Venipuncture
It is important to remember that the first, and most important, step in any surgical procedure is preparation. This includes gathering and opening supplies such as instruments, solution for prepping the skin, garbage can, etc. Both the patient and the doctor should be positioned appropriately. Procedures are not always simply done on the first attempt, therefore both the doctor and the patient should be comfortable and prepared for repeated attempts. The last step in any procedure is to clean up, and in particular, to safely dispose of all sharps in a sharps container.
The most common site of venipuncture is the antecubital vein. Venipuncture can also be performed in any other superficial vein in the upper or lower extremities.
Technique
- Apply a tourniquet on the arm proximal to the puncture site, sufficiently tight to interfere with the venous return, but not restricting arterial flow. To aid in filling the veins, the patient can open and close his/her hand. Slapping the arm over the vein is also helpful (Figure 6.1a and 6.1b).
- Insert the needle bevel up, first through the skin parallel to the vein. Then change the direction so that the needle is pushed against the side of the vein, with the bevel facing away, in order to enter the vein (Figure 6.2a – 6.2b).
- When the needle is inside the vein, blood shows within the syringe. With a further change in direction, advance the needle into the venous cavity (Figure 6.3a – 6.3b). If a Teflon catheter is used for the purpose of IV infusion, advance the catheter, take the needle out, and connect the infusion set (Figure 6.4).
- Fix the needle with adhesive plaster by crossing and wrapping the needle at the hub before the junction with the IV set (Figure 6.5).
