- Check that you are taking blood at the required time. Some tests are time-specific (e.g. serum digoxin level, which is assessed 6 hours after a digoxin dose, or a fasting blood for a lipid profile).
- Try hanging the patient’s arm over the edge of the bed and gently tap the antecubital fossa, forearm and back of the hand veins if you can not easily find a vein. Inflate the cuff to just above DBP, and/or apply a warmed pack to the patient’s arm, to enhance venous filling.
- Ultrasound is useful for finding veins and guiding venepuncture or cannulation in patients with difficult venous access
- Do not use excessive suction to extract blood, as this may cause haemolysis and causes the vein to collapse and stop flow. Using a syringe to withdraw the blood allows better control of evacuation pressure, and is less likely to collapse veins. This is especially important in children or venessection from small veins.
- Never, ever recap a needle.
- Always invert filled blood tubes gently, especially those containing anticoagulant.
- Never underfill anticoagulant tubes (citrate/blue top).
- Never overfill heparinised tubes (green top), as this will cause the sample to clot.
- Always remember to double-check that all samples have been labeled and that the correct patient’s details, date and time are entered prior to sending samples to the laboratory.
- Needle-stick injury or blood splash to a mucous membrane.
- Most likely when evacuated tubes or blood tubes are held in the hand and directly injected with blood. Do NOT do this.
- Promptly wash away the blood or body fluid and encourage bleeding. Use soap, except for the eyes and mouth, and rinse well with water.
- Report the incident to your supervisor as soon as possible.
- Haemolysis produces unreliable laboratory results.
- May be caused by incorrect venepuncture technique; pulling the tourniquet too tight or leaving it on for too long; using needles that are too small (>20G); insufficient amount of blood; incorrect filling of the blood collection tubes or too vigorous shaking of the tubes.
Ultrasound-guided Peripheral venous Access