Page 13 - THE FIRST DAY OF PHLEBOTOMY FREE

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ROUTINE VENIPUNCTURE

1) Verify the requisition for the tests.
2) Introduce yourself to the patient, explain the procedure, and secure his/her informed
consent. Implied consent is a non-verbal communication, used when the patient
is unconscious or clinically unstable.
3) Identify the patient: for in-patient check the patient’s wristband, if you can not locate
it have the nurse re-band the patient. In a clinic setting have him/her state his/her name

full name and date of birth. 2 Identifier is required, the most critical mistake
a phlebotomist can make during the collection process is not properly identifying
the patient.
4) Wash your hands before touching your patient or the equipment.
5) Tie on the tourniquet; it should be applied 3-4 inches above the site where the
venipuncture will be made. Ask the patient to make a fist or open and close his/her
hand to help engorge the vein. Do not pump this can elevate potassium levels in
the blood and cause hemoconcentration.
6) Palpate the vein while looking for the straightest point. It’s not what you see, it’s what
you feel. Cleanse the area wiping away from the venipuncture site. Allow the site
to air dry.
7) Don your gloves, assemble the needle and tube holder while the alcohol is drying.
Uncap the needle and examine it for defects such as blunted or barbed points.
8) Hold the patient’s arm, by placing four fingers under the forearm and your thumb
below the antecubital area slightly pulling the skin back (taunt) to anchor the vein.
The purpose of anchoring the vein is to keep it still, veins can move if you do not
anchor it. Hence the term “Rolling veins”
9) With the bevel facing upward, insert the needle at an angle of 15-30 degrees angle.
10) Once the needle is inside the vein (you will feel a “give” as the vein is entered), push
the collection tube into the holder to puncture the tube stopper with the back-end of

the needle. Use the flange of the hub
11) Fill the needed tubes, according to the order of draw.

12) Release the tourniquet when the last tube is half full. The tourniquet should not stay
on for no longer one (1) minute in order to prevent hemoconcentration.
13) Pull out the collection tube from the holder.
14) Place folded gauze over the venipuncture site DO NOT PRESS and withdraw the
needle. Then apply pressure until bleeding stops. This is done to prevent hematoma.
Do not allow the patient to bend the arm as it does not offer enough pressure.
15) Apply the safety feature on the needle and discard the needle into the biohazards
sharps container. NEVER RECAP A NEEDLE!
16) Label each collected specimen, writing the patient’s last name first, first name last,
the time and date of collection, and your initials. use legible handwriting with a

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