3-9. SITE FOR VENIPUNCTURE

a. Selection. Site selection for venipuncture depends on:

(1) Accessibility of the vein. A vein should be relatively easy to feel and to stabilize for venipuncture. If this task is too difficult, select another vein.

(2) General condition of the vein. If the vein is in good condition, it will easily take the venipuncture. If the vein is poor, it may collapse upon puncture.

(3) Type of fluid to be infused. If the fluid used is especially irritating, a different site will be suitable from the sites, which can be used for non-irritating fluids.

(4) Period the intravenous line is expected to be in place. Long-term intravenous therapy will often require a different site from the ones that can be used if a single bottle or bag of fluid will be used.

b. Preferred Sites. The following sites are generally used and preferred for use by most physicians in the clinical setting it is possible to select preferable veins for puncture. On the battlefield and keeping with the tenants of Tactical Combat Casualty Care (TC3), you should puncture a high percentage vein such as antecubital or external jugular.

(1) Distal to the antecubital area (that is, cephalic, basilic, antebrachial veins in the lower arms).

(2) Veins on the back of the hand.

(3) Veins in the lower extremities when necessary although danger of thrombophlebitis is considerably greater.

(4) The leg and foot veins may be used on children because these vessels are not sclerosed.

CAUTION: Select the largest vein, if possible, when injecting intravenous drugs that may produce sloughing/necrosis injury to the tissues.

 

(5) Scalp veins are used in infants.