1 Find the target vein with a light tourniquet first. If you can't find it, tighten the tourniquet, but do not over tighten the tourniquet. Using a warm damp cloth or towel to the site will increase circulation and make the veins more prominent. Nevertap or slap the site, it may cause hemolysis. Never have the patient pump his/her fist or leave the tourniquet on for more than one minute. This will cause hemoconcentration. 2 Look by feeling. Always remember that when trying to locate a vein it's by what you feel not what you see. A vein feels bouncy when your pressing. Ask your patient to make a tight fist this helps the veins to expand & rise and make it easier to feel them once the tourniquet is applied. 3 Plan your approach and subtly practice it a few times without actually sticking the patient. 4 Be sure to properly anchor the vein. Place the thumb of your free hand below the vein and pull down lightly. Sometimes veins still roll even when they are well anchored. Try to rotate the needle in the vein while trapping it by pushing the vein towards the needle with your other hand. Never dig at the vein. Sometimes you will have to adjust, using a butterfly needle. 5 Look elsewhere. Many times the veins aren't easy to find in the AC antecubital fossa area which is the main middle vein in the forearm. Sometimes the only veins that can be located are on tops of the hands. If you have an elderly person, or someone whom is very sick & has extensive surgeries, or cancer they are even more difficult to locate. Many draws I have to even go to the sides of the hand or the wrist, or veins in the fingers such as the thumb as last result due to the fact that there are no other sites. Also, this is very important if you are having a hard time locating a vein place two tourniquets together and then tie on the patients site you have chose to draw. This technique really helps to feel a vein. Sometimes, placing a warming pad will also help. 6 Ask someone else to do it for you if you feel pressured to proceed before you are confident. Never do a hard stick under time pressure. NEVER stick a patient before asking the nurse in charge if there is a planned order for a new IV placement. This could prevent a needless stick for the patient since you can draw most lab tests from a new IV start.
