why is the median cubital vein used for venipuncture

Dispose of the syringe and needle as a unit into an appropriate sharps container. The information we provide is grounded on academic literature and peer-reviewed research. There read more ). There are several major veins that run through this area, close to the surface. Gray's anatomy for students. 2019 www.azcentral.com. Veins on the underside of the wrist should be avoided. It is a critical part of the health care world. 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. The median cubital vein is the first choice for venipuncture. if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'phlebotomistreport_com-leader-3','ezslot_10',171,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-leader-3-0'); Other veins at the back of the hands or in the forearm can be used but the antecubital area is the first choice. Select the collection site and proceed as routine phlebotomy. Clinically Oriented Anatomy (7th ed.). Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. Without proper specimens, unhelpful or even harmful medical treatment could happen. Resistance when inserting the needle. Nursing Personnel. They are the cephalic, median cubital, and basilic veins. Risks associated with using this vein include penetration of The nerves are also further away in the antecubital area making drawing blood less painful. The Supervisor should be called to assess the patient. Do not attempt a venipuncture more than twice. In order to draw blood for a blood test a needle has to be inserted into a vein. Together these veins drain into the axillary vein. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Please confirm that you are a health care professional. Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. Observe special handling requirements. A lot of fat tissue in the arm area or at the back of the hand makes it difficult to feel a vein. Arteries pulsate, are, more elastic and have a thicker wall than a vein. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Release the tourniquet. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. The basilic vein basically runs from the palm of the hand and up your arm on the side of the ulna. Youll be the first to know about nursing news, trending topics and educational resources. It is the best because its larger and rolls or moves less than other veins. Nurses and doctors will sometimes draw blood from the foot when there are no other options. Perform good hand hygiene and don appropriate PPE. It can be done by palpating the vessel or via transillumination with a special light. The basilic vein is the last choice for venipuncture. Sometimes, the back of the hands will have better veins than the antecubital area and drawing blood there would be more appropriate. Deliver blood specimens to the laboratory promptly. Venipuncture is typically performed at the antecubital fossa (on the median cubital, cephalic, and basilic veins), or on the dorsum of the hand. Kenhub. Observe all applicable isolation procedures. Venipuncture; Approved StandardSixth Edition. Veins in the foot and ankle should be utilized only as a last resort. 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. In such cases, the phlebotomist cant locate the median cubital or cephalic vein but the basilic vein is easier to find. window.ClickTable.mount(options); 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). All labels must include two identifiers . Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Also, It will be more easily felt in some individuals depending on the amount of muscle and fat tissue the person have. Median cubital vein: want to learn more about it? Remove plastic cap over needle and hold bevel up. Place a gauze pad over the puncture site and quickly remove the needle. 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 information provided should not be used for diagnosing or treating a health problem or disease. 12. 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. One reason is because you may have hard-to-find veins or you may be dehydrated. Light Blue Top (plasma): 3.2% sodium citrate. 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. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. However, we know that is not always the option we are presented with. This region of the upper limb is sometimes referred to as the antecubital area. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. Each healthcare system has its own requirements prior to nurses performing blood draws. True A red-stopper tube is used to collect a blood specimen for most blood chemistries. Tables showing needle sizes Hi! 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. When bleeding stops, apply a fresh bandage, gauze or tape. 7. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. Use for phrases Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Properly label the tubes and send to the laboratory for analysis. Similar anastomotic connections are seen in other areas of the upper limb. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. If povidone-iodine is used to cleanse the skin, allow it to dry and then remove it with isopropyl alcohol, to avoid erroneous blood test results (eg, hyperkalemia, hyperphosphatemia Hyperphosphatemia Hyperphosphatemia is a serum phosphate concentration > 4.5 mg/dL (> 1.46 mmol/L). The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Some patients are easier than others because of the prominence of their veins. Give it a few seconds to pop up as it may be deeper in the arm depending on the individual. Tubes must be positively identified after filling with a firmly attached patient label. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Ask the patient to state their name and date of birth. If rapid local swelling occurs, blood is extravasating. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. True Not filling a tube to the exhaustion of the vacuum can result in hemolysis of the blood specimen. Traction may not be necessary for larger veins of the forearm or antecubital fossa. Select the appropriate vein for venipuncture. 11. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). Curated learning paths created by our anatomy experts, 1000s of high quality anatomy illustrations and articles. Latex hypersensitivity: Use latex-free gloves and tourniquet. WebThe best vein for drawing blood is the median cubital vein. True An evacuated glass tube with a lavender stopper contains EDTA. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. Needles are never recapped, removed, broken, or bent after phlebotomy procedure. Register now Instead, withdraw the needle partway before changing the angle and direction of insertion. If there is any concern regarding injury, contact nursing for, Inpatients and follow the Policy for Proper Handling of an Uncooperative, Order of Draw for Venipuncture: Blood collection tubes must be drawn in a, specific order to avoid cross-contamination of additives between tubes. The median cubital creates less bruising and pain than other draw sites. 8. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. WebFlow of blood mixed with tube additive back into a patient's vein. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. This is an extremely large vessel and if stuck properly can yield excellent blood results. Blood will appear in the needle hub (called a blood flash or flashback) when the needle tip enters the lumen of the vein. The median cubital vein (antecubital vein) is a prominent superficial upper limb vessel. venipuncture site by palpating with the gloved index finger. Do not place, tightly or leave on for more than 1 minute. At no time may phlebotomists perform venipuncture on an artery. Do not have the patient bend his/her arm; this may cause the. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Immediately apply pressure. If it is deeper in the arm it may take a little longer to feel and find it. Obese patients. Peripheral veins, typically the antecubital veins, are the usual sites for venous blood sampling. Mass formed by leakage of blood under the skin. The link you have selected will take you to a third-party website. At times, none of the veins of the antecubital fossa will be felt. Drawing blood from a patient can be a daunting task but it also is a necessity for nurses. 6. 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. The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. Become a Part of the Nurse.org Community! Dress the site with gauze and tape or a bandage. Increased resistance when trying to insert the needle and vein could roll away. 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. 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For adult patients, the most common and first choice for venipuncture and rolls or moves less than other sites... Papoose apparatus for stabilization if child is unable to sit upright on their.! And drawing blood less painful if child is unable to sit upright on their own their! Its larger and rolls or moves less than other veins arteries pulsate, are, elastic. Or at the back of the hand makes it difficult to feel and it... And fat tissue in the antecubital area making drawing blood there would be more from! Of an Uncooperative patient in an Outpatient Setting Akron are not appropriate cause the further. Cephalic vein but the basilic vein is the median cubital, and basilic veins have a greater to! That is not always the option we are presented with and peer-reviewed research drawing blood is extravasating can be by. Quickly remove the needle has either not punctured the vein or the needle light... 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