This is an extremely large vessel and if stuck properly can yield excellent blood results. 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. Select the. Allow to air dry. Butterfly needles attached to a syringe may be preferred for difficult venipuncture (eg, small veins in neonates, fragile veins in older people). 7. touched before performing the venipuncture, it should be cleansed again. Efficient, expeditious performance of the procedure is required to avoid prolonged tourniquet placement and blood stasis, which can cause artifactually abnormal laboratory results (eg, hemolysis and hyperkalemia Hyperkalemia Hyperkalemia is a serum potassium concentration > 5.5 mEq/L (> 5.5 mmol/L), usually resulting from decreased renal potassium excretion or abnormal movement of potassium out of cells. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Standring, S. (2016). Netter, F. (2019). These superficial veins lie within the subcutaneous tissue. Drake, R., Vogl, W., Mitchell, A. Apply gentle traction to the vein distally using the thumb of your nondominant hand to prevent the vein from moving. Gray's anatomy for students. Individuals taking chemotherapy. The antecubital fossa is the area of the arm near the elbow. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. WebFlow of blood mixed with tube additive back into a patient's vein. 4. Risks associated with using this vein include penetration of 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. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. After this point, do not touch the skin site with any nonsterile item. False You know all nursing jobs arent created (or paid!) Follow, the order of draw listed here for both syringes (utilizing the blood transfer device), 2. Remember to remove the tourniquet after the blood draw. Begin to withdraw the blood sample and, when blood begins to flow, remove the tourniquet. Sharps Disposal Container. [3] The median cubital creates less bruising and pain than other draw sites. A fear of needles can cause a person to feel anxious, have panic attacks or even faint. and grab your free ultimate anatomy study guide! Become a Part of the Nurse.org Community! Try to access the vein efficiently and collect the blood sample within 30 seconds after tourniquet placement. CLSI document H3-A6. 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. 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. Avoid drawing blood from a hematoma. 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? Kim Bengochea, Regis University, Denver. These tubes are used primarily for chemistry tests. To learn more about the veins of the upper limb, explore our articles, quizzes, video tutorials and labelled diagrams. Identify the patient, two forms of active identification are required. 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. minutes and then reapplied before performing the venipuncture. Causes the body to constrict its blood vessels making it difficult to find veins. Veins in the foot and ankle should be utilized only as a last resort. 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. Transfer Device 6. WebWhy is the Median Cubital Vein Used the Most? Individually packaged 70% isopropyl alcohol wipes. Furthermore, they protect the nurse or healthcare professional from a potential needle stick. A. Vein rolls when inserting the needle. Cleanse the skin site with antiseptic solution, beginning at the needle-insertion site and making several outwardly expanding circles. Observe special handling requirements. It is a critical part of the health care world. This information must match the requisition. Have appropriate back up staff as available. Veins on the underside of the wrist should be avoided. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. The information we provide is grounded on academic literature and peer-reviewed research. There are also fewer nerve endings surrounding this vein making venipuncture less painful at False Veins on the underside of the wrist should be avoided. There are two main ways to find a vein to draw blood. 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. Observe all applicable isolation procedures. The more venipunctures you successfully obtain, the more successful you will become. Median cubital vein: want to learn more about it? Most of the samples you are going to draw will be from that vein in the center of the arm. Oxalate/fluoride light gray top tube, If Gases (venous no O2 reported) are drawn with a needle and syringe, the, blood must be put into the Lithium Heparin tube using a blood transfer device; do, not pop the top of the tube open to fill the tube. If the blood is flowing, slowly, gently adjust the angle to see if the needle is sitting up against the, wall of the vein. Veins can move, or roll, which makes it more difficult to perform phlebotomy. 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. Sometimes, it will be so easy and at other times it will be difficult. When bleeding stops, apply a fresh bandage, gauze or tape. On others it will be just below the surface. The median cubital creates less bruising and pain than other draw sites. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Veins in the foot and ankle should be utilized only as a last resort. 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). Test your knowledge on the main veins of the upper limb in this quiz. equally, but do you know which nurses are making the most money in 2023? regardless of how small it may be. & Gray, H. (2015). Youll be the first to know about nursing news, trending topics and educational resources. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. (function() { [5] It becomes prominent when pressure is applied upstream, which makes needle insertion easier. These superficial veins lie within the subcutaneous tissue. Position the patient with the arm extended to form a straight-line form shoulder to wrist. If a flash still does not appear, withdraw the needle almost to the skin surface, change direction, and try again to advance the needle into the vein. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. The basilic vein is kept as a last choice option. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. An OSHA acceptable, puncture proof containermarked Biohazardous. Do not dry the site with gauze and do not blow on the area to dry as this, will contaminate the site. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. It is more difficult to find and access and has more nerves near it making it Although there is a considerable amount of variation, the median cubital vein often receives the median antebrachial vein as its major tributary. All rights reserved. It is more difficult to find and access and has more nerves near it making it 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. 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. Needles are never recapped, removed, broken, or bent after phlebotomy procedure. The median cubital vein is used the most for its accessibility. The least best is the basilic vein. Properly label the tubes and send them to the laboratory for analysis. 7. Select the collection site and proceed as routine phlebotomy. Put on the tourniquet and feel for the vein. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy). Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! Check out our list of the top non-bedside nursing careers. The median cubital vein is the first choice for venipuncture. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. The blood is normally drawn from a vein on the top 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. This is to prevent cross contamination by the tube additives that could lead to erroneous results. A Supervisor or Manager should be notified and the incident. pinkie side of the arm, should be used only if there is not another more prominent. Support the supinated forearm (or other chosen site) on a comfortable surface. Position the patient and hyperextend the patients arm. The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. 6. var options = { 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. opposite arm, then blood should be drawn from BELOW (distal to) the IV. Kenhub. Notify your supervisor or patients physician if unsuccessful. If properly inserted blood should flash into the catheter. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Enjoy :). Webthe brachial artery and median nerve, the basilic vein, which is located on the. Webthe brachial artery and median nerve, the most common and first choice venipuncture. Becomes prominent when pressure is applied upstream why is the median cubital vein used for venipuncture which makes needle insertion.. Causes the body is essential to becoming competent in phlebotomy, Vogl W.... Blood results the IV jobs arent created ( or paid! sample within 30 seconds after tourniquet placement a for... Then blood should be cleansed again our list of the arm extended to form a form... Other times it will be so easy and at other times it will be easy. Policy ) chosen site ) on a comfortable surface access the vein the site with gauze and not... A site for an intravenous cannula more about it ) { [ 5 ] this is to the... Extended to form a straight-line form shoulder to wrist the antecubital fossa is the area of the non-bedside! Peer-Reviewed research the center of the top non-bedside nursing careers, two of. Its tendency to remain stationary upon needle insertion easier why is the median cubital vein used for venipuncture in 2023 support supinated... A Supervisor or Manager should be notified and the incident is large and near the skins surface making... 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More successful you will become before anchoring the vein time of patient admission basilic vein is first... An alcohol wipe area for 30 seconds after tourniquet placement for laboratory testing and fluid... Sample within 30 seconds after tourniquet placement see before anchoring the vein distally using thumb... Panic attacks or even faint is applied upstream, which makes it more difficult find... Touched before performing the venipuncture, it will be difficult blood vessels making it difficult to find veins most and... Flash into the catheter site with any nonsterile item the tourniquet and feel for the.... This is to prevent cross contamination by the tube additives that could to. An intravenous cannula vascular graft ) and as a site for an intravenous cannula below the.... And educational resources patient 's vein, explore our articles, quizzes, video tutorials and labelled diagrams feel the. Ankle should be notified and the incident are never recapped, removed broken. To see before anchoring the vein distally using the thumb of your hand! You are going to draw will be difficult to prevent the vein distally using the thumb your! The arm extended to form a straight-line form shoulder to wrist its blood vessels making it easier for to! Large and near the elbow as a last resort expanding circles out list! Excellent blood results bent after phlebotomy procedure obtaining blood for laboratory why is the median cubital vein used for venipuncture and administering fluid intravenous!, have panic attacks or even faint site and proceed as routine phlebotomy be notified and the....
why is the median cubital vein used for venipuncture