Selecting The Venipuncture site

Presented by : Sanderina Viola (PO7134121078)

Selecting The Venipuncture site
The most common area to perform a venipuncture is in the inside of the elbow,
or antecubital area of the arm. This is where the median cubital, cephalic, and
basilic veins lie close to the surface of the arm.

Locate the median cubital vein, which is usually the

largest and best-anchored vein, near the center of
the antecubital area.

Always examine this area first, because the easiest

veins to collect from are located in the antecubital
area of the arm.
Patients generally have more prominent veins on their dominant arm.
For example, if the patient is lefthanded, look for a vein in the left
arm first. You should check and palpate both arms before deciding on
the site for the venipuncture.
To help locate veins better, position the arm at a downward angle, using the force of
gravity as an aid in making the veins more prominent. We also can use a small pillow so
the patient will feel more comfortable. In addition we can use tourniquet to slow down
the flow of venous blood so the vein become enlarged, making them easier to find.

In addition, instruct the patient to make a fist, but not to attempt to pump the
fist because this can cause hemoconcentration.
The preferred way to increase the vein size, making the venipuncture easier, is to warm the
site by using a warm, moist compress for 3 to 5 minutes, if time permits. Using plastic such
as a plastic side of a blue pad or a plastic bag or gloves against the skin is a good idea. This
will dilate the veins and increase the bloodflow but keep the skin at the site from getting
wet.
While we are selecting the venipuncture site, explain to the patient the importance of holding the arm
very still because :
• Holding the arm still will reduce the discomfort of the venipuncture
• If the patient moves during the venipuncture procedure, the needle will "tear" the vein and muscle,
causing pain and damage to the venipuncture site
• Additionally, if the patient moves during phlebotomy, the phlebotomist could miss the venipuncture
site and fail to collect the blood specimen.
 TIPS

Palpating the antecubital area will help you determine the size,
depth,and direction of the vein. Palpate the vein using the tip of the
index finger. Select a vein that is large and does not roll from side
to side or move easily.
The larger the vein, the better for blood collection. It is common to
feel for the bulge of the vein, but try feeling for the alley instead of
the bulge. Try closing your eyes if you have trouble feeling a vein.
Closing your eyes will enhance your sense of touch.
An appropriate vein for venipuncture will bounce
and have resilience to it. A vein that exhibits
sclerosis, or feels hard and cordlike (i.e., lacks
resilience), should be avoided.
A vein that feels hard tends to roll easily and
should not be used for a venipuncture.
THANK YOU!