Blood extraction and

canulation

Objectives
At the end of this session the students will
be able to :
Demonstrate venous blood extraction on
simulator .
Demonstrate arterial blood extraction on
simulator.
Differentiate between blood tubes according
to the blood tests.
Demonstrate venues canulation on
simulator.

Definition
blood extraction:
The process of getting or pulling
the blood out from vein or artery
for sample analysis .

Venous blood extraction

Introduce yourself to
the patient and
explain what you will
do with the blood
sample and why.
Make sure that this is
the correct patient
from whom you wish
to take the blood
sample.

 Select the site,

preferably at the bend
of the elbow.
Palpate the area;
locate a vein of good
size that is visible,
straight and clear.
The vein should be
visible without
applying a tourniquet

 Apply a tourniquet
around the arm.
Tie approximately 45
finger widths above the
selected site.

 Ask the patient to

form a fist so that the
veins are more
prominent

 Disinfect the area

where you will put the
needle.
Use 70% isopropyl
alcohol.
Wait 30 seconds for the
alcohol to dry.
DO NOT touch the site
once disinfected.

 When using vacuum

extraction system with
holder, insert the
blood collector tube
into the holder

Perform the blood draw.

Enter the vein swiftly at
a 30 angle

 When blood starts to

flow, ask patient to
open his/her hand.

 Once sufficient blood

has been collected
(minimum 5ml),
release the tourniquet
BEFORE withdrawing
the needle

 Withdraw the needle

gently.
Give the patient a
clean gauze or dry
cotton wool ball to
press gently on the
site.
Remove blood
collector tube from
holder

 Put needle into leak-proof and

puncture resistant sharps
container. If the sharps container
DOES NOT HAVE a needle
remover:
Put the needle and holder into a
sharps container.
Do not remove the needle from
the holder.
Do not reuse the needle. If the
sharps container HAS a needle
remover:
Remove the needle following
instructions on the sharps
container.
Put the holder into the infectious

 Do not reuse the

needle. If the sharps
container HAS a
needle remover:
Remove the needle
following instructions
on the sharps
container.
Put the holder into the
infectious waste bag
for disinfection

Blue

Na citrate to
prevent coagulation
without effect of
coagulation factors

Yellow

plan tube

Purple

Ca EDETA prevents
cougulation of blood

Pink

gray

Fluoride
prevents
anaerobic
glycolysis

Arterial blood extraction

Introduce your self to the patient and explain the
procedure
Assemble equipment and supplies
Identify the site.
Locate the radial artery by performing an Allen
test.

Allen test
The hand is elevated and the
patient/person is asked to
make a fist for about 30
seconds.
Pressure is applied over the
ulnar and the radial arteries
so as to occlude both of
them.
Still elevated, the hand is
then opened. It should
appear blanched (pallor can
be observed at the finger
nails).
Ulnar pressure is released
and the colour should return

 Perform hand hygiene.

(if using soap and
water, dry hands with
single-use towels)
Put on well-fitting,
gloves.
Disinfect the site,
using 70% isopropyl
alcohol,
and allow to dry.

 heparinized syringe.
Pull the syringe plunger to the
required fill level.
Holding the syringe and needle
like a dart
use the index finger to locate
the pulse
then insert the needle at a 45
degree angle, approximately 1 cm
away from the index finger.
Advance the needle into the
radial artery
until a blood flashback appears;
allow the syringe to fill to the

 Withdraw the needle gently ,

Give the patient a clean gauze or dry cotton-wool
ball to press firmly on the site.
Check whether bleeding has stopped after 23
minutes (longer may be needed for patients who
have high blood pressure or a bleeding disorder, or
are taking anticoagulants)..
Expel air bubbles. cap the syringe and roll the
specimen between the hands to gently mix it.
Label the syringe.
Place the syringe in ice cup .
Dispose appropriately of all used materials
Perform hand hygiene.
Transport the sample immediately to the
laboratory.

Canulation
Wash your hands.
Introduce yourself.
Ask the patients permission giving a short
explanation of rationale such as save you from
multiple injections--fluids to make you feel
better. Document that permission was obtained.
Check for suitable vein.

 Open packs for easy access. Prepare flush.

Put on or re-tighten tourniquet 6-10cms above site.

Check veins once more.

Put on gloves.

Clean site with alcohol wipe Do NOT touch site

again.

 Steady the vein and

insert cannula 30
angle approx.

Watch for blood flashback and once you

see it advance
cannula 2 3 mms
only.

 RELEASE TOURNIQUET
Occlude vessel above
cannula tip and hold
cannula steady.
Place some gauze or
cotton wool under
cannula.

 Remove the needle

and place in the
sharps bin..

Tell the patient that

the needle is gone
nothing sharp left in
the patient

 Put on stopper or
clave connector .
Apply tegaderm or
similar dressing.

 Note that there is a

facility for recording
the date on the
tegaderm dressing.
Place this along the
side of the dressing.

 Flush with normal saline.

Thank and reassure your
patient. Ask them to
report any problems they
have with the IV cannula.
Discard all waste
appropriately according
to hospital policy.

Best wishes for all
dr/ Dr . Elham Fahmawi
Dr ..mohammed Elmasri