Venepuncture

Equipment
  • Gloves
  • Hand sanitiser
  • Alcohol wipe
  • Tourniquet
  • Cotton wool/ gauze
  • Needle
  • Syringe or vacutainer
  • Blood bottles
  • Specimen bag
  • Plaster or micropore tape
  • Access to a sharps bin
Procedure
  1. Introductions, consent, handwashing, check patient ID
  2. Apply tourniquet
  3. Locate vein (try to feel rather than look)
  4. Wipe the area with an alcohol swab and allow to dry
  5. Anchor the vein distally
  6. Insert needle until flash noted
  7. Attach bottles and fill, ensure you invert the bottle once filled to ensure adequate mixing
  8. Loosen the tourniquet and remove the needle, applying pressure over the puncture site with cotton wool/ gauze
  9. Apply plaster or tape
  10. Label the bottles at the bedside and check patient wrist band!
Tips
  • If you’re struggling, ask the patient where they normally have them taken from.
  • Kneel or sit down.
  • Drop the arm from the side of the bed—gravity is your friend!
  • Be patient!
  • Don’t forget that you shouldn’t take blood from a patient where they’ve had breast surgery with lymph node clearance
Blood Cultures

Very similar to basic venepuncture, however it is imperative that you maintain an aseptic non-touch technique in order to not contaminate the sample and lead to a false result! This could lead to patients being erroneously treated or lead to the hospital getting fined.
Things to remember:

  • Remove the cap off the top of each bottle and wipe with an alcohol swab allowing to dry. You will need 3 swabs in total (one each for the bottles, one for the patient).
  • You must wear gloves.
  • Each bottle needs at least 10 ml of blood added
  • You must fill the aerobic bottle first (think about it the needle/ butterfly have air inside therefore use the aerobic bottle first!)
  • Most blood culture bottles have a sticker on the side with a unique number, either make a note of this number or put the stickers in the patient notes so that they can be tracked if needed.
  • Always document that you took the cultures with aseptic technique (or if this was not possible, why not) and the site
    • If a patient has a central line, take cultures peripherally and centrally
Bloods from central lines

Always check your hospital policy about using central lines (including PICC) to take blood samples as not all trusts accept this or may advise different methods. If in doubt, the nursing staff may be able to advise you as they have a breadth of experience!

  1. Introductions, consent, hand washing, check ID.
  2. Choose a port (without any infusions or if possible stop the infusion then take the blood sample >130 mins after this). Clamp the tube.
  3. Put on gloves
  4. If a neck line, ensure the patient’s head is turned away
  5. Clean port with an alcohol swab for 15 seconds & allow to dry
  6. Attach the syringe to the port and unclamp the tube. Withdraw 5-10 ml of blood & clamp tube.
  7. Remove the syringe and discard this blood.
  8. Attach a new syringe, release clamp, and withdraw the volume of blood needed for the blood sample, then clamp catheter. You can use a vacutainer at this point if you have compatible equipment
  9. Attach a 10 ml 0.9% sodium chloride filled syringe. Release the clamp & flush with normal saline before re-clamping. Some trusts advise heparin flushes.
  10. Give it another clean with an alcohol wipe and allow to dry.
  11. Always re-attach any infusions you have stopped! Again, if in doubt ask the nurses to show you!
Further Reading

Written By Zana Martin (FY2)

How useful was this post?

Click on a star to rate it!

Average rating 3.9 / 5. Vote count: 11

No votes so far! Be the first to rate this post.

As you found this post useful...

Follow us on social media!

We are sorry that this post was not useful for you!

Let us improve this post!

Tell us how we can improve this post?

Related Posts

Suturing
Suturing
Sutures are placed to aid with wound healing following a traumatic...
Urine Catheter
Urinary Catheterisation
In this article, we discuss when a catheter might be needed and...
FY1
Preparing for FY1
It is common for FY1s to feel anxious & feel like they’re...

Leave a Comment

Your email address will not be published. Required fields are marked *

Follow us

Favourites

Newsletter

Trending Now

Understanding the MSRA
The Multiple Specialty Recruitment Assessment (MSRA) is a computer-based exam increasingly being used...
Doctor's Pay Calculator 2023
We’ve created a pay calculator to help you better understand your salary, how much tax you’ll...
Paracetamol Overdose
Paracetamol overdose is a common presentation in A&E and so you may often find yourself looking after...
Passing the Prescribing Safety Assessment (PSA)
The PSA is aimed at final year medical students and those graduating overseas to assess their competency...
How to take a psychiatric history
Psychiatry, as a specialty is unique in that diagnostic methods, rely very heavily on symptomatology,...
Common Viral Infections (exanthem) in Paediatrics
Viral infections are extremely common in paediatrics and a common presentation to paediatric A&E...
Audits & Quality Improvement Projects (QIPs)
Audits & QIPs are a way to identify issues, drive changes and assess the effects they have. It is...

Sign up for our awesome resources

Join over 25,000 users who have signed up for our free weekly webinars, referral cheat sheet & other amazing content!