Videos
Venepuncture and phlebotomy: animated demonstration
How to take a venous blood sample from the antecubital fossa using a vacuum needle.
Equipment needed
Non-sterile gloves
Tourniquet (ideally disposable)
Alcohol wipe
Cotton wool/gauze swabs
Vacutainer barrel, or syringe
Green 21-gauge or blue 23-gauge needle, or vacutainer needle
Sample bottles including blood culture specimen bottles if required
Sticky tape
Sharps container.
Consent and patient identification
You should discuss the reason for and nature of the procedure with the patient and obtain verbal consent.[59]
Confirm the patient’s identity before taking the blood samples by asking "What is your name?" and "What is your date of birth?" Cross check this information with the patient's wristband and the blood test request.[59]
Most laboratories need handwritten labels and forms for blood bank requests like group and save or cross match. However, where electronic test requesting and form and sample labeling is available, the approved processes should be followed. Always label the tubes while in the presence of the patient.[59] This should be one uninterrupted event at the patient's side.
Contraindications
If the lucid and coherent patient refuses blood tests, do not perform venepuncture.
Other contraindications to venepuncture include:
Ipsilateral arteriovenous fistula or arteriovenous malformation
Ipsilateral axillary surgery or radiotherapy
Ipsilateral lymphoedema
Local infection or cellulitis
Severe bleeding tendency or coagulopathy.
Indications
In general, you can use blood tests to:
Diagnose conditions (together with the clinical history and exam findings)
Monitor responses to therapy and adverse effects with treatment
Monitor patients in the perioperative period
Screen for diseases
Monitor for recurrence of disease.
Complications
Temporary pain and discomfort
Bruising, bleeding, and formation of a hematoma
Local infection
Arterial puncture
Failure to obtain an adequate sample
Incorrect labeling of samples.
Aftercare
Press on the puncture site for a sufficient amount of time to stop bleeding. Apply a sticking plaster or cotton wool and tape to the puncture site.
Carefully label all samples and request forms and dispose of all sharps and other items in a sharps bin or clinical waste bin. Always label the tubes while in the presence of the patient.[59] This should be one uninterrupted event at the patient's side.