What Are the Best Sites for Venipuncture?

Venipuncture is a common medical practice that is used to get blood for testing.
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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  • Originally Written By: Jackie Myers
  • Revised By: C. Mitchell
  • Edited By: Susan Barwick
  • Last Modified Date: 08 October 2015
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The best sites for venipuncture are usually the superficial veins in the upper arms. Specifically, these veins are the median cubital vein, the cephalic vein, and the basilic vein. The main idea behind venipuncture is to draw blood for any number of diagnostic tests. Superficial veins, which are located close to the surface of the body, are typically the easiest to access. Experts usually recommend using superficial veins for venipuncture since they are not blocked by arteries and tissues the way many of the body’s deeper, thicker veins are. The arms are also usually a good choice because they can be accessed without much intrusion or inconvenience. There isn’t really a foolproof location, though, and patients who have a lot of scarring or who have suffered arm injuries in the past may need their blood drawn from some other part of the body.


Venipuncture Basics

Venipuncture is a common medical practice that’s used to get blood for testing. A trained medical practitioner will insert a needle and syringe directly into the patient’s vein, and then withdraw blood as it’s coursing through the body. When the procedure is done properly, patients may feel pressure but shouldn’t experience pain. Much of the procedure’s success depends on the location of the needle and the skill of the technician, though. Experts usually look for veins that are near the surface of the skin to avoid having to push too deep. The veins need to be strong and also need to have a good flow of blood running through them, and a lot of this depends on the individual.

Technicians are usually trained to identify three main sites for venipuncture on a patient’s arm. In most cases one of these will be suitable; if not, blood may have to be drawn from elsewhere.

Median Cubital Vein

The median cubital vein is located in what’s known biologically as 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 usually 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 using too much force and puncturing too deeply.

Cephalic Vein

The cephalic vein is found in both the forearm and the upper arm. It can be followed to where it empties into the auxiliary vein in the armpit. Health care providers often like to use the cephalic vein since it is more visible for access than other veins. Experts have reported that the cephalic vein sometimes “rolls” during venipuncture, though, which is to say that it pulsates and shifts as the blood is coursing through it; this can make slow and careful extraction more challenging. It’s usually best to start in the forearm rather than in the upper arm to avoid this.

Basilic Vein

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, they usually start in the forearm, the same as they would for the cephalic vein; in the upper arm, the basilic vein turns inward to become much deeper and harder to access.

Dangers of Poor Placement

Venipuncture can technically be performed from almost anywhere, but the best sites are usually those that are easy to access and that don’t carry risks of injury or irritation. Inappropriate sites include an arm in which blood is being transfused, since this can put undue pressure on the vein and possibly lead to its collapse; sites above an intravenous cannula, a device used to control delivery of intravenous (IV) fluids; or scarred areas.

In general health care providers should not use any site below the wrist, either. The hands are normally considered a “no draw area” because of the increased risk of hitting the ulnar or radial nerve, which controls hand movement and sensitivity. Doing so may cause permanent nerve damage and patients can lose the ability to close their hand to make a fist, among other things.


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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!

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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