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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.
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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