Download ArticleDownload ArticleThis article was co-authored by David Nazarian, MD. Dr. David Nazarian is a board certified Internal Medicine Physician and the Owner of My Concierge MD, a medical practice in Beverly Hills California, specializing in concierge medicine, executive health and integrative medicine. Dr. Nazarian specializes in comprehensive physical examinations, IV Vitamin therapies, hormone replacement therapy, weight loss, platelet rich plasma therapies. He has over 16 years of medical training and facilitation and is a Diplomate of the American Board of Internal Medicine. He completed his B.S. in Psychology and Biology from the University of California, Los Angeles, his M.D. from the Sackler School of Medicine, and a residency at Huntington Memorial Hospital, an affiliate of the University of Southern California.
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Nurses and phlebotomists draw blood to perform a variety of medical tests. This article will teach you how professionals draw blood from patients.
Steps
Observe any patient precautions. Take note of signs behind the patient's bed or on the patient's chart. Observe isolation restrictions, and make sure that, if the blood test requires fasting, that the patient fasted for the appropriate amount of time.
Introduce yourself to your patient. Explain what you are about to do as you draw blood.Advertisement
Wash and sanitize your hands. Put on sanitary gloves.
Review the patient's order.- Verify the requisition is stamped with the patient's first name, medical record number and birthday. No birth year required.
- Make sure that the requisition and labels match exactly with the patient's identification.
- Confirm the patient's identity from the wristband or by asking the patient for a name and date of birth. Only month and day of birth is required.
Assemble your supplies. You should have in front of you: blood collection tubes, a tourniquet, cotton balls, bandage or medical adhesive tape, and alcoholic wipes. Make sure that your blood tubes and blood culture bottles have not expired.
Select the appropriate needle. The type of needle that you choose will depend on the patient's age, physical characteristics and the amount of blood that you plan to draw.
Seat the patient in a chair. The chair should have an armrest to support the patient's arm but should not have wheels. Make sure that the patient's arm is not bent at the elbow. If the patient is lying down, place a pillow under the patient's arm for additional support.
Decide which arm you will be drawing from or let your patient decide. Tie a tourniquet around the patient's arm about 3" to 4" (7.5cm to 10 cm) above the venipuncture site.
Ask the patient to make a fist. Avoid asking the patient to pump his or her fist.
Trace the patient's veins with your index finger. Tap the vein with your index finger to encourage dilation.
Disinfect the area that you plan to puncture with an alcohol wipe. Use a circular motion, and avoid dragging the wipe over the same piece of skin twice.
Allow the disinfected area to dry for 30 seconds so that the patient doesn't feel a sting when the needle is inserted.
Inspect your needle for defects. The end should have no obstructions or hooks that will restrict the flow of blood.
Thread the needle into the holder. Use the needle sheath to secure the needle in the holder.
Tap any tubes that contain additives to dislodge the additives from the walls of the tube.
Insert the blood collection tube onto the holder. Avoid pushing the tube past the recessed line on the needle holder or you may release the vacuum.
Grasp your patient's arm. Your thumb should pull the skin taut about 1" to 2" (2.5cm to 5cm) below the puncture site. Make sure the patient's arm points slightly down to avoid reflux.
Line up the needle with the vein. Make sure the bevel is up.
Insert the needle into the vein. Push the collection tube toward the holder until the butt end of the needle pierces the stopper on the tube. Make sure that the tube is below the puncture site.
Allow the tube to fill. Remove and discard the tourniquet as soon as blood flow into the tube is adequate.
Remove the tube from the holder when the blood flow ceases. Mix the contents if the tube contains additives by inverting the tube 5 to 8 times. Do not vigorously shake the tube.
Fill the remaining tubes until you've completed the requisition.
Ask the patient to open his or her hand. Place a piece of gauze over the puncture site.
Remove the needle. Place the gauze on top of the venipuncture site and apply gentle pressure to stop the bleeding.
Activate the needle's safety feature and discard the needle in a sharps container.
Tape the gauze to the puncture site after the bleeding has stopped. Instruct the patient to keep the gauze on for at least 15 minutes.
Label the tubes in view of the patient. Chill the specimens if needed.
Discard all waste and put your materials away. Wipe the armrest of the chair with germicidal wipes.
Expert Q&A
- QuestionWhat does tapping a vein do?
David Nazarian, MDDr. David Nazarian is a board certified Internal Medicine Physician and the Owner of My Concierge MD, a medical practice in Beverly Hills California, specializing in concierge medicine, executive health and integrative medicine. Dr. Nazarian specializes in comprehensive physical examinations, IV Vitamin therapies, hormone replacement therapy, weight loss, platelet rich plasma therapies. He has over 16 years of medical training and facilitation and is a Diplomate of the American Board of Internal Medicine. He completed his B.S. in Psychology and Biology from the University of California, Los Angeles, his M.D. from the Sackler School of Medicine, and a residency at Huntington Memorial Hospital, an affiliate of the University of Southern California.
Board Certified Internal Medicine PhysicianWhen you tap the vein, you're actually trying to locate it, as the veins are a bit bouncy. By tapping it, you can localize exactly where it is before you use a needle or catheter.
Video
Tips
- Some patients are squeamish during a blood draw. Encourage the patient not to watch as you insert the needle. Take precautions in case your patient becomes dizzy or feels like fainting. Never let a patient leave until he or she has fully recovered.Thanks
- If you're drawing blood from a small child, suggest that the child sits in the parent's lap for comfort.Thanks
- Rather let the patient hold on to something with the other hand so to shift their focus about the needle being inserted in their vein.Thanks
Warnings
- Never attempt a blood draw more than twice. If you can't complete the procedure, consult a nurse.Thanks
- Follow precautionary procedures if any of your materials become soiled with blood or if you or your patient is pierced with a contaminated needle.Thanks
- Consult a doctor or nurse if you can't stop the puncture site from bleeding.Thanks
- Avoid leaving a tourniquet on a patient's arm for more than 1 minute.Thanks
Things You'll Need
- Chair with armrests or bed with a pillow to support the patient's arm
- Soap and water or hand sanitizer
- Sanitary gloves
- Requisition and labels
- Blood collecting trays
- Sterile needles
- Holders for needles and evacuated tubes
- Tourniquet
- Alcohol wipe
- Clean gauze
- Germicidal wipes
- Disposal box
- Adhesive tape
- Biohazard bags
Expert Interview
Thanks for reading our article! If you'd like to learn more about becoming a nurse, check out our in-depth interview with David Nazarian, MD.
References
About This Article
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
To draw blood, the doctor will start by tying a tourniquet around the patient's arm and asking them to make a fist. Then, the doctor will find the patients vein and disinfect the area with an alcohol wipe. Once the area is disinfected, the doctor will pull the patient's skin taut and line the needle up with their vein. Next, expect the doctor to insert the needle into the patient's vein and allow the attached tube to fill with blood. When the first tube is full, the doctor will remove it from the needle holder and repeat with the remaining tubes. For tips on setting up a needle and blood collection tubes, keep reading!
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