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What Are the Best Sites for Venipuncture?

Phlebotomists are trained to locate the best vein for drawing blood.
Superficial veins located close to the skin's surface are the best sites for venipuncture.
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  • Written By: Jackie Myers
  • Edited By: Susan Barwick
  • Last Modified Date: 23 November 2014
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The best sites for venipuncture are the superficial veins in the upper arms. These veins are the median cubital vein, the cephalic vein, and the basilic vein. Superficial veins are located close to the surface of the body. As a result, health care providers can easily access these sites during venipuncture. Experts recommend using superficial veins for venipuncture since they are not blocked by arteries and tissues.

As a general rule in collecting blood, arm veins are the best source from which to obtain blood. The median cubital vein is located in the antecubital fossa, which is where the arm bends towards the elbow. This vein is one of the best sites for venipuncture, because it is large enough to see and feel. A few risks associated with drawing blood from this vein include the possibility of penetrating the brachial artery and biceps tendon. Since these tissues are located underneath the median cubital vein, care must be taken to avoid puncturing too deeply.

The cephalic vein is found in both the forearm and the upper arm. It can be followed to where it empties into the axillary vein in the armpit. Health care providers use the cephalic vein as one of the sites for venipuncture since it is more visible for access than other veins. Experts have reported that the cephalic vein sometimes rolls during venipuncture. When accessing the cephalic vein, the forearm is better than the upper arm.

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One of the other common sites for venipuncture is the basilic vein. It is a main superficial vein located in the arm the runs alongside the inner areas of the forearm and upper arm. The basilic vein divides to join the brachial vein. When health care providers want to collect blood from this vein, the forearm is commonly used rather than the upper arm. Experts recommend accessing the vein from the forearm, as the basilic vein turns inward to become a deep vein in the upper arm.

Inappropriate sites for venipuncture include an arm in which blood is being transfused, sites above an intravenous cannula, or scarred areas. Health care providers should not use any site below the wrist. This location is considered a no draw area. Those who do have an increased risk of hitting the ulnar or radial nerve. Doing so may cause permanent nerve damage and patients can lose the ability to close their hand.

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Lostnfound
Post 2

I have to have bloodwork done every three to four months. I have great veins, but sometimes, they don't want to plump up like they're supposed to. The last time, my blood just stopped running into the tube, and I had to go back and give again. Sigh.

A couple of good tips to help you and the lab tech, though: Drink a lot of water the morning you're going to give. A 16 or 20-ounce bottle is always good, and it won't affect your bloodwork results. It helps plump up your veins.

Second, if you're not on an aspirin regimen already, and can take aspirin safely,, about three or four days before your lab appointment, take one regular strength aspirin every day. That should thin your blood out enough that it runs nicely into the collection tubes. Works very well for me!

Grivusangel
Post 1

Frequently, doctors will tell a woman who has had a mastectomy not to have venipuncture or blood pressure taken in the arm on the side of the surgery. This is because some women have problems with lymphedema on the surgery side and drawing blood on that side can cause problems.

My mom had a mastectomy 25 years ago, and only just recently has her doctor cleared her to have sticks and blood pressure taken on that side. They take that very, very seriously, indeed. I remember reading the list she got from her surgeon about dos and don’ts, and number one on the “don’t” side was making sure no one took blood from her left arm.

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