Table of Contents IntroductionPreparation ProcedureVein identificationVenepuncture To completeTry it out with a simulated station Introduction Wash handsIntroduce selfPatient’s name, DOB and wrist bandExplain procedure and obtain consentCheck for allergies (including chlorhexidine)Ask preferred (or non-dominant) arm Venepuncture equipment Preparation Wash hands Clean trayGather equipment around tray (think through what you need in order) Equipment list GlovesTourniquet Alcohol 70%/chlorhexidine 2% skin-cleansing wipeGreen 21G Vacutainer needle (standard or butterfly)Vacutainer holderRequired blood tubes (in order of draw order)Light blue – clotting Yellow – U&Es and everything else Purple – FBC Pink – group and saveGrey – glucose NB: yellow tube must be taken before purple tube which contains K+ EDTA that will produce a pseudo-hyperkalaemia)Sterile gauzeTape Wash handsOpen packets and place neatly in tray, keeping items in plastic parts of packets (without touching the instruments themselves)Attach Vacutainer holder to end of needle/butterflyReturn to patient (with tray and a sharps bin) Procedure Vein identification Wash hands Expose arm and place a pillow beneath itPlace tourniquet around patient’s arm 4-5 finger widths above intended venepuncture site (antecubital fossa is usually the easiest)NB: if you are using the back of the hand, you must use a butterfly needle.Identify a suitable vein (i.e. one you can feel, not necessarily one you can see)NB: take sufficient time to find the best vein – this is the main determinant of whether you will be successful or not.Remove tourniquet Venepuncture Wash handsPut on glovesSterilise area using skin-cleansing wipe (clean for 30 seconds, then allow to air-dry for 30 seconds)Re-apply tourniquetAnchor the skin distally with your non-dominant hand and insert the needle (bevel up) at 10-30˚ with your dominant hand Use your dominant hand to hold the butterfly wings/Vacutainer steady on the patient’s arm. Then use your non-dominant hand to: Fill blood bottles in correct order of draw, inverting them after fillingRemove tourniquet after removing the last bottle Place gauze loosely over the puncture site while you remove the needle. Then apply pressure to the gauze once the needle is fully removed.Put the needle immediately in the sharps binMaintain pressure over the gauze until bleeding has stopped, then tape the gauze down over puncture site To complete Thank patient and restore clothingDiscard waste and clean tray; then discard gloves; wash handsFill in blood bottle labels, put in bags with printed request forms, send to labDocument procedure and tests requested in patient’s notes Learn how to interpret the results too…We have notes on interpreting the full blood count, urea & electrolytes, liver function tests, and the coagulation screen! Try it out with a simulated station VenepunctureFind more stations here!