OUR LADY OF FATIMA UNIVERSITY
College of Medical Laboratory Science
VENIPUNCTURE
Prepared by:
Lalaine P. Cezar, RMT
VENIPUNCTURE / PHLEBOTOMY
– use of a needle to puncture a vein and collect blood
P atient preparation
A ssemble Supplies and Equipment
V enipuncture
S pecimen preparation
Patient Preparation
• Prepare test request form
• Greet the patient and identify by having them state their full
name and birthday
• Verify any dietary restrictions (fasting or non fasting)
• Check for latex sensitivity
• Verify any blood thinner intake
Assemble Supplies and Equipment
• Collection tubes with proper additives
• Syringe, needles and needle holders
• Tourniquet
• Micropore
• Cotton
• Alcohol
• Marker
Assemble Supplies and Equipment
Order of draw for Venipuncture Parts of a Syringe and Needle
Venipuncture
Vein for Routine Venipuncture
1. Median Cubital Vein
2. Basilic Vein
3. Cephalic Vein
Note: AVOID COLLECTING BLOOD
FROM ARTERIES
Venipuncture
1. Evacuated Tube System – CLOSED SYSTEM; needles screw into a plastic needle holder
and are double pointed. Has rubber sleeve that prevent blood from dripping into the holder
when changing tubes. Used for multiple blood draw.
2. Winged Blood Collection Set (Butterfly) – has tubing that can be connected to a needle
holder. Used in children or hard to extract patients.
3. Syringe – useful in drawing blood from pediatric, geriatric or patients with fragile or rolling
veins because the phlebotomists controls the pressure by pulling the plunger.
Venipuncture
1. POSITION YOUR PATIENT – laying down for kids and sitting position for adults
2. APPLY TOURNIQUET – 3 to 4 inches above the venipuncture site, ensure the tourniquet is on for
no longer than 1 minute
3. SELECT APPROPRIATE VENIPUNCTURE SITE – give priority to median cubital vein
4. PALPATE VEIN – use the tip of the middle or index finger
5. APPLY 70% ALCOHOL – circular motion from inside to outside, allow skin to air dry
6. PERFORM VENIPUNCTURE – anchor the vein 1-2 inches below the puncture site.
Insert the needle bevel up with < 30 (15-30) degrees angle between the needle and the skin.
Remove tourniquet as soon as blood flow is established and no longer than 1 minute.
7. REMOVE NEEDLE AND PLACE GAUZE LIGHTLY WITHOUT PRESSING DOWN
8. APPLY PRESSURE FOR 1 TO 2 MINUTES
9. TRANSFER THE SPECIMEN AND LABEL BLOOD COLLECTION TUBES
Venipuncture
Venipuncture
Failure to Draw Blood
• Reposition needle
• Insertion of new vacuum tube
Note: after 2 unsuccessful attempts, CLSI recommends that
phlebotomist seek the assistance of another practitioner with
blood collection expertise
Venipuncture
Venipuncture in Special Situations
• Burned, Damaged, Scarred, and Occluded Veins – avoided because they
do not allow the blood to flow freely
• Intravenous Therapy – draw the blood from the opposite arm without
the IV. Stop the infusion for 2 minutes before the specimen is drawn
• Mastectomy patients – requires physician consultation prior blood
collection
• Dialysis patients with fistula – draw the blood from the opposite arm
without the fistula
Specimen Preparation
• Label the tube with the correct patient information
a. Patient’s full name
b. Birthday
c. Age
d. Gender
e. Date of collection
f. Time of collection
g. Collector’s initials or code number
• Compare the labeled tube with the patient’s identification bracelet
• Compare the label with the name and patient information on the test request form
CAPILLARY PUNCTURE
• Technique of choice to obtain small amounts of blood
• Used in newborns, pediatric patients or adults with severe burn,
extremely obese or elderly patients with fragile veins.
MATERIALS USED:
1. Puncture devices / lancets
2. Microcollection tubes
CAPILLARY PUNCTURE
FINGER PRICK
Suggested site: Middle or ring finger, puncture across fingerprints
1. Warm the site for 3-5 mins to increase blood flow
2. Cleanse the fingertip with alcohol and cotton
3. Using a sterile lancet, puncture the fingertip in the fleshy
part of the finger, slightly to the side of the center.
4. Wipe away the first drop of blood
5. Collect drops of blood into microcollection tubes
6. After collection, apply pressure with clean gauze to stop
bleeding
7. Label the specimen tubes
CAPILLARY PUNCTURE
HEEL STICK
Suggested site: Plantar surface of the heel
1. Warm the site to increase blood flow
2. Cleanse the heel with alcohol and cotton
3. Using a sterile lancet, puncture the most medial or lateral portion of
the plantar surface of the heel. Puncture no deeper than 2.4mm
(approximately 0.1 inches)
4. Previous puncture sites should be avoided. Avoid bruising the infant’s
heel when obtaining blood
5. Wipe away the first drop of blood
6. Collect drops of blood into microcollection tubes
7. After collection, apply pressure with clean gauze to stop bleeding
8. Label the specimen tubes
THANK
YOU!
Reference: Rodak’s Hematology Clinical Principles and Applications, Fifth Edition
