INTRODUCTION

Blood has to be tested in most of the blood- related disorders,

metabolic disorders and various infections. There are two
different ways of obtaining the blood depending upon the
volume of blood required for the test.

1. Capillary or peripheral blood

2. nous blood.

CAPILLARY BLOOD COLLECTION

Capillary blood is obtained by pricking the tip of finger, lobeof ear,

from the toe, and in infants, it is obtained from the
heel. However, the most convenient place to prick is finger.
It is to be pricked from about half (1/2) cm from the nail. It is to be
pricked about 3 mm deep. The area to be punctured should not be cold.
If it is cold, warm it by massaging. Disinfect the site of puncture by using
spirit or 95 % alcohol. Wipe- off the first drop of blood, and use the next
drop for testing. After obtaining sufficient amount of blood, let the
patient apply slight pressure by using spirit with sterile swab.
This way of blood collection can be used when the amount of
blood required is only few drops, like Hb, total leukocyte count (TLC),
differential leukocyte count (DLC), etc. For capillary puncture, sterile
needle or sterile lancet should be used. Generally, nowadays,
disposable needles are used. If, reusable needles are used, it should be sterile one.

VENOUS PUNCTURE
When large quantity of blood is required, it is obtained from
the vein. Generally, vein of arm is used. There are five veins
passing through arm. These are cephalic vein, basilic vein,
accessory cephalic vein, median vein and anterior ulnar vein.
Any prominent vein is used for the collection of blood. In
some cases, vein from wrist part or leg can be used, but it
should be prominent.

THE COLLECTION PROCESS

NEEDLE
Sterilized sharp needles of bore size of 18 to 20 gauge
(medium, 1.2 to 0.9 mm) for adults and 23 gauge (0.5
mm) for children are needed. The length should be
medium, about 20 mm for adults, and short about 15
mm for children are used. Generally, disposable
needles are recommended. If reusable needles are
used, it should be sterilized properly.

PROCEDURE
1. First of all decide the amount of blood required and select
the container according to the test to be done.
2. Now ensure the patient what is to be done.
3. Lay the arm of the patient on the table.
4. Apply the tourniquet and select the prominent vein of the patient.
5. With cotton swab, disinfect the puncture site.
6. The cotton swab should be previously soaked in the disinfectant.
7. Assemble needle and syringe, check that, it is sharp and
unblocked, and it is moving smoothly. Passing air through the
syringe can do this. But there should not be any air present in the
syringe at the time of blood collection.
8. With the left hand, hold patients arm, so that skin over vein is
tightened. Ask the patient to open and close the wrist.
9. Take the syringe in right hand, holding index finger against the
base of the needle, keep the point of needle to upper side and
push firmly and steadily without any hesitation into the center
of vein.

10. The angle between skin and needle should not be more than 30
to 40°. The moment needle enters in vein, blood flows back into
syringe.

11. With your left hand, slightly pull back the piston till required
amount of blood is obtained in the syringe.
12. Now, remove the tourniquet, place cotton swab over the needle
and wound. Withdraw the needle slowly, and ask the patient to
place a cotton swab over the wound. This stops bleeding from
wound.
13. Remove the needle from the syringe and gently expel the blood
into appropriate container.
14. If anticoagulant is used, gently shake the bottle for proper mixing
15. If reusable syringe is used immediately wash the needle with
water using water tray.