UNIVERSITY OF SANTO TOMAS

FACULTY OF PHARMACY
DEPARTMENT OF MEDICAL TECHNOLOGY
Principles and Strategies of Teaching in Health Education
TEACHING DEMONSTRATION
VENIPUNCTURE
I.

OVERVIEW
Venipuncture is the process of obtaining intravenous access for the purpose of
intravenous therapy or for blood sampling of venous blood.

II.
1.

PRINCIPLE

Venipuncture is an invasive procedure, which carries a small risk to the patient as

well as to the phlebotomist. The following techniques and procedures are used to minimize
these risks. In addition, procedures for specimen handling are followed in order to preserve
specimen integrity. Venipuncture is the collection of blood from a vein, usually for laboratory
testing. Most of the time, blood is drawn from a vein located the inside of the elbow or the back
of the hand. The site is cleaned with germ-killing medicine (antiseptic).
III.

MATERIALS
A.
Blood collecting trays.
B.
Gloves
C.
Sterile Needles
D.
Push Button Winged butterflies
E.
Evacuated tubes
F.
Tourniquet
G.
Antiseptic
H.
Clean Gauze
I.
Antiseptic

IV.

METHOD
A.
Identify the patient. Outpatients are called into the phlebotomy area and asked
their name and date of birth. This information must match the requisition. Add
B.

0.1 ml of PTT reagent.

Reassure the patient that the minimum amount of blood required for testing will

C.

be drawn.
Assemble the necessary equipment appropriate to the patient's physical

D.
E.

characteristics.
Wash hands and put on gloves.
Position the patient with the arm extended to form a straight-line form shoulder to

F.

wrist.
Do not attempt a venipuncture more than twice. Notify your supervisor or
patient's physician if unsuccessful.

UNIVERSITY OF SANTO TOMAS

FACULTY OF PHARMACY
DEPARTMENT OF MEDICAL TECHNOLOGY
Principles and Strategies of Teaching in Health Education
TEACHING DEMONSTRATION
G.

Select the appropriate vein for venipuncture. The larger median cubital, basilic

H.
I.

and cephalic veins are most frequently used.

Apply the tourniquet 3-4 inches above the collection site.
Clean the puncture site by making a smooth circular pass over the site with the

J.

70% alcohol pad.

Perform the venipuncture
A. Attach the appropriate needle to the hub by removing the plastic cap
over the small end of the
needle and inserting into the hub, twisting it tight.
B. Remove plastic cap over needle and hold bevel up.
C.
Pull the skin tight with your thumb or index finger just below the
puncture site.
D. Holding the needle in line with the vein, use a quick, small thrust to
penetrate the skin and
enter the vein in one smooth motion.
E.
Holding the hub securely, insert the first vacutainer tube following
proper order of draw into
the large end of the hub penetrating the stopper. Blood should flow into
the evacuated tube.
F. After blood starts to flow, release the tourniquet and ask the patient
to open his or her hand.
G. When blood flow stops, remove the tube by holding the hub securely
and pulling the tube off the needle. If multiple tubes are needed, the

1.
2.

proper order of draw to avoid cross

contamination and erroneous results is as follows:
Blood culture vials or bottles, sterile tubes
Coagulation tube (light blue top)
(Routine PT/PTT may be performed if blue top is first tube collected. It may be

desirable to
collect a second tube for other coagulation assays.)
3. Serum tube with or without clot activator or silica gel (Red or Gold)
4. Heparin tube (Green top)
5. EDTA (Lavender top)
6. Glycolytic inhibitor (Gray top)
K. Each coagulation tube (light blue top) should be gently inverted 4 times
after being removed from the hub. Red and gold tops should be inverted 5 times.
All other tubes containing an additive should be gently inverted 8-10 times.
V.

INTERPRETATION:

UNIVERSITY OF SANTO TOMAS

FACULTY OF PHARMACY
DEPARTMENT OF MEDICAL TECHNOLOGY
Principles and Strategies of Teaching in Health Education
TEACHING DEMONSTRATION
If a blood sample is not attainable:
A. Reposition the needle.
B. Ensure that the collection tube is completely pushed onto the back of the needle in
the hub.
C. Use another tube as vacuum may have been lost.
D. Loosen the tourniquet.
E. Probing is not recommended. In most cases, another puncture in a site below the
first site is advised.
F. A patient should never be stuck more than twice unsuccessfully by a phlebotomist.
The Supervisor should be called to assess the patient.