Venepuncture - How To Take Blood

Venepuncture is a relatively common OSCE station. You’ll be expected to demonstrate your clinical skills and ability to communicate effectively. This venepuncture OSCE guide provides a clear step by step approach to venepuncture, with an included video demonstration. This guide discusses venepuncture using vacutainer bottles, so steps may differ if you are using different equipment (e.g. needle and syringe). Check out the venepuncture OSCE mark scheme here.

Introduction

• Introduce yourself

• Confirm patient details – name / DOB

• Explain procedure:

“I need to take a blood sample which will involve inserting a needle into your vein.“
“It will feel like a sharp scratch and shouldn’t take too long.“

• Gain consent – “Do you understand everything I’ve said?” “Are you ok for me to go ahead?“

Gather equipment

• Gloves
• Apron
• Needle
• Barrel
• Sample bottles
• Tourniquet
• Antiseptic swab
• Gauze
• Tape
• Sharps bin

It’s often wise to bring two needles, barrels, bottles and swabs, just in case you fail first time.



Procedure
- Preparation
Ensure the patient is lying or sitting comfortably (place a pillow under the arm if possible).

1. Wash hands
2. Apply tourniquet – avoid nipping the patient’s skin
3. Palpate a vein:

• The antecubital fossa is most frequently used location
• Go for a straight vein- ideally it should feel “springy”
• Avoid areas where veins are joining together – valves present

4. Don gloves
5. Clean the site with an antiseptic swab – 30 seconds
6. Attach the needle to the barrel


Apply tourniquet


Palpate a vein


Clean the area


Attach needle to barrel

- Insertion of the needle

7. Unsheathe the needle
8. Anchor the vein from below with your non-dominant hand
9. Warn the patient of a sharp scratch
10. Insert the needle through the skin at 20-40 degrees– bevel upwards
11. You should feel a slight give as the needle enters the vein
12. Lower the needle and anchor the barrel firmly to the skin
13. Fill the required amount of blood sample bottles
14. It’s essential to keep the barrel still whilst changing bottles
15. Remove the tourniquet
16. Remove the needle carefully and place immediately into a sharps bin
17. Apply pressure to the site with some gauze
18. Tape a dressing to the patient’s arm (cotton wool / gauze)
19. Dispose of the equipment into a clinical waste bin


Unsheath needle


Ensure bevel is pointing upwards


Insert needle


Attach bottle


Remove bottle


Remove tourniquet


Remove needle & apply wool / gauze


Dispose of sharp


Dispose of clinical waste


Label bottle at bedside

To complete the procedure…

• Thank patient

• Wash hands

• Fill out patient details on the sample bottles at the bedside

• Send the blood samples to the lab for testing

Source