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The Venipuncture From An Arm Vein
The Venipuncture From An Arm Vein
Venipuncture means the collection of blood from a vein. As a general rule, arm veins are the best source from which to obtain blood. The preferred site is the antecubital fossa, which is where the arm bends at the elbow. The vein of choice is the median cubital vein (see diagram). The cephalic vein is not preferred as it has a tendency to roll. The basilic vein lies close to the brachial nerve and artery, and for this reason should be avoided. In unusual situations, it may be necessary to use hand or wrist veins when a suitable arm vein cannot be located, or if the arms are bandaged or have been punctured repeatedly and are sore. Veins from the underside of the wrist should not be used. Sometimes, if the arm veins are used for repeated injection of fluids, they may be thrombosed. Thrombosed means that clots have formed and blood no longer flows. Thrombosed veins are usually firm, discolored, and tender. If the arm veins are thrombosed, you must use another site. Also, you should not obtain blood from a vein that has a hematoma (bruise) from a previous venipuncture.
Cephalic vein
Radial artery
Obtaining blood from a site other than the arm often requires special instruction. Notify your supervisor or follow your institutions procedures Arterial punctures prior to obtaining Do not attempt arterial blood from any site punctures unless you have other than the upper been properly trained and extremities. (See page 29 for information on collecting competency has been blood from arms that are receiving intravenous fluids.) established. Always follow your institutions policies Preparing the patient and procedures. Ensure that the patient does not have anything in their mouth prior to performing the venipuncture. Position the patient so that:
The vein you will use is readily accessible. You are able to work in a comfortable position. If you are working from a cramped position or in awkward quarters, your chance of performing a successful venipuncture will decrease. If the patient has a reaction, they will not fall.
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