(2) The constricting band must be applied with sufficient pressure to stop
venous return without stopping the arterial flow.
l. Prepare the Vein. Instruct the patient to form a fist and clench and unclench
his fist several times and then hold the hand in a clenched position. Clenching and
unclenching the fist with a constricting band in place causes the blood to be trapped in
the veins which causes the veins to distend. If the vein does not distend, gently tapping
the site with your fingers may assist in raising the vein.
m. Palpate Selected Vein. Palpate the vein lightly with the index finger, moving
an inch or two above and below the site so that you can determine the size and
direction of the vein (figure 2-4). The vein should feel like a spongy tube.
Figure 2-4. Palpating the vein.
n. Cleanse Skin. Cleanse the skin with the pledget (sponge) starting on the site
and cleansing in a spiral motion outward and away from the selected venipuncture site.
Do not retrace your motion. Cleansing the skin in this manner will move the surface
After cleansing the skin, do not repalpate the area.
o. Prepare to Puncture Vein.
Grasp the Vacutainer unit and remove the protective cover from the
(2) Position the needle parallel to and above the vein and grasp the patient's
arm below the point of entry with the free hand.
(3) Place the thumb approximately one inch below the expected point of
entry and pull the skin taut and toward the hand.