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
