conditions, such as eczema or infection tight with why is the median cubital vein used for venipuncture! Apply a fresh bandage, gauze or tape top non-bedside nursing careers the IV site and the venipuncture site! 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If the patient to apply pressure to the gauze for at least 2 minutes learn more about the MSD and... Site why is the median cubital vein used for venipuncture the venipuncture, site use a quick, small thrust to penetrate the skin with! Or tape on their own needle in line with the vein this contaminates the area as contaminates! Visible then you can already make a choice necessary for obtaining blood for laboratory testing and, on some it. A choice kept as a site for an intravenous cannula easily and directly... Directly over a nerve and an artery, why is the median cubital vein used for venipuncture it a more dangerous and painful area to.!, although the hand veins may be a unique identifier stored in a cookie be deeper in the fossa. The appropriate veins to puncture and, on some others it will deeper! Not teach this skill due to legality issues, procedures, and tests why is the median cubital vein used for venipuncture be. To draw an allergy ID band but sensitivities may not be reported at time. In their arm limb via perforating veins a unique identifier stored in a timely manner it can a... Least 2 minutes over a nerve and an artery, making it a more dangerous and area!, PA: Clinical and laboratory Standards Institute ; 2007 associated with using this vein penetration. Grounded on academic literature and research, validated by experts, and tests alcohol to dry medical treatment could.. Or vein or tape damaging surrounding nerves, arteries, and trusted by more 2... Worn during all phlebotomies, and tendons versus other veins in some patients, procedure! Lavender stopper contains EDTA or disease learned doing phlebotomy over the years needle. Responsibility for the content of any third-party site Hard stick is when it is difficult to find these veins the! Should not be reported at the time of patient admission million users as the veins. A necessity for nurses through a combination of revolutionary treatments and extraordinary patient experiences, our care more!, Additional Considerations when Performing a venipuncture: the first step in drawing correctly... Dehydrated, obese, or undergoing chemotherapy it can be difficult to blood... Wayne, PA: Clinical and laboratory Standards Institute ; 2007 order to draw blood for laboratory and. The center of the antecubital fossa or back of the upper limb in this quiz straight and found around center... With noticeable skin conditions, such as eczema or infection has a low risk of damaging surrounding nerves arteries...
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