3-24

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3-24. PROCEDURE FOR VENIPUNCTURE

a.Explain the procedure to the patient. If the patient is conscious and objects to the procedure for religious or other reasons, no further attempt should be made. If the patient is unconscious, consent is implied, and the venipuncture may proceed.

b. Assemble and set up the equipment. (See paragraph 3-23 for equipment)

c. Wash your hands

d. Select an infusion site on the uninjured arm. Site should be at the most distal and accessible vein. Distal pulse should be present.

e. Apply the constricting band above the site and palpate for a fairly straight vein which lies on a hard surface. Vein should feel springy to palpation. Avoid sites near joints.

f. Cleanse the selected site and instruct the patient to clench and unclench his fist several times to improve venous distention.

g. Remove protective cover from catheter/needle unit without contaminating the needle.

h. Apply gentle pressure on the vein about one inch below the injection site and pull the skin taut.

i. Position the needle at a 20- to 30-degree angle and in the direction of the venous flow.

j. Insert needle and decrease the angle until almost parallel to skin surface. Aspirate for blood backflow or note blood in the flash chamber. If the first attempt is unsuccessful, pull the needle back slightly (but not

above the flesh surface) and direct the needle point into the vein again. If this second attempt is unsuccessful, release the constricting band and withdraw the needle.

k. Remove the constricting band. Press the skin lightly over the catheter to constrict the vein and prevent excessive blood loss into the catheter. This procedure should be attempted again in another place.

l. Using your dominant hand, remove the protective cover from the needle adaptor and connect it quickly and tightly to the catheter hub.

m. Remove your other hand from the hub, release the clamp and adjust the flow. Check for infiltration.

n. Clean the area around the venipuncture and place ointment/dressing IAW local SOP. Tape the looped tubing securely to the patient's arm.

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