Pharmacology Assignment Submitted To Prof. Waqar Sarosh Moeen Bsmit-F19-099 Section B Topic: Venipuncture Techniques

PHARMACOLOGY ASSIGNMENT
Submitted to Prof. Waqar
SAROSH MOEEN
Bsmit-f19-099
Section B
Topic:
VENIPUNCTURE TECHNIQUES
Definition:
“Venipuncture is the process of obtaining intravenous access for the purpose of intravenous
therapy or for blood sampling of venous blood”
In other words:
“Venipuncture is puncturing vein with sterile cannula/ needle into a vein to supply the blood
with fluids, electrolyte, nutrients and medication”
 It is one of the most commonly performed procedures which, carried out skillfully,
carefully and accurately, will provide high quality blood samples without causing
discomfort to the patient.
 To perfect the technique of venipuncture, you should have a good understanding of the
arteries, veins and associated nerves within the arm.
Venipuncture is one of the most routinely performed invasive procedures and is carried out for
any of five reasons:
1. To obtain blood for diagnostic purposes.

2. To monitor levels of blood components.
3. To administer therapeutic treatments including medications, nutrition, or
chemotherapy.
4. To remove blood due to excess levels of iron or erythrocytes (red blood cells).
5. To collect blood for later uses, mainly transfusion either in the donor or in another
person.
INDICATION:
 To save the patient in life-threatening situation.

 To supply fluids and nutrients to the patient who are unable to digest or absorb a diet
administered mouth or through the nasal tube.
 To introduce a drug into the circulation for diagnostic purpose when blood or blood
products are to be given.
COMMONLY USED VEINS:
 Basilica and cephalic veins (forearm)

 Median cubital, cephalic and Basilica veins (antecubital fossa)
 Radial vein (radical area)
 Dorsal metacarpal vein (the hand)
PERFORMING A VENIPUNCTURE:
There are two stages to locating a vein:
1. Visual inspection
2. Palpation
 Visual Inspection:
The scrutiny of the veins in both arms is essential prior to choosing a vein
Venipuncture Site Selection:
The median cubital and cephalic veins are most commonly used for venipuncture. See below.
Alternative sites are the basilica vein on the dorsum of the arm or dorsal hand veins. Due to its
close proximity to the brachial artery and median nerve, the basilica vein, which is located on
the pinkie side of the arm, should be used only if there is not another more prominent arm
vein. Veins in the foot and ankle should be utilized only as a last resort. Veins on the underside
of the wrist should be avoided.
 Veins to avoid:
1. Veins close to an infection.
2. Veins close to bruising and phlebitis.
3. Edematous limbs as there is danger of stasis of lymph, predisposing to such
complications as phlebitis and cellulites.
4. Areas of previous venipuncture should be avoided as a buildup of scar tissue can
cause difficulty in accessing the vein and can result in pain.
5. Avoid veins that are thrombosed.
6. Do not use the affected arm in CVA or mastectomy patients.
7. A vein sited in the region of a drip site should never be used as it may result in the
collection of a diluted samples.
Palpation:
Palpation is also an important assessment technique as it:
 Determines the location and condition of the veins.

 Distinguishes veins from arteries and tendons.
 Identifies the presence of valves.
 Healthy veins feel soft and bouncy and will refill when depressed.
 Improving venous access:
There are a number of methods to improve venous access, for example:
1. Application of a Tourniquet. Promotes venous distension.

 The tourniquet should be tight enough to impede venous return but not restrict arterial
flow.
 The tourniquet should be placed about 7 – 8 cm above the venipuncture site.
 The tourniquet should not be left on for longer than 1 minute as it may result in haemo-
concentration or pooling of the blood, leading to inaccurate blood results.
2. Opening and closing of the fist:
 The muscles will force blood into the veins and encourages distension. However this action may
affect certain blood results, e.g. potassium.
3. Light tapping of the vein:

 May be useful but can be painful and may result in the formation of a hematoma in
patients with fragile veins
4. The use of heat:
In the form of warm pack to encourage vasodilatation and venous filling
5. Lowering the arm below the level of the heart
Skin preparation:
 Asepsis is vital when performing venipuncture as the skin is breached and a foreign
device is introduced into a sterile circulatory system
 Skin cleaning is a controversial subject and it is acknowledged that a cursory wipe with
an alcohol swab does more harm than good as it disturbs the skin flora
 However, where time permits and always for blood culture sampling or if the patient is
at increased risk of infection the skin should be cleaned with an alcohol swab BUT you
must allow at least 2 minutes for the area to dry thoroughly before proceeding with
venipuncture.
Hand hygiene:
Is the single most important activity for reducing the spread of disease, yet evidence suggests
that many health care professionals do not decontaminate their hands as often as they need to,
or use the correct technique which means that areas of the hands can be missed.
 Improper drying can recontamination hands that have been washed. Wet surfaces
transfer organisms more effectively than dry ones and inadequately dried hands are
prone to skin damage. Disposable paper hand towels of good quality should be used to
ensure hands are dried thoroughly
Safety of the practitioner – It is recommended that well-fitting gloves are worn during any
procedure that involves handling of blood and body fluids, particularly with venipuncture. This
is to prevent contamination of the practitioner from potential blood spills.
Whilst it is recognized that gloves will not prevent a needle stick injury, the wiping effect of the
glove on a needle may reduce the volume of blood to which the hand is exposed, thereby
reducing the volume inoculated and the risk of infection
Used needles should always be discarded directly into an appropriate sharps container, without
being re sheathed
Specimens from patients with known suspected infections such as hepatitis or HIV should be
double bagged in clear polythene bags with a biohazard label attached.
The accompanying request forms should be kept separate from the specimen to avoid
contamination (two pockets in bag)
Complications
 Inability to obtain specimen due to:

1. Inappropriate choice of vein
2. Thrombosed vein (due to previous or repeated attempts)
3. Inexperience of operator
4. Patient shocked, cold or dehydrated causing vasoconstriction
 Formation of hematoma due to:

1. Poor technique
2. Pressure not being applied to puncture site following removal of needle
 Puncture of an artery:
If an artery is punctured: release the tourniquet, remove the needle and apply firm pressure for
a minimum 5 minutes. Cover the site with a dressing once bleeding has stopped. Re-check for
signs of bleeding in 20 minutes.
THANKYOU

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PHARMACOLOGY ASSIGNMENT

Submitted to Prof. Waqar

therapy or for blood sampling of venous blood”

1. To obtain blood for diagnostic purposes.

 To save the patient in life-threatening situation.

COMMONLY USED VEINS:

 Basilica and cephalic veins (forearm)

 Radial vein (radical area)

 Dorsal metacarpal vein (the hand)

Palpation is also an important assessment technique as it:

 Determines the location and condition of the veins.

 Improving venous access:

There are a number of methods to improve venous access, for example:

1. Application of a Tourniquet. Promotes venous distension.

3. Light tapping of the vein:

In the form of warm pack to encourage vasodilatation and venous filling

5. Lowering the arm below the level of the heart

 Inability to obtain specimen due to:

 Formation of hematoma due to:

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