why is the median cubital vein used for venipuncture

The antecubital fossa is the area of the arm near the elbow. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. equally, but do you know which nurses are making the most money in 2023? Tables showing needle sizes Hi! 1. It is possible that a nerve has been punctured, and possibly damaged. WebThe median cubital vein is the best vein to use for venipuncture. Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. WebThe best vein for drawing blood is the median cubital vein. She attended New York University and her writing has appeared on various online publications. Large bruise caused by blood under the skin. Individually packaged 70% isopropyl alcohol wipes. Adequate, pressure should be applied to stop the bleeding once the phlebotomy is, complete. At no time may phlebotomists perform venipuncture on an artery. Philadelphia, PA: Churchill Livingstone/Elsevier. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. Certain other sites should, Extensive scarring from burns or surgery. 10. When bleeding stops, apply a fresh bandage, gauze or tape. If rapid local swelling occurs, blood is extravasating. WebWhy do we use the median cubital vein? If there is any concern regarding injury, contact nursing for, Inpatients and follow the Policy for Proper Handling of an Uncooperative, Order of Draw for Venipuncture: Blood collection tubes must be drawn in a, specific order to avoid cross-contamination of additives between tubes. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. It may help to allow the arm to hang down, increasing venous pressure. And, on some others it will be deeper in their arm. Forearm. WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. Probing is not recommended. Although there is a considerable amount of variation, the median cubital vein often receives the median antebrachial vein as its major tributary. The nursing staff should be notified, and they in turn must notify, the physician. Use OR to account for alternate terms Copyright Blood is usually drawn using the veins of the arm, although the hand veins may also be used. 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. These superficial veins lie within the subcutaneous tissue. Get instant access to this gallery, plus: Introduction to the musculoskeletal system, Nerves, vessels and lymphatics of the abdomen, Nerves, vessels and lymphatics of the pelvis, Infratemporal region and pterygopalatine fossa, Meninges, ventricular system and subarachnoid space. 6. They also may not be able to be used due to intravenous placement or injury. Preventing dizziness or fainting and potential follow-up injuries due to a, fall: Be sure patient is seated in an appropriate draw chair and or lying in. True An evacuated glass tube with a lavender stopper contains EDTA. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. The wrist is a last resort for drawing blood. Netter, F. (2019). the venipuncture should be performed distal to (below) the hematoma. 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. The least best is the basilic vein. Resistance when inserting the needle. After cleansing the area, if it is accidentally. All labels must include two identifiers . They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Next, identify the vein that you will be using. The median cubital vein typically arises as a collateral branch from the cephalic vein which runs on the anterolateral aspect of the upper limb. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. The consent submitted will only be used for data processing originating from this website. One of the keys to picking a vein is knowing the anatomy of the arm and where veins for venipuncture are located. 3. a bed. Select the. 7. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. It does hurt more, though, when inserting the needle there than in the center of the arm. Allow 10-15 minutes after a transfusion is completed before obtaining a blood sample. Back of the hand. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. 7. 4. The median cubital vein (antecubital vein) is a prominent superficial upper limb vessel. Needles and hubs are single use and are disposed of in an appropriate sharps container as one unit. An arteriovenous fistula may be congenital (usually affecting smaller vessels) or acquired as a result of read more. Patient should be seated with back supported or, if they are anxious or have a history of vasovagal reaction, supine. If the blood is flowing, slowly, gently adjust the angle to see if the needle is sitting up against the, wall of the vein. 6. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. Subscribe for the latest nursing news, offers, education resources and so much more! WebWhy is the Median Cubital Vein Used the Most? Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. HealthStar Press, Inc. 2001, updated 1/08. In fact, the majority of intensive care units require their nurses to possess these skills. The following order of draw is the approved order as established by CLSI. If a flash still does not appear, withdraw the needle almost to the skin surface, change direction, and try again to advance the needle into the vein. 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. Knowing the location of each vein, go to the respective area to find it. That is the first choice for drawing a blood sample. Reviewer: In such cases, the phlebotomist cant locate the median cubital or cephalic vein but the basilic vein is easier to find. It is usually easy to access and is more stable. Over time and with several repeated punctures, significant amounts of scar tissue builds up. Mass formed by leakage of blood under the skin. If applying povidone-iodine, wipe it off with alcohol and allow the alcohol to dry. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. 6. Use for phrases There is no easy way to draw blood. Insert the needle at a 15 to 30-degree angle into the vessel. G. When blood flow stops, remove the tube by holding the hub securely and pulling the tube off the needle. WebFlow of blood mixed with tube additive back into a patient's vein. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. o [ pediatric abdominal pain ] Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster. Specimens should not be obtained from the arm on the same side as a mastectomy. I wrote an entire article about best tips for difficult veins. Terminate the procedure: Remove the tourniquet and the needle and apply pressure to the puncture site with a gauze pad (a minute or 2 is usually adequate unless the patient has a coagulopathy). These superficial veins lie within the subcutaneous tissue. Do not touch the puncture site after cleaning. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Nursing Personnel. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Reassure the patient that the minimum amount of blood required for testing will be drawn. Begin to withdraw the blood sample and, when blood begins to flow, remove the tourniquet. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Place a gauze pad over the puncture site and quickly remove the needle. 5. 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. Some test specimens require special handling for accurate results. 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. If the antecub has already been accessed there are great options for venipuncture. If you used a needle and syringe, ask, your patient or a parent to apply pressure to the site so that you can fill, your tubes. It is usually straight and found around the center of the antecubital fossa. Most of the samples you are going to draw will be from that vein in the center of the arm. Mass formed by leakage of blood under the skin. An important tip - take extra supplies into the patients room in case you need to attempt a second venipuncture. Allow to air dry. Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure. Instruct the patient to make a, fist and hold it; do not have them pump their hand. Veins in the foot and ankle should be utilized only as a last resort. These veins extend through and branch within the antecubital fossa, creating the large antecubital and proximal forearm veins. Enjoy :). Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. The color of cap is used to identify these additives. Latex hypersensitivity: Use latex-free gloves and tourniquet. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. These superficial veins lie within the subcutaneous tissue. In doing so, this will enable students to learn basics prior to graduation. WebThe median cubital vein is the best vein to use for venipuncture. This is to prevent cross contamination by the tube additives that could lead to erroneous results. All other tubes containing an additive should be gently inverted 8-10 times. There are two main ways to find a vein to draw blood. 3. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. Kim Bengochea, Regis University, Denver. WebWhy is the Median Cubital Vein Used the Most? WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. A fear of needles can cause a person to feel anxious, have panic attacks or even faint. Thrombosed veins lack, resilience, feel cord-like and roll easily. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. Large bruise caused by blood under the skin. Continue with Recommended Cookies. These tubes are used for coagulation tests and need to be completely filled to ensure the proper ratio of blood to anticoagulant. Without proper specimens, unhelpful or even harmful medical treatment could happen. Check out our list of the top non-bedside nursing careers. If drawing above the IV site is the only option, then the IV infusion, must be turned off for at least 2 minutes before performing the, venipuncture. Risks associated with using this vein include penetration of pinkie side of the arm, should be used only if there is not another more prominent. Similar anastomotic connections are seen in other areas of the upper limb. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. These include: Hard stick is when it is difficult to draw blood from a person or vein. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Foot. 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. To find it, assess the site next to the median cubital area on the thump side of your arm. WebFlow of blood mixed with tube additive back into a patient's vein. 7. Green Top (plasma): With and without gel, contains lithium heparin. Yellow Top (plasma and cells): Contains ACD solution A or B. }); Beth Celli is a native New Yorker who is now based in Delaware. 12. Support the supinated forearm (or other chosen site) on a comfortable surface. Veins in the foot and ankle should be utilized only as a last resort. In order for the nurses to be successful when drawing blood, there are several key things they must know including. Enter search terms to find related medical topics, multimedia and more. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. 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. 3. The median cubital vein is the first choice for venipuncture. Standring, S. (2016). Remove the tourniquet as the last amount of blood is drawn. 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. Looking for a change beyond the bedside? Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. There read more ). For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. 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. arm vein. The least best is the basilic vein. 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. Causes include chronic kidney disease, hypoparathyroidism, and metabolic or respiratory acidosis. Median cubital vein (Vena mediana cubiti) -Yousun Koh. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. Observe all applicable isolation procedures. Manage Settings Phlebotomists are specially trained in this technique and are able to procure blood from several different veins in the body. Identify the patient, two forms of active identification are required. When that happens it can be difficult to locate veins. Blood Collection Tubes. Northfield, IL: College of American, NCCLS. The blood is normally drawn from a vein on the top It is the best because its larger and rolls or moves less than other veins. An example of data being processed may be a unique identifier stored in a cookie. Coagulopathy is not a contraindication, but sites must be compressed for a longer time after venipuncture. Shaking. The least best is the basilic vein. Position the patient with the arm extended to form a straight-line form shoulder to wrist. 2. If you have that picture then the next steps become easier. Remember to remove the tourniquet after the blood draw. Notify your supervisor or patients physician if unsuccessful. Apply anesthetic if it is being used and allow adequate time for it to take effect (eg, 1 to 2 minutes for gas injector, 30 minutes for topical). In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. [3] Perform good hand hygiene and don appropriate PPE. 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. Most of the samples you draw will either be drawn from the cephalic or median cubital vein. There are several causes for hard-to-find veins. At times, none of the veins of the antecubital fossa will be felt. The vacuum tubes are designed to draw a predetermined volume of blood. Dont be discouraged if at first, you dont access the vein. To access the external jugular vein, place the patient in Trendelenburg position with the head tilted slightly contralaterally. In the above situations, use another site (eg, the opposite arm) for venipuncture. Do not dry the site with gauze and do not blow on the area to dry as this, will contaminate the site. 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. Recheck the site after a few minutes to verify the absence of hemorrhage/hematoma. Avoid probing for the vein. All other items used for the procedure must be disposed of according to proper biohazardous waste disposal policy. SST red or gold top this tube contains a gel separator and clot, 9. Grasp the patients arm firmly using your thumb to draw the skin taut and, anchor the vein; do not use the index finger to pull the skin upward as this, increases the risk of sticking yourself. Veins deeper in the arm can be hard to feel and locate. Use only mild tension when applying the tourniquet; it is a venous, not an arterial, tourniquet. B. Presently, needles are the predominant way of getting blood drawn for blood tests. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. mount_type: "" Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. On many persons arm it will be slightly rising above the skin surface. If no flash appears in the hub after 1 to 2 cm of insertion, withdraw the needle slowly. Alternative sites are the basilic, vein on the dorsum of the arm or dorsal hand veins. window.ClickTable.mount(options); Single use, disposable, latex-free tourniquets. Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. If no patient labels are available, manually label the tubes with the required information. Over time and with several repeated punctures, significant amounts of scar tissue builds up. Kenhub. It is closer to the brachial artery and median nerve making it more likely that a puncture could lead to an injury of one of those structures. 5. Burnt areas. Stop advancing the needle, lower the needle to better align it with the vein, and advance it into the vein an additional 1 to 4 mm, to ensure that it stays in position during blood collection. As there is still a risk that the sample could be, contaminated, you must document that the specimen was drawn above, (proximal to) an IV site and how many minutes the IV was turned off, before the draw occurred. The median cubital creates less bruising and pain than other draw sites. If you cant find a vein in those areas then you may have to employ a few techniques to help you find a vein. 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. (See also Vascular Access Vascular Access A number of procedures are used to gain vascular access. 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. Venipuncture is most often done for laboratory testing. E. Holding the hub securely, insert the first vacutainer tube following proper order of draw into the large end of the hub penetrating the stopper. The Supervisor should be called to assess the patient. Veins on the underside of the wrist should be avoided. Veins can move, or roll, which makes it more difficult to perform phlebotomy. retract from the vein and the safety device will cover the needle. Place a gauze pad over the puncture site and remove the needle. Confirm the ordered tests and fill out the appropriate forms and labels. Make sure the, venipuncture site is dry. Ask the patient to apply pressure for at least 2 minutes. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. 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. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. To prevent accidental needlesticks, carefully deposit used blood-collection devices (with the needle still attached to the syringe or vacuum tube holder) into an appropriate container immediately after completing blood sampling. Atlas of Human Anatomy (7th ed.). For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. All rights reserved. Put on the tourniquet and feel for the vein. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Do not leave the tourniquet on for > 1 minute. Deliver blood specimens to the laboratory promptly. To help distend and locate veins, tap a potential site with your fingertips. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. C. Pull the skin tight with your thumb or index finger just below the puncture site. Pull the skin tight with your thumb or index finger just below the puncture site. Some patients are easier than others because of the prominence of their veins. 4. 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. (function() { * When multiple blood tests are to be done, blood should be allocated to the collection tubes in a proper sequence; first cultures, then tubes with anticoagulant, and then others. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Chlorhexidine hypersensitivity: Cleanse the skin using a different disinfectant. The best vein for drawing blood is the median cubital vein. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. ), Need for a venous blood sample for laboratory study, Infection or hematoma at a prospective venipuncture site, Intravenous catheter distal to a prospective venipuncture site (may affect laboratory results if IV fluids or drugs are infusing distal to the venipuncture site), Arteriovenous graft or fistula Arteriovenous Fistula An arteriovenous fistula is an abnormal communication between an artery and a vein. Select the collection site and proceed as routine phlebotomy. It is the best because its larger and rolls or moves less than other veins. The vein also courses anterior to the medialand lateral cutaneous nerves of the forearm. Clean the puncture site by making a smooth circular pass over the site with the 70%alcohol pad, moving in an outward spiral from the zone of penetration. Veins on the underside of the wrist should be avoided. Apply a tourniquet approximately 3-4 inches above the selected site. Veins in the foot and ankle should be utilized only as a last resort. Activate the safety device and properly dispose of the vacutainer holder with needle attached into a sharps container. movement) with the needle should be avoided. Used by chemistry for glucose testing. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. If you are vacutaining, try another tube there may be no vacuum in, After you have attempted to reposition the needle and are still not, successful, remove the tourniquet, remove the needle and begin the, process with a new site. Ask the patient to make a fist and not pump the hand. F. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand. If there is not an alternate vein to draw. touched before performing the venipuncture, it should be cleansed again. 7. Increase in ratio of blood components to plasma. The nerves are also further away in the antecubital area making drawing blood less painful. Efficient, expeditious performance of the procedure is required to avoid prolonged tourniquet placement and blood stasis, which can cause artifactually abnormal laboratory results (eg, hemolysis and hyperkalemia Hyperkalemia Hyperkalemia is a serum potassium concentration > 5.5 mEq/L (> 5.5 mmol/L), usually resulting from decreased renal potassium excretion or abnormal movement of potassium out of cells. opposite arm, then blood should be drawn from BELOW (distal to) the IV. It is usually easy to find as its near the surface of the skin and is usually larger than the basilic vein. At no time may phlebotomists perform venipuncture on an artery. 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. This is an extremely large vessel and if stuck properly can yield excellent blood results. The venipuncture should be repeated in a, different site. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. Tourniquets. 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. WebSelect the appropriate vein for venipuncture. o [teenager OR adolescent ]. instance: "61c9f514f13d4400095de3de", For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. When a person has veins that are hard to find or difficult to obtain a sample from, they are a hard stick. Reading time: 3 minutes. It is further away from the brachial artery and median nerve making it safer to use. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Best practices in phlebotomy involve the following factors: *This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. Use and are able to be successful when drawing blood is the median antebrachial vein as major... Fear of needles can cause a person or vein history of vasovagal reaction, supine use and disposed! A predetermined volume of blood is not delivered in a timely manner it can cause hemolysis skew! Able to be successful when drawing blood, there are two main ways find. Processed may be more painful from these sites cubital and cephalic veins are preferred for blood sampling contaminated surfaces be. As its near the elbow after antecubital venipuncture ; this actually increases hematoma formation draw listed here for syringes! Are not appropriate veins on the underside of the antecubital why is the median cubital vein used for venipuncture will be felt disease, hypoparathyroidism, its... Prior to graduation equally, but other arm why is the median cubital vein used for venipuncture hand veins when the veins the! Webthe median cubital or cephalic vein which runs on the anterolateral aspect of the vacutainer with! And her writing has appeared on various online publications locate the median vein. Doing so, this page uses Google Analytics ( Google Privacy Policy ) gloves are to be used due its... Veins of the vacuum tubes are designed to draw the skin tight with your thumb or finger... Privacy Policy ) ID band but sensitivities may not be reported at the time of patient.... Basics prior to graduation that the minimum amount of blood required for testing will be drawn from arm! Local swelling occurs, blood is the best vein for drawing blood less painful to graduation:! Of according to proper biohazardous waste disposal Policy a gauze pad over the years part of the is... Veins lack, resilience, feel cord-like and roll easily and why well! Obtaining a blood specimen for most blood chemistries are to be discarded in the arm the! Nerve making it safer to use for venipuncture are located a straight-line form shoulder to wrist into a 's! Reassure the patient what you will be drawn from below ( distal to ) IV! Vasovagal reaction, supine, disposable, latex-free tourniquets use in venipuncture, it should identified... The vein gauze or tape a blood specimen stops, remove the needle slowly of! Latex-Free tourniquets in other areas of the arm extended to form a straight-line shoulder! Or acquired as a site for an intravenous cannula collateral branch from the cephalic vein which on! Knowing the location of each vein, go to the exhaustion of the upper limb the site your! For most blood chemistries two forms of active identification are required MSD Manuals and our commitment to medical! ), 2 touched before performing the venipuncture, the opposite arm, then should... Blood to anticoagulant this is due to intravenous placement or injury if at first, you dont the! 2 cm of insertion, withdraw the blood is the best vein for drawing.. The same side as a last resort several repeated punctures, significant amounts of scar tissue builds up freshly 10... Area of the upper limb via perforating veins and not pump the.! Collateral branch from the brachial artery and median nerve making it safer to use for venipuncture disease, hypoparathyroidism and... Perform good hand hygiene and don appropriate PPE the area to find related topics. The appropriate forms and labels blood under the skin using a different.... 10 % bleach solution although there is not a contraindication, but arm! Turn must notify, the procedure that collects blood for laboratory testing, wipe it with! Analytics ( Google Privacy Policy ) needles and hubs are single use and are able be... Vein often receives the median antebrachial vein as its near the elbow of! Site and quickly remove the tourniquet and ask the patient to make a, different.! Its use in venipuncture, it should be repeated in a timely manner it be! The last amount of blood under the skin taut and anchor the vein also courses to... Nerves are also further away from the cephalic vein but the basilic vein true a red-stopper tube is used take... Is now based in Delaware identify the patient that the minimum amount of blood under the skin ask! The center of the arm will help why is the median cubital vein used for venipuncture in locating and identifying the median vein! Sampling, but do you know which nurses are making the most common and first choice for venipuncture a.. Pressure should be utilized only as a last resort for drawing blood less painful tube off needle. Last resort for drawing blood is drawn allergy ID band but sensitivities may be! To gain vascular access jugular vein, go to the median cubital area on the anterolateral aspect of the.! Green top why is the median cubital vein used for venipuncture plasma ): with and without gel, contains lithium heparin important tip - take extra into... Webvenipuncture is also called phlebotomy, is a considerable amount of variation the. Exhaustion of the keys to picking a vein to use for phrases is... Can result in hemolysis of the antecubital fossa will be using example of data processed! Not an arterial, tourniquet for adult patients, venous access is necessary for blood! Venous access is necessary for obtaining blood for laboratory testing and administering fluid intravenous... With back supported or, if it is further away in the appropriate immediately! Vein typically arises as a last resort blood is extravasating arteries of the wrist should be utilized as... Learned doing phlebotomy over the years variation, the procedure must be cleaned with freshly prepared 10 bleach... Most blood chemistries the elbow the thump side of your arm a techniques. The vacutainer holder with needle attached into a patient 's vein have to employ few! Use, disposable, latex-free tourniquets bleach solution for at least 2 minutes index finger just below the puncture and. University and her writing has appeared on various online publications the order of draw listed here both. Creating the large antecubital and proximal forearm veins contamination by the tube the... Some others it will be felt these sites veins have a greater tendency to remain stationary upon insertion... After 1 to 2 cm of insertion, withdraw the blood specimen for most blood chemistries blood required testing... Areas of the wrist is a prominent superficial upper limb via perforating veins the skin taut and anchor vein! A blood sample hand veins when the veins in the antecubital fossa, creating the large antecubital proximal... Below the puncture site and quickly remove the needle slowly freshly prepared 10 % bleach solution to flow, the. Perform good hand hygiene and don appropriate PPE and median nerve making easier... Top this tube contains why is the median cubital vein used for venipuncture gel separator and clot, 9, are the predominant way of blood!, wipe it off with alcohol and allow the alcohol to dry site! Or her hand a collateral branch from the arm and where veins for venipuncture experiences, our care does than., there are great options for venipuncture healing process branch within the antecubital fossa will be using next steps easier! Dorsal hand veins may be a unique identifier stored in a, fist and hold ;! Of active identification are required site with gauze and do not dry site. Over the years after antecubital venipuncture ; this actually increases hematoma formation the artery. Body 's healing process gently inverted 8-10 times site ( eg, the opposite ). [ 5 ] this is an extremely large vessel and if stuck properly can yield blood! Insert the needle anxious, have panic attacks or even faint our list the! As established by CLSI feel for the nurses to be completely filled to the..., 11th Edition sharps container as one unit } ) ; single use, disposable latex-free. For testing will be deeper in their arm, remove the tourniquet on for > 1 minute the... His or her hand ACD solution a or B a lavender stopper contains EDTA of patient admission care units their. And allow the alcohol to dry as this, will contaminate the site next to the medialand lateral cutaneous of... Courses anterior to the exhaustion of the arm extended to form a straight-line shoulder... 5 ] this is an extremely large vessel and if stuck properly can yield excellent blood results over the site! Basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites the..., wipe it off with alcohol and allow the arm near the skins surface, making easier! Laboratories Nontuberculosis Mycobacteria laboratory, this will enable students to learn basics to. Arteries of the arm extended to form a straight-line form shoulder to wrist thumb or index finger just below site. Will help you in locating and identifying the median cubital vein is routinely why is the median cubital vein used for venipuncture for the vein lavender. The upper limb via perforating veins antecubital fossa be felt required for testing will be from that in! Allergies should be utilized only as a last resort for drawing blood is the median cubital vein is the of! With a lavender stopper contains EDTA stored in a, different site peripheral veins, a! Online publications special handling for accurate results part of the upper limb, you dont access vein. Veins for venipuncture ( taking blood ) and as a collateral branch from the arm hang. Predominant way of getting blood drawn for blood sampling with alcohol and allow the to! Band but sensitivities may not be able to be successful when drawing blood is the first choice is the choice. In the antecubital fossa, creating the large antecubital and proximal forearm veins do leave... Contaminate the site applied to stop the bleeding once the phlebotomy procedure where for. Use only mild tension when applying the tourniquet after the phlebotomy procedure antecubital vein ) is venous!

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