Venepuncture
Foreword
This skill involves taking blood from a patient's vein. This is then sent to the laboratory and tested for various conditions, depending upon which tests you request.
Each hospital has its own policy for blood sampling, such as some use syringes, butterflies, the Vacutainer system, or the Monovette system. In this station we will be demonstrating the use of the Vacutainer system. Whichever method is used however, there is little difference in the technique.
Remember that different hospitals may use different coloured blood tubes, so if you are asked to take a specific blood sample be sure to check which colour of tube you will require.
This is a core clinical skill that you should be proficient in, and as such is frequently examined on.
Procedure Steps
Step 01
Introduce yourself to the patient and confirm their identity. Explain what you are going to do and obtain consent. As this is a potentially painful procedure so explain that they may feel some discomfort and answer any questions they may have.
Step 02
Ensure that you have all of your equipment ready as follows:
- Alcohol cleanser.
- Gloves.
- An alcohol wipe.
- A disposable tourniquet.
- Needle.
- Needle holder.
- Appropriate sample tubes.
- Gauze.
- A plaster.
- A clinical waste bin.
Step 03
Wash and sanitise your hands using alcohol cleanser.
Step 04
Place the patient’s arm in a comfortable position so that you can identify the veins. Select a vein, apply the tourniquet and re-check the vein making sure you are comfortable with its course.
Step 05
Put on your gloves. This not only helps protect the patient but also yourself from any contact with blood should there be a spillage. It also reduces the risk of blood-borne virus transmission should you obtain a needle stick injury.
Step 06
Clean the venepuncture site using the alcohol wipe in downward strokes.
Step 07
Remove the grey cap from the needle, attach the needle to the needle holder, and remove the other cap to reveal the needle.
Step 08
Retract the skin distally, prepare the patient for a 'sharp scratch', and insert the needle into the vein bevel upwards.
Step 09
Once in the vein, attach a bottle and let it fill, changing if more than one bottle is required. Whilst the last bottle is filling, loosen the tourniquet and when full, remove it from the needle holder.
Step 10
Withdraw the needle, applying the gauze over the puncture site. Ask the patient to apply pressure with the gauze, keeping their arm straight as bending the arm may increase any bruising.
Step 11
Carefully dispose of the needle in the sharps bin.
Step 12
At this point, invert the tubes 3 times to ensure full mixing with any additives in the tubes such as heparin.
Step 13
Whilst still at the bedside, ensure that you complete all of the patient details required on the bottles.
Step 14
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.
