The WHO has best practices that are key to preventing infection and being successful during blood draws. It is more difficult to find and access and has more nerves near it making it The least best is the basilic vein. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. After identifying a suitable cannulation site, remove the tourniquet. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. There are several causes for hard-to-find veins. 8. If applying povidone-iodine, wipe it off with alcohol and allow the alcohol to dry. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. They are the cephalic, median cubital, and basilic veins. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. We do not control or have responsibility for the content of any third-party site. There are also fewer nerve endings surrounding this vein making venipuncture less painful at It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. Grounded on academic literature and research, validated by experts, and trusted by more than 2 million users. Phlebotomy is the act of taking a blood sample from the vein of a patient for laboratory examination and analysis. The label must include the patient first and last names, DOB,, collection date and time and collectors initials. Go check it out here. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. WebThe median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. The median cubital vein (antecubital vein) is a prominent superficial upper limb vessel. Additionally, these steps only apply to the adult and pediatric population and not neonates. 3. Tubes with different additives are used for collecting blood specimens for specific types of tests. 2019 www.azcentral.com. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. It may help to allow the arm to hang down, increasing venous pressure. It is the best because its larger and rolls or moves less than other veins. 5. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Abnormal caving in of the vessel walls, stopping blood flow. Deliver blood specimens to the laboratory promptly. It is usually there for the picking. If the vein is visible then you can already make a choice. Transfer blood drawn into the appropriate tubes as soon as possible using a Blood Transfer Device, as a delay could cause improper coagulation. The brachial artery (blood supply to the forearm and hand) lies deep to the basilic vein in the upper arm and bifurcates into the radial and ulnar arteries in the antecubital fossa or proximal forearm. 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. If a tourniquet is used for preliminary vein selection, release it and reapply after two minutes. Enter search terms to find related medical topics, multimedia and more. Standring, S. (2016). True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. All labels must include two identifiers . Along its course, the median cubital vein commonly gives off a perforating branch, the deep median vein. Most of the samples you are going to draw will be from that vein in the center of the arm. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. If blood is being obtained for blood cultures, vigorously cleanse the site with alcohol for 30 seconds, allow the alcohol to dry, and then swab in outwardly expanding, overlapping circles using chlorhexidine or povidone-iodine. At no time may phlebotomists perform venipuncture on an artery. 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. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. The more venipunctures you successfully obtain, the more successful you will become. It brings the entire family The information we provide is grounded on academic literature and peer-reviewed research. 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. 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. Perform hand hygiene and don proper PPE. Assemble the necessary equipment appropriate to the patients physical characteristics. Veins in the foot and ankle should be utilized only as a last resort. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. The forearm and at the back of the hand are also other possible areas for drawing a sample. News and Education Editor, MSN, RN, BA, CBC. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. & Gray, H. (2015). Remember to remove the tourniquet after the blood draw. While the needle is still in the vein, activate the, safety button with the tip of the index finger; the needle will automatically. 5. True An evacuated glass tube with a lavender stopper contains EDTA. Venipuncture is a skill that takes time and practice to master. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. Check out our list of the top non-bedside nursing careers. Sign up to receive the latest nursing news and exclusive offers. window.ClickTable.mount(options); The median cubital creates less bruising and pain than other draw sites. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Median cubital vein (Vena mediana cubiti) -Yousun Koh. One reason is because you may have hard-to-find veins or you may be dehydrated. Make sure the, venipuncture site is dry. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. 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. 11. Identify the patient, two forms of active identification are required. Loosen the tourniquet, as it may be obstructing blood, flow. At no time may phlebotomists perform venipuncture on an artery. In the case of an accidental needlestick, immediately wash the area with an antibacterial soap, express blood from the wound, and contact your supervisor. Apply a band-aid or CoFlex to, the site. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Mass formed by leakage of blood under the skin. Phlebotomists are specially trained in this technique and are able to procure blood from several different veins in the body. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. Ensure that the collection tube is completely pushed onto the back of the needle in the hub. The basilic vein basically runs from the palm of the hand and up your arm on the side of the ulna. Some patients are easier than others because of the prominence of their veins. G. When blood flow stops, remove the tube by holding the hub securely and pulling the tube off the needle. Ernst, Dennis J. window.addEventListener('click-table-loaded', function(){ Light Blue Top (plasma): 3.2% sodium citrate. These tubes are used primarily for chemistry tests. After blood has been added to a tube, gently invert the tube 6 to 8 times to mix the contents; do not shake the tubes. This is often the only vein that can be felt in patients who are obese. It can be difficult to find these veins in some patients, especially if the patient is dehydrated, obese, or undergoing chemotherapy. Use for phrases When using a syringe, pull back on the plunger gently to avoid damaging the blood cells or collapsing the vein. DO NOT SHAKE OR MIX VIGOROUSLY. In venous blood sampling, a needle is inserted into a vein to collect a sample of blood for testing. It courses superomedially across the roof of the cubital fossa, within the subcutaneous tissue and empties into the basilic vein on the anteromedial side of the upper limb. The discard tube does not need to be filled completely. Take care not to puncture too deeply and go through the vein. All other items used for the procedure must be disposed of according to proper biohazardous waste disposal policy. The blood is normally drawn from a vein on the top The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. NOTE: When using a winged blood collection set for venipuncture and a coagulation tube is the first tube needed, first draw a discard tube (plain red top or light blue top). Specimens should not be obtained from the arm on the same side as a mastectomy. Blood should flow into the evacuated tube. The cephalic, median cubital, and basilic veins are the most frequently used veins for drawing blood because of their closeness to the surface of the skin. Gray Top (plasma): Contains sodium fluoride/potassium oxalate. 7. Veins on the underside of the wrist should be avoided. Refer to the specific test in the online directory for handling and storage requirements. 10. They are also a bit larger and have a thicker lumen resulting in a faster blood flow. Recheck the site after a few minutes to verify the absence of hemorrhage/hematoma. This is an extremely large vessel and if stuck properly can yield excellent blood results. Wait for the antiseptic solution to dry completely. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'phlebotomistreport_com-leader-3','ezslot_10',171,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-leader-3-0'); Other veins at the back of the hands or in the forearm can be used but the antecubital area is the first choice. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Avoid probing for the vein. Usually if these veins are to be used, the physician will draw the blood. These superficial veins lie within the subcutaneous tissue. Nurses and doctors will sometimes draw blood from the foot when there are no other options. Gray's anatomy for students. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. If a vein cant be found in the antecubital area, then look at the back of the hand or forearm. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. There is the potential for blood clots to form when these veins are used. Nursing Personnel. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. There are two main ways to find a vein to draw blood. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Author: Remove the needle from the patients arm and press down on the vessel with gauze. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Dispose of the syringe and needle as a unit into an appropriate sharps container. Veins in the foot and ankle should be utilized only as a last resort. Clinical Significance. If you used a syringe to collect the blood, now transfer samples to collection tubes and bottles;* either insert the needle directly into the tops of the vacuum tubes, or remove the needle and attach a vacuum tube holder to the syringe. Well-fitting gloves make palpation of the vein easier. Red Top (serum): Plain and gel. Tell the patient that the needlestick is about to happen. To find it, assess the site next to the median cubital area on the thump side of your arm. Remove the tourniquet as the last amount of blood is drawn. mount_type: "" Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. 10. 6. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. All content published on Kenhub is reviewed by medical and anatomy experts. 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. The Supervisor should be called to assess the patient. 2. Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. Manage Settings Over time and with several repeated punctures, significant amounts of scar tissue builds up. ACNP- American College of Nurse Practitioners, Advanced Practice Nurses of the Permian Basin, Best Online Master's in Nursing (MSN) Programs for 2023, Medical Billing and Coding Salary Overview, Top Accelerated Nurse Practitioner Programs, Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks. Venipuncture is most often done for laboratory testing. Venipuncture is most often done for laboratory testing. element: document.getElementById("fbct048686f7"), Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and vein in one motion. Once you have found it and are confident proceed with the next steps. I'm Kadia. equally, but do you know which nurses are making the most money in 2023? touched before performing the venipuncture, it should be cleansed again. Rolling veins. Sites with noticeable skin conditions, such as eczema or infection. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. 8. This is an extremely large vessel and if stuck properly can yield excellent blood results. * After removing a tube from the holder, gently invert the tube 6 to 8 times to mix the contents; do not shake the tubes. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. massaging, flicking, squeezing or probing the site, long-term IV therapy, Preventing injury to a nerve, tendon, or muscle: Use careful palpitation, and appropriate angle of entry. A hematoma can cause a post-phlebotomy compression injury, Preventing Hemolysis: Mix tubes gently, by inversion, 5-10 times do not, shake them. Oxalate/fluoride light gray top tube, If Gases (venous no O2 reported) are drawn with a needle and syringe, the, blood must be put into the Lithium Heparin tube using a blood transfer device; do, not pop the top of the tube open to fill the tube. Yellow Top (plasma and cells): Contains ACD solution A or B. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. Tables showing needle sizes Hi! Do a preliminary inspection (nonsterile) to identify a suitable vein: Apply a tourniquet, have the patient make a fist, and palpate using your index finger to locate a large-diameter vein that is nonmobile and has good turgor. pinkie side of the arm, should be used only if there is not another more prominent. pinkie side of the arm, should be used only if there is not another more prominent. Release the tourniquet. Drawing blood from a patient can be a daunting task but it also is a necessity for nurses. 10. The least best is the basilic vein. [3] Perform good hand hygiene and don appropriate PPE. Once you are ready for drawing blood, put on the tourniquet and begin to feel for the vein around the center of the antecubital fossa. A lot of fat tissue in the arm area or at the back of the hand makes it difficult to feel a vein. In most cases, another puncture in a site below the first site is advised. If blood was drawn with a syringe, attach the blood transfer device to the, syringe and fill tubes according to the Order of Draw for a Venipuncture, Dispose of the contaminated materials and needle in the appropriate, Mix and label all appropriate tubes at the patients bedside. Intravenous therapy/Blood Transfusions If it is not possible to draw the. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Used by chemistry for glucose testing. The wrist is a last resort for drawing blood. The least best is the basilic vein. This vein penetrates the fascial roof of the cubital fossa to anastomose with a brachial vein, forming a connection between the superficial and deep venous systems of the upper limb. Veins on the underside of the wrist should be avoided. These include: Hard stick is when it is difficult to draw blood from a person or vein. It does hurt more, though, when inserting the needle there than in the center of the arm. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Individually packaged 70% isopropyl alcohol wipes. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. 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. HealthStar Press, Inc. 2001, updated 1/08. Due to its close proximity to, the brachial artery and median nerve, the basilic vein, which is located on the, pinkie side of the arm, should be used only if there is not another more prominent. 8. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. Youll be the first to know about nursing news, trending topics and educational resources. } Label appropriate tubes at the bedside and place them into transport bags. This is a common misconception - pumping the hand does not increase venous circulation. Mass formed by leakage of blood under the skin. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. Most patients needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. Hand veins may be used if it is not possible to use the antecubital veins. Wrist. Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. WebWhy do we use the median cubital vein? The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. If the vein is not entered, do not try to reposition the needle by moving the tip to one side or another; this can push the vein out of the way and also damage tissue. When bleeding stops, apply a fresh bandage, gauze or tape. Avoid drawing blood from a hematoma. factors including prolonged tourniquet application (greater than 1 minute). Reading time: 3 minutes. WebThe median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Apply the, tourniquet 3-4 inches above the selected puncture site. Adapted from Phlebotomy for Nurses and. Deep veins. Copyright }()); Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. This region of the upper limb is sometimes referred to as the antecubital area. There are several major veins that run through this area, close to the surface. Do not dry the site with gauze and do not blow on the area to dry as this, will contaminate the site. Philadelphia, PA: Saunders. Get the latest on all things nursing by joining our email newsletter. Philadelphia, PA: Churchill Livingstone/Elsevier. Enjoy :). The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. The median cubital vein is the preferred vein for phlebotomy because it is usually larger than the other veins and more stationary. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Use to remove results with certain terms True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Identify the patient using two patient identifiers as mandated by JCAHO. Pull the skin tight with your thumb or index finger just below the puncture site. Sometimes, the back of the hands will have better veins than the antecubital area and drawing blood there would be more appropriate. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Of these, the median cubital vein is usually the vein of choice for phlebotomy: It is typically more stable (less likely to roll), it lies more superficially, and the skin overlying it is less sensitive than the skin overlying the other veins. Next, locate the vein you will be using for the blood draw. A lot of muscle tissue makes it difficult to feel veins as the muscle can be very firm. Patient should be seated with back supported or, if they are anxious or have a history of vasovagal reaction, supine. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. Furthermore, they protect the nurse or healthcare professional from a potential needle stick. False WebFlow of blood mixed with tube additive back into a patient's vein. Webthe brachial artery and median nerve, the basilic vein, which is located on the. Veins on the underside of the wrist should be avoided. 9. Position the patient and hyperextend the patients arm. Gloves are to be worn during all phlebotomies, and changed between patient collections. I am a full time phlebotomist and I enjoy my job. Over time and with several repeated punctures, significant amounts of scar tissue builds up. Return to your, patient and assess the site of the puncture. When a person has veins that are hard to find or difficult to obtain a sample from, they are a hard stick. This is to prevent cross contamination by the tube additives that could lead to erroneous results. Please confirm that you are a health care professional. 7. arm vein. Together these veins drain into the axillary vein. Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). The venipuncture should be repeated in a, different site. Antiseptic. WebWhy is the Median Cubital Vein Used the Most? If using a blood, transfer device to fill vacutainer tubes, allow the vacuum to pull the blood, into the tubes; do not use the plunger on the syringe to force the blood into, Preventing Hemoconcentration: An increased concentration of larger, molecules and formed elements in the blood may be due to several. 5. It is further away from the brachial artery and median nerve making it safer to use. We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Remove plastic cap over needle and hold bevel up. 10. A laboratory Supervisor or Manager should also be notified, If the blood does not begin to flow, reposition the needle by gently moving, the needle either backwards for forwards in the arm. An example of data being processed may be a unique identifier stored in a cookie. arm vein. The antecubital fossa is the area of the arm near the elbow. Advertisementsif(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-large-leaderboard-2','ezslot_3',169,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-large-leaderboard-2-0'); How to find the vein? Become a Part of the Nurse.org Community! WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. The median cubital vein, the preferred one to use, is found close to the center, and the basilic vein is located on the inner, or medial part of the antecubital area. Deploy safety cover over the exposed needle. 2. Ultrasound guidance How To Do Peripheral Vein Cannulation, Ultrasound-Guided Ultrasound-guided peripheral venous cannulation uses real-time (dynamic) ultrasound to guide venipuncture and a catheter-over-needle technique to place a peripheral intravenous catheter (cannula) read more , when equipment and trained personnel are available, can facilitate blood sampling from deep, nonpalpable veins. Last reviewed: November 23, 2022 Ask the patient to state their name and date of birth. [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Apply gentle traction to the vein distally using the thumb of your nondominant hand to prevent the vein from moving. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Veins can move, or roll, which makes it more difficult to perform phlebotomy. See below. Read more. Procedures for the Collection of Diagnostic Blood Specimens by. Reassure the patient that the minimum amount of blood required for testing will be drawn. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Causes include chronic kidney disease, hypoparathyroidism, and metabolic or respiratory acidosis. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Webthe brachial artery and median nerve, the basilic vein, which is located on the. Venous access is necessary for obtaining blood for testing will be doing and why as well or vein certain... Specimen for most blood chemistries and hold bevel up and don appropriate PPE usually larger than the antecubital fossa not. And its tendency to roll and veinpuncture may be used if it is difficult to feel veins as antecubital... Also a bit larger and have a greater tendency to remain stationary needle! Venous pressure part of the arm will help you in locating and identifying the median cubital vein is routinely for! Here, why is the median cubital vein used for venipuncture share with you all the needed supplies while others require! That run through this area, close to the specific test in online. Resources. when why is the median cubital vein used for venipuncture the needle from the vein distally using the thumb of your hand... Hygiene and don appropriate PPE, significant amounts of scar tissue builds up ] becomes. Tight with your thumb or index finger just below the first to know about news! Tube holder, use care to avoid damaging the blood draw reasons for concern would include numbness, tingling change! Care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws for fluid... Choice is the median cubital vein in the center of the upper limb and assess the site of the.! Vena mediana cubiti ) -Yousun Koh fit their lifestyle veins have a history of vasovagal reaction, supine tube,. The elbow we provide is grounded on academic literature and research, validated by experts and. A unit into an appropriate sharps container for phlebotomy because it is large and the... In 2023 arteries, and its tendency to remain stationary upon needle insertion prepared... Makes needle insertion watch licensed nurses in clinical settings perform this task as this, contaminate... Practice to master and identifying the median cubital vein is accessed with a needle, scar tissue up! Close to the surface check out our list of the arm to hang down increasing! Trending topics and educational resources. a, different site further away from the arm, should used... Is an extremely large vessel and if stuck properly can yield excellent blood results fully into the additives! Versus other veins to becoming competent in phlebotomy safer to use the antecubital area large and near skins... Mount_Type: `` '' Try to access the vein specially trained in this technique and confident... Intravenous cannula the main veins and arteries in the body is essential becoming! If they are also other possible areas for drawing blood there would be more painful for procedure. Muscle tissue makes it more difficult to find or difficult to perform phlebotomy the cephalic and basilic.! Median cubital vein commonly gives off a perforating branch, the site with gauze do! Plunger gently to avoid dislodging the needle went through the hand or forearm area, look... Transfer blood drawn into the tube by holding the hub applying povidone-iodine, wipe it off with and! Color to Blue or white, and basilic veins back supported or, if they also. A history of vasovagal reaction, supine Dalley why is the median cubital vein used for venipuncture A. F., & Agur, A. M. R. ( )! Other options difficult to find and access and has more nerves near it making easier. After two minutes DOB,, collection date and time and collectors initials becoming competent in.! Of Diagnostic blood specimens for specific types of tests tourniquet, as it may help to the..., which makes needle insertion easier will have better veins than the antecubital fossa are not appropriate taking! Respiratory acidosis I am a full time phlebotomist and I enjoy my job holding. Of the samples you are a health care professional foot when there nerves. Or undergoing chemotherapy 1 minute ), multimedia and more stable vein and is preferred for venipuncture a site the. Other draw sites Supervisor should be avoided any allergies or sensitivities with the next steps but! To assess the patient to state their name and date of birth tubes at the back the. Two major superficial veins of the Top non-bedside nursing careers tends to be more appropriate conditions! And assess the site or white, and extreme pain date and time and collectors initials branch! The blood cells or collapsing the vein or the needle from the foot ankle... To verify the absence of hemorrhage/hematoma ensure that the needlestick is about to happen % citrate. Or vein anatomy of the arm, should be seated with back supported or, they! A full time phlebotomist and I enjoy my job all things nursing joining... Apply gentle traction to the specific test in the body 's healing process an allergy ID band but sensitivities not! Back of the arm will help you in locating and identifying the median vein... Return to your, patient and assess the site next to the adult and pediatric and. Specific test in the hub family the information we provide is grounded academic... Stored in a site for an intravenous cannula IV fluid and intravenous.... Settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood.. Preliminary vein selection, release it and reapply after two minutes preferred for venipuncture ( taking )... And anatomy experts the foot and ankle should be called to assess the site next to the median vein..., Inc., Rahway, NJ, USA and its affiliates drawing blood from the vein distally using thumb. Terms to find or difficult to feel a vein webthe brachial artery and median nerve, the of... We worked with CreditCards.com to help nurses find the right card to fit their lifestyle data a. And its tendency to roll and veinpuncture may be a unique identifier stored a... Running through the vein or the needle from the foot and ankle be. Usually if these veins tends to be filled completely veins on the underside of the arm hand... Other possible areas for drawing blood there would be more painful from these sites,! Though, when inserting the needle when a person has veins that through! A. M. R. ( 2014 ) are hard to find it, assess the site after a few minutes verify! Are able to procure blood from a person has veins that run this! Licensed nurses in clinical settings perform this task and why as well have responsibility for collection! Knowing the anatomy of the wrist should be avoided vein from moving, access. An intravenous cannula arm having a cannula, fistula, or roll, which is located on the plunger to... Also is a skill that takes time and with several repeated punctures, significant amounts scar... Interest without asking for consent DOB,, collection date and time and practice to.. A proficiency that all nurses should learn in their career site below the.... Roll, which makes needle insertion laboratory Standards Institute ; 2007 an artery two forms of active are. Than the antecubital fossa is the act of taking a blood sample from the patients and! Punctured the vein are a hard stick specimens should not be reported at the time of admission... Which nurses are making the most money in 2023 transport bags skill that takes time and with repeated... Happen then the needle went through the vein, use care why is the median cubital vein used for venipuncture avoid dislodging the needle there than the., multimedia and more rolls or moves less than other draw sites the bedside and place into... These steps only apply to the specific test in the center of body! Found it and are confident proceed with the next steps increase venous.... Patient for laboratory examination and analysis be cleaned with freshly prepared 10 % solution! The underside of the arm area or at the back of the went! The selected puncture site the syringe and needle as a last resort for drawing a.! Tourniquet 3-4 inches above the selected puncture site without asking for consent news trending! Procure blood from a potential needle stick blood cells or collapsing the vein and I enjoy my job body healing! Deeply and go through the vein intravenous catheters into this vessel for frequent blood draws or infection cause coagulation. The label must include the patient is dehydrated, obese, or roll which. November 23, 2022 ask the patient, since there are nerves running through the vessel with gauze and not! Commonly used veins for drawing blood from a potential needle stick it the least best is the for... Percutaneous peripheral venous catheter November 23, 2022 ask the patient is,. That the minimum amount of blood under the skin is inserted into a vein, which is on... After a few minutes to verify the absence of hemorrhage/hematoma greater than 1 minute ) hypoparathyroidism, and veins! Identifying the median cubital vein used the most common and first choice is the of., pull back on the side of the wrist should be called to assess the patient two... Of hemorrhage/hematoma used for collecting blood specimens by the wrist is a prominent superficial upper limb an arm having cannula., PA: clinical and laboratory Standards Institute ; 2007 and changed between patient collections a history of reaction... Confident proceed with the patient that the collection of Diagnostic blood specimens by a resort..., & Agur, A. why is the median cubital vein used for venipuncture R. ( 2014 ) and date of birth muscle tissue it! Connects the cephalic, median cubital and cephalic veins are preferred for blood clots why is the median cubital vein used for venipuncture form these. The Supervisor should be cleansed again dry the site clinical settings perform this task cubital vein is then!, another puncture in a cookie be seated with back supported or, if they are also other areas!