Sno Venipuncture procedure

Rationale
Venipuncture is defined as the collection of a blood specimen or specimens
from a vein for the laboratory testing of the blood sample.
SNO
Equipments:
Gloves: at least two pairs of unsterile gloves
Needles: 18 gauge to 23 gauge, single and
multidraw .
Labels for evacuated tubes, ready with
patients name and pertinent
information for each tube
Syringes: 1, 3, 5, and 10 mL, or larger (plastic
or glass)
IV butterfly (useful for children to prevent
excessive suction on the vein)
infusion sets: 21, 23, or 25 gauge, or all three
Tourniquets: 34 inch or 1 inch for adults and
18 inch for children.
Gauze pads: 2 inch 2 inch or 4 inch 4 inch
Isopropyl alcohol pads, 70%
Povidone-iodine (used for cleansing
venipuncture sites for blood cultures)
Adhesive strips (Band-Aids
Sharps disposal container
PROCEDURE FOR SYRINGE
VENIPUNCTURE
Note: Syringes may be used for venipuncture
when the patients veins are small or fragile
and Vacutainer tubes may cause the veins to
collapse.
Using a syringe with a 20- or
21-gauge needle or butterfly allows for greater
control.

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The order of draw is as follows:
Blood cultures, using only iodine as a skin
preparation
Light blue top (requires a full draw of
sample; uses include coagulation tests
such as thrombin and prothrombin times)
Lavender top (requires a full draw and
inverting at least eight times slowly to
prevent clotting and platelet clumping;
uses include hematology, blood bank)
Green top
Gray top (requires a full draw to prevent
hemolysis; uses include lithium, sodium
heparin, and glucose levels).
Red top (chemistry, immunology, and
serology panels; blood bank)
1. Wash your hands. Cleanse the area, select
the venipuncture site, and palpate the
vein .
2. Once the needle is in the vein, keep the
needle steady and still, and then pull back
gently on the syringe plunger while
holding the syringe securely to keep the
needle in the vein.
3. Using the syringe to brace against you,
pull back on the plunger and fill the
syringe with the desired amount of blood
(usually three quarters full) needed for
the tubes to be filled.
4. Release the tourniquet and complete the
dressing procedure using the same
technique as described for the Vacutainer
system.

5. When transferring from the syringe to the

tubes, remove the 20- or 21-gauge needle
from the syringe and replace it with an
18- or 19-gauge needle.
6. Take extreme care to puncture the tubes in
the right order and allow the tubes to fill
by using the pressure of the vacuum tube.
7. Do not use the plunger to fill the tubes.
8. Continue with the same labeling procedure
SPECIAL CONSIDERATIONS
If no blood is obtained, change the position
of the needle carefully. Move
it forward or backward. Watch for formation of
a hematoma. If this
occurs, stop the procedure. Also consider
adjusting the angle of the
needle.
If blood stops flowing into the vacuum tube,
the vein may have
collapsed. Resecure the tourniquet to increase
venous filling. If this is
not successful, remove the needle, take care of
the puncture site, and
redraw.
Never draw from a thrombosed or scarred
vein. Thrombosed veins lack
resilience, feel cordlike, and roll easily.
Never attempt venipuncture in an artery.
Arteries pulsate, are very
elastic, and have a thick wall. If you see bright
red blood, be cautious:
Remove the tourniquet, carefully remove the
needle, and apply a firm
steady pressure for at least 10 minutes.