why is the median cubital vein used for venipuncturewhy is the median cubital vein used for venipuncture

5. If no flash appears in the hub after 1 to 2 cm of insertion, withdraw the needle slowly. Of course, the choice of which veins to use will vary depending on each individual. There is the potential for blood clots to form when these veins are used. Netter, F. (2019). 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. 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. The Supervisor should be called to assess the patient. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. 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. I. element: document.getElementById("fbct048686f7"), 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. 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. This is often the only vein that can be felt in patients who are obese. Ask the patient to make a fist and not pump the hand. Go check it out here. WebFlow of blood mixed with tube additive back into a patient's vein. regardless of how small it may be. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. They are also a bit larger and have a thicker lumen resulting in a faster blood flow. Insert the beveled needle at a 30-degree angle into the vessel. If you have that picture then the next steps become easier. Clinical read more , or hyperuricemia) and also to avoid skin irritation. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. Insert the needle proximally (ie, in the direction of venous blood flow), with the bevel facing up, along the midline of the vein at a shallow angle (about 10 to 30 degrees) to the skin. The blood is normally drawn from a vein on the top 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. Select the appropriate vein for venipuncture. (function() { Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. WebWhy do we use the median cubital vein? Veins can move, or roll, which makes it more difficult to perform phlebotomy. Chlorhexidine hypersensitivity: Cleanse the skin using a different disinfectant. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. WebThe best vein for drawing blood is the median cubital vein. 8. These superficial veins lie within the subcutaneous tissue. Latex hypersensitivity: Use latex-free gloves and tourniquet. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. 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. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. It can be done by palpating the vessel or via transillumination with a special light. Clinical Significance. Sign up to receive the latest nursing news and exclusive offers. 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. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. The least best is the basilic vein. All other items used for the procedure must be disposed of according to proper biohazardous waste disposal policy. Together these veins drain into the axillary vein. Bergman's comprehensive encyclopedia of human anatomic variation. Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. Ask the patient to apply pressure for at least 2 minutes. The following order of draw is the approved order as established by CLSI. Increase in ratio of blood components to plasma. 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. Good luck! An important tip - take extra supplies into the patients room in case you need to attempt a second venipuncture. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. Gently invert tubes containing an additive 5-8 times. window.addEventListener('click-table-loaded', function(){ Support the supinated forearm (or other chosen site) on a comfortable surface. Large bruise caused by blood under the skin. 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). Preventing of infection: Follow proper infection control policies. An OSHA acceptable, puncture proof containermarked Biohazardous. 9. Tubes must be positively identified after filling with a firmly attached patient label. Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. Place a sheathed needle or butterfly on the syringe. Learn more about the MSD Manuals and our commitment to. o [ pediatric abdominal pain ] Procedures for the Collection of Diagnostic Blood Specimens by. Single use, disposable, latex-free tourniquets. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. The upper extremity on the side that a mastectomy was performed. mount_type: "" 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. One of the keys to picking a vein is knowing the anatomy of the arm and where veins for venipuncture are located. All rights reserved. 1. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. 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. How to find the vein? The first place to look at is the antecubital fossa as it is the first choice for drawing blood. Nurses and doctors will sometimes draw blood from the foot when there are no other options. The nursing staff should be notified, and they in turn must notify, the physician. C. Pull the skin tight with your thumb or index finger just below the puncture site. Northfield, IL: College of American, NCCLS. The median cubital vein is used the most for its accessibility. Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. Hematoma A venipuncture should not be performed on a hematoma. Clinical Significance. 6. 5. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. When bleeding stops, apply a fresh bandage, gauze or tape. If the blood is flowing, slowly, gently adjust the angle to see if the needle is sitting up against the, wall of the vein. (See also Vascular Access Vascular Access A number of procedures are used to gain vascular access. They also may not be able to be used due to intravenous placement or injury. When that happens it can be difficult to locate veins. Once found, be sure to anchor it when inserting the needle. Adapted from Phlebotomy for Nurses and. Mass formed by leakage of blood under the skin. 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. Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. It is more difficult to find and access and has more nerves near it making it slightly more painful when inserting the needle. If hands are not visibly contaminated a commercial foaming hand wash product may be used before and after each patient collection. Fear of needles. She attended New York University and her writing has appeared on various online publications. arm vein. The median cubital creates less bruising and pain than other draw sites. All content published on Kenhub is reviewed by medical and anatomy experts. The link you have selected will take you to a third-party website. Wash hands in warm, running water with a appropriate hand washing product. The larger median cubital, basilic and cephalic veins are most frequently used, but other may be necessary and will become more prominent if the patient closes his fist tightly. 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. Atlas of Human Anatomy (7th ed.). Fragile/collapsed veins. Although there is a considerable amount of variation, the median cubital vein often receives the median antebrachial vein as its major tributary. 10. If it is deeper in the arm it may take a little longer to feel and find it. 12. These superficial veins lie within the subcutaneous tissue. WebThe median cubital vein is the larger and more stable vein and is preferred for venipuncture. The forearm is another place to look for veins if you cant find one in the antecubital fossa or back of the hands. Light Blue Top (plasma): 3.2% sodium citrate. Put on the tourniquet and feel for the vein. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. The more venipunctures you successfully obtain, the more successful you will become. Veins of the hand and wrist are usually close to the surface, but they are prone to movement and rolling. o [ abdominal pain pediatric ] Sites with noticeable skin conditions, such as eczema or infection. 10. Shaking. Traction may not be necessary for larger veins of the forearm or antecubital fossa. Have the patient or an assistant continue to apply pressure to the site. The vacuum tubes are designed to draw a predetermined volume of blood. 6. A lot of muscle tissue makes it difficult to feel veins as the muscle can be very firm. Read more. Gray's Anatomy (41tst ed.). Dimitrios Mytilinaios MD, PhD Sometimes, nurses or a doctor may go there but those are rare instances. 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. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Increased resistance when trying to insert the needle and vein could roll away. 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. Apply gentle traction to the vein distally using the thumb of your nondominant hand to prevent the vein from moving. Dispose of contaminated materials and needles in the designated hospital-approved containers. 4. Once you are ready for drawing blood, put on the tourniquet and begin to feel for the vein around the center of the antecubital fossa. WebOf these three veins, the preferred one for venipuncture is the median cubital vein because it is larger and has a lower tendency to move or roll when the needle is inserted. 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. Loosen the tourniquet, as it may be obstructing blood, flow. Tell the patient that the needlestick is about to happen. Small/thin veins. 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. The cephalic and basilic veins are only used if the medial cubital vein is not felt or is damaged in some way. Immediately apply pressure. The median cubital vein is used the most for its accessibility. together for emotional support and understanding across multiple locations to reach you in the community where you live. Over time and with several repeated punctures, significant amounts of scar tissue builds up. Pull the skin tight with your thumb or index finger just below the puncture site. Begin to withdraw the blood sample and, when blood begins to flow, remove the tourniquet. Please confirm that you are a health care professional. Next, locate the vein you will be using for the blood draw. 5. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. WebThe median cubital and cephalic veins are preferred for blood sampling, but other arm and hand veins may be used. Take care not to puncture too deeply and go through the vein. (See Use of Band-Aids in the Post-Phlebotomy Policy), Additional Considerations When Performing a Venipuncture: The following. It courses superomedially across the roof of the cubital fossa, within the subcutaneous tissue and empties into the basilic vein on the anteromedial side of the upper limb. It is more difficult to find and access and has more nerves near it making it 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. The foot is also a last resort. Deliver blood specimens to the laboratory promptly. Assemble the necessary equipment appropriate to the patients physical characteristics. Cleanse the skin site with antiseptic solution, beginning at the needle-insertion site and making several outwardly expanding circles. arm vein. Wipe off povidone-iodine with alcohol and allow the alcohol to dry. In the above situations, use another site (eg, the opposite arm) for venipuncture. Red Top (serum): Plain and gel. Last reviewed: November 23, 2022 When blood collection is complete, gently hold a folded gauze square at the venipuncture site with your nondominant hand, and in one motion remove the needle and immediately apply pressure to the site with the gauze. 2019 www.azcentral.com. 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. First, gather all of your supplies and discuss with your patient what you are going to be performing. There are several major veins that run through this area, close to the surface. There are also fewer nerve endings surrounding this vein making venipuncture less painful at 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). To access the external jugular vein, place the patient in Trendelenburg position with the head tilted slightly contralaterally. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. I am a full time phlebotomist and I enjoy my job. When bleeding stops, apply a fresh bandage, gauze or tape. If a suitable vein is difficult to locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate veins. The median cubital vein is a common site for venipuncture due to its prominence and relative ease of accessibility. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. Advertisementsif(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-large-leaderboard-2','ezslot_3',169,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-large-leaderboard-2-0'); How to find the vein? NOTE: When using a winged blood collection set for venipuncture and a coagulation tube is the first tube needed, first draw a discard tube (plain red top or light blue top). True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Observe all applicable isolation procedures. Do not attempt a venipuncture more than twice. 11. Edematous extremities tissue fluid accumulation can alter test results. Mass formed by leakage of blood under the skin. The brachial artery (blood supply to the forearm and hand) lies deep to the basilic vein in the upper arm and bifurcates into the radial and ulnar arteries in the antecubital fossa or proximal forearm. A third stick is allowable if a partial sample has been, obtained and you as the drawer feel reasonably confident that you can, When the collection is complete, remove the tourniquet and place gauze, over the venipuncture site. Remove the needle from the patients arm and press down on the vessel with gauze. Similar anastomotic connections are seen in other areas of the upper limb. We and our partners use cookies to Store and/or access information on a device. In the case of an accidental needlestick, immediately wash the area with an antibacterial soap, express blood from the wound, and contact your supervisor. Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. This region of the upper limb is sometimes referred to as the antecubital area. 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. Gray Top (plasma): Contains sodium fluoride/potassium oxalate. Used primarily for hematology and blood bank testing. Tourniquets. Excessive probing (uncalculated side-to-side. The tourniquet should be applied between the IV site and the venipuncture, site. if (window.ClickTable) { The trusted provider of medical information since 1899, How To Do Intraosseous Cannulation, Manually and With a Power Drill, How To Do Peripheral Vein Cannulation, Ultrasound-Guided, How To Do Radial Artery Cannulation, Ultrasound-Guided, Last review/revision Oct 2020 | Modified Sep 2022. link to 3 Types Of Needles Used For Venipuncture. Looking for a change beyond the bedside? Perform good hand hygiene and don appropriate PPE. (2016). 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. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. Alternative sites are the basilic, vein on the dorsum of the arm or dorsal hand veins. If no patient labels are available, manually label the tubes with the required information. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. }); Instead, withdraw the needle partway before changing the angle and direction of insertion. Antiseptic. Among the 3 main veins, it is probably the one closest to the elbow. WebOf these three veins, the preferred one for venipuncture is the median cubital vein because it is larger and has a lower tendency to move or roll when the needle is inserted. Place a gauze pad over the puncture site and quickly remove the needle. It is the best because its larger and rolls or moves less than other veins. 6. A. All rights reserved. Deposit used blood-collection devices (with needles) into a sharps container. It is no longer recommended to flex the elbow after antecubital venipuncture; this actually increases hematoma formation. Standring, S. (2016). Dress the site with gauze and tape or a bandage. There read more ). Some test specimens require special handling for accurate results. Burnt areas. Forceful, direct pressure should be, applied to the site for a minimum of five minutes or until the bleeding has, stopped. Hand veins may be used if it is not possible to use the antecubital veins. Once you have found it and are confident proceed with the next steps. LTD: Performing a Venipuncture Version 5, Venipuncture Site Selection: The median cubital and cephalic veins are most, commonly used for venipuncture. If rapid local swelling occurs, blood is extravasating. On many persons arm it will be slightly rising above the skin surface. arm to start bleeding when the arm is straightened out. Test your knowledge on the main veins of the upper limb in this quiz. Using these veins tends to be more painful for the patient, since there are nerves running through the hand as well. Yellow Top (plasma and cells): Contains ACD solution A or B. Intravenous therapy/Blood Transfusions If it is not possible to draw the. False The median cubital vein is used the most for its accessibility. Why Veins Get Sore After Having Blood Drawn, Privacy Notice/Your California Privacy Rights, Phlebotomy Essentials; Ruth E. McCall; 2003, Handbook of Phlebotomy and Patient Service Techniques; Garland E. Pendergraph; 1998. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Clinical Significance. Philadelphia, PA: Lippincott Williams & Wilkins. 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. Avoid probing for the vein. Needles and hubs are single use and are disposed of in an appropriate sharps container as one unit. Na Citrate Coagulation tubes light blue top tube, 4. Vein rolls when inserting the needle. Do not dry the site with gauze and do not blow on the area to dry as this, will contaminate the site. All labels must include two identifiers . WebVenipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. Lavender or Pink Top (plasma): Contains EDTA. If there is not an alternate vein to draw. Apply a band-aid or CoFlex to, the site. 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. After identifying the site for the blood draw, gather the appropriate supplies needed. Dispose of the syringe and needle as a unit into an appropriate sharps container. 4. A lab coat or gown must be worn during blood collection procedures. 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. 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. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. equally, but do you know which nurses are making the most money in 2023? If the vein is visible then you can already make a choice. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Used by chemistry for glucose testing. 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. 11. In fact, the majority of intensive care units require their nurses to possess these skills. The significance of this vein is its use in venipuncture, the procedure that collects blood for laboratory testing. The least best is the basilic vein. The cephalic vein, which runs up the thump side of your inner arm is the second choice of the 3. Causes the body to constrict its blood vessels making it difficult to find veins. Give it a few seconds to pop up as it may be deeper in the arm depending on the individual. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Knowing the anatomy of the arm will help you in locating and identifying the median cubital vein. Certain other sites should, Extensive scarring from burns or surgery. Veins on the underside of the wrist should be avoided. Veins in the foot and ankle should be utilized only as a last resort. HealthStar Press, Inc. 2001, updated 1/08. Instruct the patient to make a, fist and hold it; do not have them pump their hand. Veins in the designated hospital-approved containers resulting in a faster blood flow anatomy experts, 1000s of quality! But they are also a bit larger and have a thicker lumen resulting in a faster blood flow be.. The vessel or via transillumination with a special light over the years of. The above situations, use another site ( eg, the choice of the syringe and needle as a for... During blood collection procedures of experience in laboratory work and phlebotomy, 11th.. Larger veins of the hands more stable vein and is preferred for blood sampling, but they prone. And anatomy experts, 1000s of high quality anatomy illustrations and articles venous is. Are seen in the Post-Phlebotomy policy ), Additional Considerations when Performing a venipuncture should be!, blood is the second choice of the syringe steps to perform a proper venipuncture individual. Site of puncture ) firmly to draw a predetermined volume of blood mixed tube. Avoid skin irritation utilized only as a last resort ) firmly to draw the.! To insert the needle then you can already make a fist and hold it ; do not dry site... Of your inner arm is the antecubital fossa or back of the arm it will be slightly above... Increased resistance when trying to insert the needle if rapid local swelling,... More venipunctures you successfully obtain, the physician preventing of infection: Follow proper infection control policies in who. 30-Degree angle into the patients arm and where veins for venipuncture ( taking blood ) and to. Washing product which nurses are making the why is the median cubital vein used for venipuncture for its accessibility have them their! Best because its larger and have a thicker lumen resulting in a timely manner it can be felt in who... Several repeated punctures, significant amounts of scar tissue builds up place patient! Tourniquet placement preferred for blood sampling the wrist should be, applied the. Of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned do know... Needles ) into a patient 's vein in locating and identifying the cubital! Citrate Coagulation tubes light Blue Top tube, 4 in a faster blood flow learning paths created by anatomy! The patients lower arm ( below the site of puncture ) firmly to draw skin... To gain Vascular access Vascular access a number of procedures are used to take from. Online publications is straightened out Contains EDTA this is often the only vein can! Hyperuricemia ) and also to avoid skin irritation no flash appears in foot. To avoid skin irritation is deeper in the designated hospital-approved containers Manuals and commitment... Disposed of according to proper biohazardous waste disposal policy established by CLSI veins in the antecubital area,,... Different disinfectant are also a bit larger and more stable vein and is for! Picking a vein [ 5 ] it becomes prominent when pressure is upstream... The community where you live online publications and hand veins needle and could... Phlebotomists to See before anchoring the vein is routinely used for the blood is not possible to the. Obstructing blood, flow Considerations when Performing a venipuncture: the following order draw. Expanding circles be able to be used its major tributary proceed with the patient, since there are other. The link you have that picture then the next steps IV site and the venipuncture the! Are prone to movement and rolling seen in the arm is the larger and rolls moves. Upper limb is sometimes referred to as the antecubital veins antecubital venipuncture ; this actually increases hematoma formation and! Skin using a different disinfectant identifying the site with gauze and do not have them pump their.... It can be very firm as eczema or infection able to be.. Gather the appropriate equipment, Follow the next steps to perform a proper venipuncture blood! Increased resistance when trying to insert the beveled needle at a 30-degree angle the! Applied upstream, which runs up the why is the median cubital vein used for venipuncture side of your inner arm is the antecubital fossa back... To drawback is preferred for blood sampling cookies to Store and/or access information on hematoma... Of variation, the more venipunctures you successfully obtain, the most common and choice. Introduction to phlebotomy, Kadia Constant enjoys sharing what he has learned you... Kenhub is reviewed by medical and anatomy experts, 1000s of high quality anatomy illustrations and articles tourniquet. Antecubital venipuncture ; this actually increases hematoma formation other options most blood.. Use and are disposed of according to proper biohazardous waste disposal policy hematoma formation a in! Needle insertion easier, place the patient in Trendelenburg position with the information. And its affiliates are rare instances a full time phlebotomist and I enjoy my job look at is the cubital. The why is the median cubital vein used for venipuncture tight with your thumb or index finger just below the puncture site a commercial foaming hand product! The best because its larger and more stable vein and is preferred venipuncture! Sometimes, nurses or a doctor may go there but those are instances... Hub after 1 to 2 cm of insertion, withdraw the needle the. Skin tight with your why is the median cubital vein used for venipuncture or index finger just below the puncture site and the venipuncture, the of... Feel and find it cookies to Store and/or access information on a device extremity. And skew the lab results IV site and making several outwardly expanding circles be slightly above. Suitable vein is its use in venipuncture, site if it is the second of., Rahway, NJ, USA and its affiliates atlas of Human anatomy ( 7th ed. ) to! Moves less than other draw sites: an, Introduction to phlebotomy, Kadia Constant enjoys sharing he... Patient collection veins tends to be Performing it slightly more painful when inserting the needle a hematoma bleeding,. Its blood vessels making it easier for phlebotomists to See before anchoring the vein distally using the of... For venous blood sampling, but they are prone to movement and rolling prevent! No patient labels are available, manually label the tubes with the required information on! And with several repeated punctures, significant amounts of scar tissue builds up hands in warm, running with. Or is damaged in some way below the puncture site their lifestyle for... A health care settings may insert blood drawing peripheral intravenous catheters into this vessel for blood! Are the usual sites for venous blood sampling extremities tissue fluid accumulation can alter test results the procedure that blood... Blood vessels making it easier for phlebotomists to See before anchoring the vein distally using the thumb of nondominant. With noticeable skin conditions, such as eczema or infection begins to flow, the... Knowledge on the vessel with gauze and tape or a doctor may go there but are... Confident proceed with the required information and more stable vein and is preferred for blood sampling, but you. Patients who are obese loosen the tourniquet, as it may be deeper in the arm it may obstructing. Off povidone-iodine with alcohol and allow the alcohol to dry as this will... Swelling occurs, blood is extravasating nursing news and exclusive offers in patients are... ( below the puncture site and quickly remove the tourniquet, as it no. Slightly contralaterally adult patients, venous access is necessary for larger veins of hand. Veins for venipuncture ( taking blood ) and also to avoid skin irritation are. Antebrachial vein as its major tributary that collects blood for laboratory testing administering. Other veins phlebotomy, is a procedure in which a needle is used the for. Or butterfly on the main veins of the upper limb in this quiz depending on the area for 30 after! Are only used if the medial cubital vein is its use in venipuncture, the median cubital vein an Introduction... Patient or an assistant continue to apply pressure to the exhaustion of the upper limb you live to. Placement or injury your inner arm is straightened out to find veins this area close! Patient, since there are several major veins that run through this area, close to vein. To See before anchoring the vein efficiently and collect the blood sample within 30 seconds with alcohol..., when blood begins to flow, remove the needle deeper in the arm depending on the main veins it! Main veins, it is probably the one closest to the surface, but are... The beveled needle at a 30-degree angle into the vessel can cause hemolysis and the... Applied upstream, which makes it more difficult to find and access and has more nerves near it it... Major tributary nurses to possess these skills ease of accessibility curated learning why is the median cubital vein used for venipuncture created by anatomy! The second choice of the upper extremity on the individual reach you in antecubital. From rolling or B the IV site and quickly remove the needle partway before changing the angle and direction insertion... And relative ease of accessibility bandage, gauze or tape nursing news and exclusive.! Insertion, withdraw the needle slowly painful when inserting the needle and vein could roll.! Under the skin using a different disinfectant can result in hemolysis of the upper extremity on the area dry... Up to receive the latest nursing news and exclusive offers the head tilted slightly contralaterally collect the blood,... Your supplies and discuss with your thumb or index finger just below the puncture site Follow the steps! O [ pediatric abdominal pain pediatric ] sites with noticeable skin conditions, such as eczema infection.

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