Venepuncture – How To Take Blood

By | April 17, 2017
Loading...

Venepuncture is a relatively common OSCE station. You’ll be expected to demonstrate your clinical skills and ability to communicate effectively. This venepuncture OSCE guide provides a clear step by step approach to venepuncture, with an included video demonstration. This guide discusses venepuncture using vacutainer bottles, so steps may differ if you are using different equipment (e.g. needle and syringe). Check out the venepuncture OSCE mark scheme here.

Introduction

  • Introduce yourself
  • Confirm patient details – name / DOB
  • Explain procedure:

“I need to take a blood sample which will involve inserting a needle into your vein.“

“It will feel like a sharp scratch and shouldn’t take too long.“

  • Gain consent – “Do you understand everything I’ve said?” “Are you ok for me to go ahead?“

Gather equipment

  • Gloves
  • Apron
  • Needle
  • Barrel
  • Sample bottles
  • Tourniquet
  • Antiseptic swab
  • Gauze
  • Tape
  • Sharps bin

It’s often wise to bring two needles, barrels, bottles and swabs, just in case you fail first time.

f91a728d418027a4ffb9032cd0d74759.jpg

Procedure

-Preparation

Ensure the patient is lying or sitting comfortably (place a pillow under the arm if possible).

  1. Wash hands
  2. Apply tourniquet – avoid nipping the patient’s skin
  3. Palpate a vein:
  • The antecubital fossa is most frequently used location
  • Go for a straight vein- ideally it should feel “springy”
  • Avoid areas where veins are joining together – valves present
  1. Don gloves
  2. Clean the site with an antiseptic swab – 30 seconds
  3. Attach the needle to the barrel

3eb25fdfa8c0c020b5f0044c30f4dcd4.jpgApply torniquet

f2538e307c7d2f70000c4d2968e03caa.jpgPalpate a suitable vein

f92075854c5c6d8a13d0f332ee7d6609.jpgClean the area

1bdceade3f61f5016ccb75c0593ad5ed.jpgAttach needle to the barrel

-Insertion of the needle

loading...
  1. Unsheathe the needle
  2. Anchor the vein from below with your non-dominant hand
  3. Warn the patient of a sharp scratch
  4. Insert the needle through the skin at 20-40 degrees– bevel upwards
  5. You should feel a slight give as the needle enters the vein
  6. Lower the needle and anchor the barrel firmly to the skin
  7. Fill the required amount of blood sample bottles
  8. It’s essential to keep the barrel still whilst changing bottles
  9. Remove the tourniquet
  10. Remove the needle carefully and place immediately into a sharps bin
  11. Apply pressure to the site with some gauze
  12. Tape a dressing to the patient’s arm (cotton wool / gauze)
  13. Dispose of the equipment into a clinical waste bin

2658dd2971d0d22c9221abcbdd603780.jpgUnsheath Needle

0c0980606d165d563ee1eaa069acb0fa.jpgEnsure bevel is pointing upwards

a67d337c6b9ce863cab9cc1b8297b525.jpgInsert the needle

37166f977e1ff4d7b738b0ac0bdc4b34.jpgAttach bottle

a4fed5af85abed017a8764dcd48ecd7a.jpgRemove bottle

ee1e821bd22fc9ac88a8851cb5ab229b.jpgRemove torniquet

09c566941e0feebd80c9625cd050fe8a.jpgRemove needle and apply wool/guaze

96ef82478df88539c502c942774d1772.jpgDispose of sharps

6288b0c294fc0d6a92120cfd2b2a43a8.jpgDispose of clinical waste

ce8823b66fc7ede3b67ae3d510a3ffab.jpgLabel bottle at the bedside

To complete the procedure

  • Thank patient
  • Wash hands
  • Fill out patient details on the sample bottles at the bedside
  • Send the blood samples to the lab for testing
Loading...

Source

Leave a Reply

Your email address will not be published. Required fields are marked *