Venipuncture Lab

Upon completion of this laboratory, students will:

1. Identify and define use of supplies for IV injections

a. Tourniquet
b. Syringe and needles with assorted gauges
c. Syringe shield
d. Bandage/tape
e. Aseptic prep solution
f. Gloves
g. Sharps disposal location

2. Describe and demonstrate aseptic venipuncture technique

a. Assemble supplies
b. Verify patient requisition/physician’s order
c. Check Patient Identification (2 methods)
d. Hand washing
e. Explain the procedure
f. Put on Disposable gloves
g. Choosing vein site
h. Cleansing of site
i. Tourniquet tying
j. Vein stabilization
k. Proper syringe holding (bevel up)
l. Venipuncture and draw 1cc of blood
m. Remove tourniquet
n. Remove syringe, apply gauze and hold pressure
o. Proper disposal of syringe and needle
p. Apply bandage
q. Record relevant information
r. Assess injection site

BEVEL 15-45 degrees

 Needle Gauge

4
3.5
External diameter/mm

3
2.5
2
1.5
1
0.5
0
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

needle gauge
General Guidelines for Venipuncture and Drawing Blood:

Assemble supplies needed. The needle to be used should be a safety needle. It

should be a 21gauge or larger in order to facilitate rapid flow into and out of the
syringe and thus minimize hemolysis. Disposable needles are routinely used. Make
sure you briefly inspect the needle to make sure it is free of any nicks or damage.

If one standard size of syringe is used, the 20 ml size is recommended in order to

accommodate larger amounts of specimen required for some procedures. Inspect
syringe by moving the plunger within the barrel to ensure free movement. NOTE:
Disposable plastic syringes are required.

After assembly of the needle/syringe unit, move the plunger within the unit to ensure
syringe patency.

Wash hands, approach the patient and introduce yourself. The patient should be
identified using 2 sources of identification. Explain the procedure to the patient.

Select appropriate site for venipuncture.

Put on Gloves.

Apply the tourniquet around arm at least 2 inches above venipuncture site. You may
ask the patient to squeeze their fist or pump their fist to plumb up the vein. Do NOT
leave tourniquet on the arm for more than 1-2 minutes. If there is going to be a
delay, remove the tourniquet

Cleanse venipuncture site with an alcohol swab using a circular motion from the
inside out. Allow area to dry before proceeding. The reason is twofold: it prevents
the burning sensation for the patient when the venipuncture is performed and it
prevents hemolysis of the blood.

If phlebotomy site must be palpated again, it can only be done with one finger that
was cleansed with alcohol before touching to feel the vein.

Grasps patient’s arm firmly, placing the thumb 1-2 inches below the chosen site to
draw skin taut. This will anchor the vein.

Perform venipuncture with the needle bevel facing up and enter the vein at a 15 to
45 degree angle and inserting the needle in the same direction as the vein.

Grasp the barrel of the syringe firmly and pull firmly on the plunger until required
amount of blood n in the syringe.

Ask the patient to open their fist, and then remove the tourniquet as soon as the
desired amount of blood has been obtained.
At the completion of the venipuncture, lightly place gauze over the venipunture site and
remove the needle. Immediately apply direct preessure to the punture site and hold for a
couple of minutes.

Check site for bleeding, if site is still bleeding continue to hold pressure. Elevating
the arm while holding pressure may be helpful. Do not bandage site until bleeding
has completely stopped. Once the bleeding has stopped, apply bandage over the
gauze pad at site and advise patient to leave in place for about 15 minutes.

Discard needles and other soiled material in the proper containers: Radioactive,
Non-radioactive and Sharps.

Remove gloves and wash hand.

Inspect puncture site any signs of a hematoma and treat accordingly

Post Venipuncture “Hematoma” Care Instructions
What is a hematoma - A hematoma is a swollen or raised area at the venipuncture site
resulting from the leakage of blood into the tissues.

What will happen to the hematoma - In the next few days, the blood will be absorbed
by the body. The blood will surface to the skin causing a bruised appearance. As the
bruise is healing, it will turn a yellowish-green in color and then gradually fade.

How to treat a hematoma - Apply a pressure bandage on the hematoma. Immediately

apply Ice or cold packs to the site for approximately 15 minutes to produce
vasoconstriction to decrease hemorrhage and edema. Instruct the patient to reapply
cold pack one or more times to the area within the first 24 hours following the
formation of the hematoma. If possible the patient may elevate the affected arm to
help reduce swelling. Avoid lifting heavy objects with the affected arm. If the area is still
painful and swollen, apply warm moist compresses to the site for 20 minutes one or
more times during the second 24 hours following the formation of the hematoma. If any
of the following complications occur, have the patient notify their physician and report
the problem to your department:

• Discoloration of the hand

• Additional swelling or redness
• Signs of infection
• Fever
• Generalized pain or discomfort of the arm
• Throbbing of the arm
• Numbness in the arm