Venipuncture for Blood Test: Procedure (Nursing)

00:04 So, here we want to go ahead and assess the client's vein to select an appropriate venipuncture site.

00:11 So, if you see here in this image, they're going for what we call the “Anti-cubital” or “AC”, that's a very popular venipuncture site.

00:20 Now, we can apply our tourniquet and then use alcohol swabs to clean.

00:25 Now, it's really important when you clean, that we don't retouch the site after it's been disinfected.

00:32 Now, once we've cleaned, we can now remove the plastic protective sheath from the needle and then immobilize the vein using your non-dominant hand.

00:41 That way, it doesn't roll around when you try to stick.

00:46 Now, we can use our dominant hand and insert the needle at about a 30-degree angle, now, make sure that bevel is up.

00:54 So, when we're talking about bevel up, remember, we should be able to look down and see a little hole and that's how we know the bevel is up on the needle.

01:03 Now, once we access that vein, keep the needle stable.

01:08 Then, we can use our non-dominant hand to insert the blood collection tubes, into the blood transfer device.

01:16 Now, just keep in mind when you're using a winged needle, the waste tube should be used so that, the air within the tubing is not displaced into a blood collection tube.

01:28 Now, we can release the tourniquet, once the blood begins to flow freely into the first blood collection tube.

01:34 Now, we want to fill the required blood collection tubes, by replacing each one in each filled tube with an empty tube and once we've collected all of our labs, we can place our gauze over the insertion site and withdraw the needle and of-course activate the needle safety device.

01:53 Now, it's a good idea to hold pressure to the insertion site using that gauze, until the bleeding stops.

02:00 We want to now place the needle into the sharps container.

02:04 Gently invert that filled blood collection tubes, to mix the blood with the tube's additives.

02:11 And of-course, don't forget to label, all blood collection tubes at the client's bedside.

02:18 Now, place the blood collection tubes into a laboratory biohazard bag.

02:26 Okay، so when we don our gloves, it's important here to assess the client's veins, to select which venipuncture site we would like to use.

02:36 Now, many times it's very common, that you will see a venipuncture in what we call, the “Anti-cubital” or the “AC” site, so, now we can go ahead and apply our tourniquet.

02:46 So, if you remember when we do our tourniquet, I like to hold it a little bit closer here and this is just going to provide some more tension.

02:55 Then, I like to cross my hands and gather it in one to where you see a nice “X”, then, I’m going to poke through just this little side here.

03:08 So, when we're done, we can quick release.

03:11 And again, I’m going to show you the tourniquet one more time, I’m going to grab the sides here, just for a little bit more tension.

03:18 I’m going to cross my hands and I want to just make sure, we gather this in an x-like fashion.

03:28 Then, I’m going to take the tail and poke this to where it does not go all the way through and leave that there.

03:35 So, once we've got the tourniquet, now I can clean my site.

03:38 I’m going to take my alcohol pad and then I’m going to go here and make sure that I thoroughly clean with the alcohol swab.

03:48 And it's important here to make sure you let this dry.

03:51 Now, once you've done that, we can remove the plastic protective sheath from the needle.

03:57 So, this is the plastic part and I’m going to pull straight out and this is what's great about these needles, they have these little wean devices that I like to hold onto, for the insertion of the needle.

04:09 Now, once I’ve done this, I can immobilize the vein, using my other hand.

04:15 Now, with my dominant hand as you see here, I’m going to make sure I insert the needle with the bevel up.

04:21 So, if you remember, when you're talking about the bevel if you look down at the needle, you should see the eyelet or the hole of the needle looking up at you.

04:30 So, now that I’ve done this with the bevel up, I’m going to access the vein.

04:42 Now, once we've been successful in accessing the vein, do your best here to keep the needle as stable as possible with your dominant hand.

04:52 Then you will use your non-dominant hand and that's what's going to help you to insert your blood collection tubes into the blood transfer device.

05:01 Now, just keep in mind here, this is just my personal preference, but I used a butterfly or a wingtip needle.

05:09 Now, sometimes because of this extra tubing, there can be some air that gets into the tubing, we do not want this in our lab sample.

05:17 Therefore, it's a great idea to use an extra tube, of what we call as a "Waste Tube" just to remove the excess air.

05:24 Now, once we're ready, go ahead and that blood is free-flowing, go ahead and release your tourniquet here.

05:30 Now, we can go ahead and take our waste tube and I like to just keep it here flat take my waste tube, stick it into the blood transfer device and push the end.

05:42 Now, what's really neat here, is this, gray that you see has a puncture, that will release the vacuum to help pull the sample.

05:50 So, I’m just going to push this all the way to the top and it's going to fill.

05:55 Now, once we decide that there's not any more air into the line, we can remove this, by simply just pulling this off, get rid of our waste tube and then replacing it with our lab collection tubes and then again going to stick it here, push this in all the way till it punctures and then make sure that fills appropriately.

06:17 Now, once we've got our blood collection tubes, then we can go ahead and remove these and then place the gauze over the insertion site.

06:26 Now, once we do this we want to go ahead and withdraw the needle.

06:30 So, once we withdraw the needle, go ahead and pull this out, then it's really important to activate the safety device.

06:38 So, what I like to do here is just hold my wings and very carefully slide the yellow which is the safety device, over the needle, until it clicks.

06:49 So, now I’m going to put this, to the side.

06:52 So, once I’ve done this, I’m holding pressure, once we've decided the bleeding stops, it's a good idea to go ahead and tape this down.

07:06 And, if your patient has another hand, they can help you here as well.

07:16 Okay, so now that we've got this down, just remember that you want to take your needle here and we can remove it from the blood collection device and place this into the sharps container.

07:31 Now, once we've done that it's a good idea, that we gently invert our blood collection tubes.

07:38 So, when we do this, we don't want to shake this, we just want to simply take this and gently invert it, to mix the blood with the tube's additives.

07:48 Now, it's also important to note that once we invert it and we're ready, you've got to make sure that you label the blood collection tubes.

07:57 Now, you want to do this, at the client's bedside to make sure you get the right patient and the right date of birth.

08:04 Also know, that, sometimes you can get this label from the electronic medical record or the patient label.

08:10 So, make sure you follow your agency's policy now once we're labeled, we can go ahead and place our blood collection tubes into the laboratory bag.

08:20 And it's also important to note that all specimens, that have any sort of blood or body fluids, need to go into this type of bag.