Confirm the ordered tests and fill out the appropriate forms and labels. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. The basilic vein is kept as a last choice option. Wait for the antiseptic solution to dry completely. 5. 10. If blood is being obtained for blood cultures, vigorously cleanse the site with alcohol for 30 seconds, allow the alcohol to dry, and then swab in outwardly expanding, overlapping circles using chlorhexidine or povidone-iodine. Nursing Personnel. WebWhy is the Median Cubital Vein Used the Most? The Supervisor should be called to assess the patient. 5. This region of the upper limb is sometimes referred to as the antecubital area. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and vein in one motion. If the needle had initially passed completely through the vein, a flash may now appear as you withdraw the needle tip back into the lumen. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. This information must match the requisition. Use to remove results with certain terms It is more difficult to find and access and has more nerves near it making it Traction may not be necessary for larger veins of the forearm or antecubital fossa. Dehydration. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. There are two main ways to find a vein to draw blood. Veins on the underside of the wrist should be avoided. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. After cleansing the area, if it is accidentally. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. In such cases, the phlebotomist cant locate the median cubital or cephalic vein but the basilic vein is easier to find. Once you have found it, take care in anchoring the vein to prevent rolling when you insert the needle to draw blood. 8. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Causes the body to constrict its blood vessels making it difficult to find veins. Foot. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Tubbs, R. S., Shoja, M. M., Loukas, M., & Bergman, R. A. touched before performing the venipuncture, it should be cleansed again. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. At no time may phlebotomists perform venipuncture on an artery. This article will discuss the anatomy and function of the median cubital vein. Venipuncture is most often done for laboratory testing. Select the collection site and proceed as routine phlebotomy. Venipuncture is a skill that takes time and practice to master. link to 3 Types Of Needles Used For Venipuncture. If using a needle, and syringe, avoid drawing the plunger back too forcefully. She attended New York University and her writing has appeared on various online publications. 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. Read more. False Deep veins. Over time and with several repeated punctures, significant amounts of scar tissue builds up. 3. We and our partners use cookies to Store and/or access information on a device. It is the best because its larger and rolls or moves less than other veins. pinkie side of the arm, should be used only if there is not another more prominent. These include: Hard stick is when it is difficult to draw blood from a person or vein. If you are not able to find the median cubital or cephalic veins, then try the basilic vein. Verify that any diet or time restrictions have been met. Immediately apply slight pressure to the gauxe pad over the venipuncture site.. 12. The foot is also a last resort. 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. Gloves are to be worn during all phlebotomies, and changed between patient collections. Remove the tourniquet before removing the needle. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. Clinical Significance. Although there is a considerable amount of variation, the median cubital vein often receives the median antebrachial vein as its major tributary. Forearm. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. In order to draw blood for a blood test a needle has to be inserted into a vein. Transfer Device 6. Blood should flow into the evacuated tube. if (window.ClickTable) { Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. New technology is being developed, Below is a needle gauge chart showing the sizes of needles used for the Evacuated Tube System, Syringe Method, and the Butterfly Needle when performing venipuncture. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Do not have patients make a fist or let their arm hang down during the blood sampling, because these maneuvers may cause various erroneous laboratory values (eg, increased potassium, lactate, phosphate). That makes them more visible and easier to locate and feel for venipuncture. Without proper specimens, unhelpful or even harmful medical treatment could happen. How To Do Diagnostic Peritoneal Lavage (DPL), 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. The first place to look at is the antecubital fossa as it is the first choice for drawing blood. The median cubital vein is used the most for its accessibility. There is no easy way to draw blood. Mass formed by leakage of blood under the skin. WebThe best vein for drawing blood is the median cubital vein. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. It is the best because its larger and rolls or moves less than other veins. If an arterial puncture is suspected, as indicated by a bright red, quick, pulsing flow, with or without rapid development of a hematoma, the needle, should be removed immediately. Support the supinated forearm (or other chosen site) on a comfortable surface. An arteriovenous fistula may be congenital (usually affecting smaller vessels) or acquired as a result of read more. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. Procedures for the Collection of Diagnostic Blood Specimens by. Most patients needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. Red Top (serum): Plain and gel. Individuals taking chemotherapy. Transfer blood drawn into the appropriate tubes as soon as possible using a Blood Transfer Device, as a delay could cause improper coagulation. Do not have the patient bend his/her arm; this may cause the. Apply adequate pressure to the puncture site to stop the bleeding and, avoid formation of a hematoma. When using a syringe, pull back on the plunger gently to avoid damaging the blood cells or collapsing the vein. 2023 Most of the samples you are going to draw will be from that vein in the center of the arm. Hand veins may be used if it is not possible to use the antecubital veins. WebVenipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. pinkie side of the arm, should be used only if there is not another more prominent. Dimitrios Mytilinaios MD, PhD When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. arm vein. Vein rolls when inserting the needle. Prepare the patients arm using a Chlorhexadine wipe. 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. If there is not an alternate vein to draw. Adapted from Phlebotomy for Nurses and. Preventing of infection: Follow proper infection control policies. 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. Make sure the, venipuncture site is dry. 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. Remember to remove the tourniquet after the blood draw. Among the 3 main veins, it is probably the one closest to the elbow. (See also Vascular Access Vascular Access A number of procedures are used to gain vascular access. Kenhub. All rights reserved. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. At no time may phlebotomists perform venipuncture on an artery. All rights reserved. Use a vein-finder device if a suitable vein is not readily seen or palpated. 2. 3. o [ abdominal pain pediatric ] WebThe best vein for drawing blood is the median cubital vein. We've looked at programs nationwide and determined these are our top schools. Venipuncture; Approved StandardSixth Edition. Presently, needles are the predominant way of getting blood drawn for blood tests. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. Fragile/collapsed veins. 1. 12. Gray's Anatomy (41tst ed.). factors including prolonged tourniquet application (greater than 1 minute). The median cubital vein, the preferred one to use, is found close to the center, and the basilic vein is located on the inner, or medial part of the antecubital area. Extensive scarring or healed burn areas should be avoided. Clinically Oriented Anatomy (7th ed.). This is an extremely large vessel and if stuck properly can yield excellent blood results. 1. Some persons have good veins and others have veins that are difficult to find. Do not leave the tourniquet on for > 1 minute. They are the cephalic, median cubital, and basilic veins. Yellow Top (plasma and cells): Contains ACD solution A or B. The cephalic vein, which runs up the thump side of your inner arm is the second choice of the 3. Arteries pulsate, are, more elastic and have a thicker wall than a vein. The five places for drawing blood include: There are also a few more areas like the femoral vein for example where a doctor may draw blood when peripheral vein access is not possible. 3. While it is important to know the best veins to access its also important to know which areas to avoid. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. Reassure the patient that the minimum amount of blood required for testing will be drawn. Abnormal caving in of the vessel walls, stopping blood flow. All content published on Kenhub is reviewed by medical and anatomy experts. 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. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. Fear of needles. Do not attempt a venipuncture more than twice. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. (function() { A laboratory Supervisor or Manager should also be notified, If the blood does not begin to flow, reposition the needle by gently moving, the needle either backwards for forwards in the arm. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. The median cubital vein passes anterior to the bicipital aponeurosis, below which lie the brachial artery and median nerve. It has the tendency to roll sometimes so care must be taken to anchor it when inserting the needle. Most times it will be big and plump but the size will vary depending on each individual. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Na Citrate Coagulation tubes light blue top tube, 4. Clinical read more , or hyperuricemia) and also to avoid skin irritation. Veins in the foot and ankle should be utilized only as a last resort. Abnormal caving in of the vessel walls, stopping blood flow. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. Tables showing needle sizes Hi! There are also fewer nerve endings surrounding this vein making venipuncture less painful at A. Palpate with your gloved finger to locate the middle of the target vein. F. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand. Leg veins (eg, dorsal digital veins and the greater saphenous vein inferoanterior to the medial malleolus) or external jugular veins may be used if upper extremity veins are inaccessible. Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! While not commonly taught in nursing school programs, many recommend that nursing students take extra courses in how to take blood to hone this skill. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Do not dry the site with gauze and do not blow on the area to dry as this, will contaminate the site. Avoid probing for the vein. Observe universal (standard) safety precautions. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. 5. 6. The information we provide is grounded on academic literature and peer-reviewed research. together for emotional support and understanding across multiple locations to reach you in the community where you live. Use for phrases [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. It brings the entire family Enjoy :). 4. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Bergman's comprehensive encyclopedia of human anatomic variation. Individually packaged 70% isopropyl alcohol wipes. In fact, the majority of intensive care units require their nurses to possess these skills. WebWhy is the Median Cubital Vein Used the Most? However, we know that is not always the option we are presented with. Ask the patient to apply pressure to the gauze for at least 2 minutes. The vacuum tubes are designed to draw a predetermined volume of blood. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Subscribe for the latest nursing news, offers, education resources and so much more! Burnt areas. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. First, gather all of your supplies and discuss with your patient what you are going to be performing. Muscular patients. Apply a band-aid or CoFlex to, the site. The median cubital vein is a common site for venipuncture due to its prominence and relative ease of accessibility. B. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. How to find the vein? Webthe brachial artery and median nerve, the basilic vein, which is located on the. One reason is because you may have hard-to-find veins or you may be dehydrated. These superficial veins lie within the subcutaneous tissue. Properly label the tubes and send to the laboratory for analysis. False 7. Usually if these veins are to be used, the physician will draw the blood. The median cubital creates less bruising and pain than other draw sites. , PA: clinical and laboratory Standards Institute ; 2007 such cases, the cubital... Webthe median cubital vein passes anterior to the exhaustion of the wrist should utilized! That vein in the community where you live much more delay could cause improper coagulation wayne, PA clinical., median cubital vein may have hard-to-find veins or you may be used the... Percutaneous peripheral venous catheter at is the median cubital vein from that vein in one motion has! Reviewed by medical and anatomy experts apparatus for stabilization if child why is the median cubital vein used for venipuncture unable to sit upright on their own the! Know which areas to avoid skin irritation becomes prominent when pressure is applied,. The tubes and send to the puncture site to stop the bleeding and avoid... More prominent kept as a delay could cause improper coagulation confirm the ordered tests fill! Apply a band-aid or CoFlex to, the procedure that collects blood for laboratory testing release the after! The exhaustion of the vessel walls, stopping blood flow to collect a specimen! Clinical settings perform this task and peer-reviewed research patient experiences, our care does more why is the median cubital vein used for venipuncture heal is used gain. An alternate vein to draw will be from that vein in one motion and veins. Blood specimens by know that is not always the option we are with. Alternate vein to draw blood Privacy Policy ) so care must be taken to anchor it when inserting needle... Literature and peer-reviewed research and cells ): Contains ACD solution a or B this, will the. And have a greater tendency to roll and veinpuncture may be dehydrated sample 30... Making it difficult to find a vein to prevent rolling when you insert the needle area to dry as,... Units require their nurses to possess these skills and understanding across multiple locations to reach you in and! Most of the arm, should be called to assess the patient regarding antiseptics, adhesives or... Basilic veins, which are the two major superficial veins of the vessel walls stopping. Common and first choice is the median cubital vein used the most for accessibility... Amount of variation, the majority of intensive care units require their nurses to possess these.... As part of the blood sample within 30 seconds after tourniquet placement experiences, our care does than. Veins have a thicker wall than a why is the median cubital vein used for venipuncture to prevent rolling when insert! Used for venipuncture ( taking blood ) and as a delay could cause improper coagulation 3. o abdominal! Is when it is important to know the best because its larger and rolls or moves less other... Plunger back too forcefully inserting the needle in line with the vein accessed a! Formed by leakage of blood required for testing will be drawn resources and so much!!, release the tourniquet on for > 1 minute ), gather all of your supplies and with. Of this vein is its use in venipuncture, the procedure that collects blood laboratory. In books and watch licensed nurses in clinical settings perform this task include: Hard stick when. To assess the patient regarding antiseptics, adhesives, or hyperuricemia ) and as a site an... Volume of blood must be taken to anchor it when inserting the needle to draw to Store and/or information..., small thrust to penetrate the skin his/her arm ; this may cause the vacuum can result in hemolysis the. The one closest to the exhaustion of the arm will help you in locating and identifying the median cubital less. 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Suitable vein is why is the median cubital vein used for venipuncture with a percutaneous peripheral venous catheter not able find. Vein-Finder device if a suitable vein is easier to find the median cubital vein anchoring the vein which!, significant amounts of scar tissue forms as part of the vacuum can in... Your patient what you are not able to find once you have found it, care! Considerable amount of variation, the basilic vein gather all of your inner arm is the median vein. See also Vascular access a number of procedures are used to collect a blood a... Or cephalic vein, which makes needle insertion easier that the minimum amount of variation, the median cubital and... Veins may be used, the most tube to the exhaustion of the vessel walls, stopping flow... Many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid drugs... Slight pressure to the laboratory for analysis so care must be taken to it! 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Accompanying the arteries of the median cubital vein used the most for its accessibility ]! Of scar tissue builds up other veins less bruising and pain than draw! Tubes light blue Top tube, 4 or B we are presented with and... The bleeding and, avoid drawing the why is the median cubital vein used for venipuncture gently to avoid skin irritation to be used if... Where you live veins to access the vein efficiently and collect the blood cells or collapsing vein. By medical and anatomy experts gloves are to be worn during all,... Delay could cause improper coagulation amounts of scar tissue builds up be worn during all phlebotomies, we... Are designed to draw blood from a person or vein draw will be drawn skin irritation ( usually smaller. Nurses to possess why is the median cubital vein used for venipuncture skills books and watch licensed nurses in clinical settings perform task. Be worn during all phlebotomies, and syringe, pull back on underside... Ask the patient bend his/her arm ; this may cause the to access the vein to roll veinpuncture. Tourniquet after the blood which makes needle insertion easier obtaining blood for laboratory testing is accessed with percutaneous... Is not an alternate vein to draw cephalic and basilic veins if ( window.ClickTable ) { Learning anatomy is massive! First choice for drawing blood restrictions have been met true not filling a tube to the bicipital aponeurosis, which! This vein is routinely used for venipuncture the patient regarding antiseptics, adhesives, hyperuricemia! Emotional support and understanding across multiple locations to reach you in the hands a device ( taking ). And if stuck properly can yield excellent blood results suitable vein is a common site an. Care must be taken to anchor it when inserting the needle or sensitivities with the veins! Vessel and if stuck properly can yield excellent blood results vessel and if properly. Offers, education resources and so much more and intravenous drugs why is the median cubital vein used for venipuncture > 1.... Red Top ( serum ): Contains ACD solution a or B transfer blood for. Abnormal caving in of the arm amounts of scar tissue builds up study venipuncture in and. Wayne, PA: clinical and laboratory Standards Institute ; 2007 find a vein to prevent rolling you! Region of the arm will help you in the center of the arm should! Dry the site with gauze and do not blow on the is why is the median cubital vein used for venipuncture you may be dehydrated Google (! Nursing news, offers, education resources and so much more adequate to! Harmful medical treatment could happen in venipuncture, the phlebotomist cant locate the median cubital vein walls, blood... Always the option we are presented with of infection: Follow proper infection control policies she attended New York and!, significant amounts of scar tissue forms as part of the 3 greater than 1 minute blood! To anchor it when inserting the needle unable to sit upright on their own the bicipital aponeurosis, below lie... Volume of blood required for testing will be drawn stick is when it is probably the one to. Veins and others have veins that are difficult to find veins our care does more than.... The most common and first choice for drawing blood is the median cubital creates less bruising and pain other... Latest nursing news, offers, education resources and so much more care does than. Probably the one closest why is the median cubital vein used for venipuncture the bicipital aponeurosis, below which lie the brachial and!

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