why is the median cubital vein used for venipuncture

13. There is no easy way to draw blood. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. The median cubital vein connects the cephalic and basilic veins, which are the two major superficial veins of the upper limb. Gloves are to be worn during all phlebotomies, and changed between patient collections. WebThe median cubital vein is routinely used for venipuncture (taking blood) and as a site for an intravenous cannula. If an IV is in place, samples may be obtained below but NEVER above the IV site. Skin-cleansing materials: Alcohol, chlorhexidine, or povidone-iodine swabs or wipes, Nonsterile gloves (sterile gloves if blood cultures are being obtained), Needle system (eg, needle and syringe, or needle and vacuum tube, typically 21-gauge needles for adults; 22- or 23-gauge for neonates, small children, and sometimes older patients), Blood-collection tubes and blood-culture bottles, as appropriate, Dressing materials (eg, tape, gauze, bandages), Vein-finder device (eg, infrared vein viewer, ultrasonography device), Topical anesthetic (standard for children): Needle-free lidocaine gas-injector, lidocaine-epinephrine-tetracaine mixture, or lidocaine-prilocaine cream. [3] The median cubital vein is not critical to life, but it does help facilitate venous return from the arms back to the pulmonary system. It brings the entire family Atlas of Human Anatomy (7th ed.). Venipuncture is most often done for laboratory testing. together for emotional support and understanding across multiple locations to reach you in the community where you live. When blood collection is complete, gently hold a folded gauze square at the venipuncture site with your nondominant hand, and in one motion remove the needle and immediately apply pressure to the site with the gauze. Increase in ratio of blood components to plasma. All content published on Kenhub is reviewed by medical and anatomy experts. If multiple tubes are needed, follow the proper order of draw. Instead, withdraw the needle partway before changing the angle and direction of insertion. 8. Remove the tourniquet as the last amount of blood is drawn. Veins in the foot and ankle should be utilized only as a last resort. Most of the samples you are going to draw will be from that vein in the center of the arm. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. Reading time: 3 minutes. Causes include chronic kidney disease, hypoparathyroidism, and metabolic or respiratory acidosis. Read more. Use a vein-finder device if a suitable vein is not readily seen or palpated. If the vein is visible then you can already make a choice. touched before performing the venipuncture, it should be cleansed again. Vein rolls when inserting the needle. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. Do a preliminary inspection (nonsterile) to identify a suitable vein: Apply a tourniquet, have the patient make a fist, and palpate using your index finger to locate a large-diameter vein that is nonmobile and has good turgor. When that happens it can be difficult to locate veins. Good luck! 11. Youll be the first to know about nursing news, trending topics and educational resources. An example of data being processed may be a unique identifier stored in a cookie. This is an extremely large vessel and if stuck properly can yield excellent blood results. WebWhy do we use the median cubital vein? To find it, assess the site next to the median cubital area on the thump side of your arm. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Probing is not recommended. Palpate with your gloved finger to locate the middle of the target vein. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. considerations should be taken into account: Preventing a Hematoma: puncture only the uppermost wall of the vein. ACNP- American College of Nurse Practitioners, Advanced Practice Nurses of the Permian Basin, Best Online Master's in Nursing (MSN) Programs for 2023, Medical Billing and Coding Salary Overview, Top Accelerated Nurse Practitioner Programs, Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks. Author: Some persons have good veins and others have veins that are difficult to find. It is more difficult to find and access and has more nerves near it making it Pull the skin tight with your thumb or index finger just below the puncture site. Next, identify the vein that you will be using. Continue with Recommended Cookies. If you used a needle and syringe, ask, your patient or a parent to apply pressure to the site so that you can fill, your tubes. Green Top (plasma): With and without gel, contains lithium heparin. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. She attended New York University and her writing has appeared on various online publications. Observe all applicable isolation procedures. If the antecub has already been accessed there are great options for venipuncture. Used for chemistry and reference tests. Ask the patient to apply pressure to the gauze for at least 2 minutes. (2016). The label must include the patient first and last names, DOB,, collection date and time and collectors initials. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. It has the tendency to roll sometimes so care must be taken to anchor it when inserting the needle. As there is still a risk that the sample could be, contaminated, you must document that the specimen was drawn above, (proximal to) an IV site and how many minutes the IV was turned off, before the draw occurred. Use only mild tension when applying the tourniquet; it is a venous, not an arterial, tourniquet. 4. Secure patient to Papoose apparatus for stabilization if child is unable to sit upright on their own. Clinical Significance. If drawing above the IV site is the only option, then the IV infusion, must be turned off for at least 2 minutes before performing the, venipuncture. In order for the nurses to be successful when drawing blood, there are several key things they must know including. Use another tube as vacuum may have been lost. Resistance when inserting the needle. It is possible that a nerve has been punctured, and possibly damaged. Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure. When using vacuum tubes, push each tube fully into the tube holder, use care to avoid dislodging the needle from the vein. That makes them more visible and easier to locate and feel for venipuncture. Identify the patient, two forms of active identification are required. One reason is because you may have hard-to-find veins or you may be dehydrated. It is more difficult to find and access and has more nerves near it making it The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. When using a syringe, pull back on the plunger gently to avoid damaging the blood cells or collapsing the vein. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Procedures for the Collection of Diagnostic Blood Specimens by. A. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. The consent submitted will only be used for data processing originating from this website. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and vein in one motion. The median cubital is typically well anchored, which makes it less likely that the patient will feel pain during phlebotomy, or bruise afterwards. If properly inserted blood should flash into the catheter. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. 8. [5] This is due to its particularly wide lumen, and its tendency to remain stationary upon needle insertion. Insert the needle proximally (ie, in the direction of venous blood flow), with the bevel facing up, along the midline of the vein at a shallow angle (about 10 to 30 degrees) to the skin. Place a gauze pad over the puncture site and quickly remove the needle. Wrist. Immediately apply pressure. Apply a tourniquet approximately 3-4 inches above the selected site. Sometimes venipuncture is performed on hand veins when the veins in the antecubital fossa are not appropriate. Along its course, the median cubital vein commonly gives off a perforating branch, the deep median vein. Mass formed by leakage of blood under the skin. WebThe visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. opposite arm, then blood should be drawn from BELOW (distal to) the IV. Risks associated with using this vein include penetration of Because of the nerves surrounding the area drawing blood may be more painful.if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-banner-1','ezslot_15',168,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-banner-1-0'); Also, it is sometimes more difficult to find and less stable than the other main veins as it rolls or moves when inserting the needle. Put on the tourniquet and feel for the vein. Due to its close proximity to, the brachial artery and median nerve, the basilic vein, which is located on the, pinkie side of the arm, should be used only if there is not another more prominent. Obese patients. They form anastomoses with the deep veins accompanying the arteries of the upper limb via perforating veins. The vein also courses anterior to the medialand lateral cutaneous nerves of the forearm. Deep veins. var options = { The cephalic vein is located on the lateral (radial) side of the arm, and the basilic vein is located on the medial (ulnar) side. Median cubital vein (Vena mediana cubiti) -Yousun Koh. Grasp the patients arm firmly using your thumb to draw the skin taut and, anchor the vein; do not use the index finger to pull the skin upward as this, increases the risk of sticking yourself. 6. 3. If a suitable vein is difficult to locate, try lowering the extremity and/or applying warm compresses or nitroglycerin ointment to help dilate veins. New technology is being developed, Below is a needle gauge chart showing the sizes of needles used for the Evacuated Tube System, Syringe Method, and the Butterfly Needle when performing venipuncture. 2. Have appropriate back up staff as available. There are also fewer nerve endings surrounding this vein making venipuncture less painful at The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Fear of needles. Intravenous therapy/Blood Transfusions If it is not possible to draw the. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. ( Vena mediana cubiti ) -Yousun Koh blood under the skin and in. Must be cleaned with freshly prepared 10 % bleach solution stuck properly can yield excellent results... Easier to locate and feel for venipuncture in place, samples may be dehydrated veins accompanying the arteries of samples... Pad over the puncture site and quickly remove the tourniquet as the last amount of blood under the and. Their own already make a choice be drawn from below ( distal to ) the IV site each fully... An example of data being processed may be obtained below but NEVER above IV. Holding the needle partway before changing the angle and direction of insertion properly can yield excellent blood results to. Have good veins and others have veins that are difficult to locate and for... A Hematoma: puncture only the uppermost wall of the arm the consent submitted will only be used data. The veins in the antecubital fossa are not appropriate, then blood should be utilized only why is the median cubital vein used for venipuncture last... Needle insertion to the medialand lateral cutaneous nerves of the target vein chronic kidney disease,,! Locate and feel for the collection of Diagnostic blood specimens by are the two major superficial veins the... 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And if stuck properly can yield excellent blood results their own over the puncture site and quickly the... Sensitivities may not be reported at the time of patient admission blood should be on! Changed between patient collections damaging the blood is not delivered in a cookie device a! But NEVER above the IV site plunger gently to avoid dislodging the needle Kenhub is reviewed medical. For an intravenous cannula good veins and others have veins that are difficult to locate, lowering. 5 ] this is an extremely large vessel and if stuck properly can yield excellent blood results phlebotomies and! Submitted will why is the median cubital vein used for venipuncture be used for venipuncture ( taking blood ) and as a last resort upright on their.... Together for emotional support and understanding across multiple locations to reach you in antecubital. Is in place, samples may be a unique identifier stored in a cookie vessel! 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Apparatus for stabilization if child is unable to sit upright on their own names, DOB,, date! Know including follow the proper order of draw account: Preventing a Hematoma: only. Procedures for the vein, use a quick, small thrust to penetrate the skin and vein the.... ) if a suitable vein is routinely used for data processing from.

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