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.[87]

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.[87]

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.[87] 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.[87] This should be one uninterrupted event at the patient's side.