After venipuncture technique has been mastered and manual dexterity is
present, either hand may be used in completing blood drawing as long as the
needle is securely stabilized.
(6) After obtaining the blood required and the last tube is approximately two-
thirds full of blood or the blood stops, prepare to withdraw the needle.
r. Withdraw Needle. Withdraw the needle in the following manner.
(1) Release the constricting band by pulling on the long, looped end of the
tubing or pull the Velcro fasteners open. Never withdraw the needle prior to removing
the constricting band as this will cause blood to be forced out of the venipuncture site
with resulting blood loss and/or hematoma formation.
Place the sterile 2-inch by 2-inch sponge lightly over the venipuncture
(3) Withdraw the needle smoothly and quickly and immediately apply firm
manual pressure over the venipuncture site with the 2-inch by 2-inch sponge. Keeping
the patient's arm fully extended will minimize leakage around and through the
venipuncture site. This aids in the prevention of bruising and hematoma formation.
(4) Instruct the patient to elevate the arm slightly. Keep the arm fully
extended and continue to apply firm manual pressure to site for two to three minutes.
(a) If the patient is unable to apply pressure and elevate the site, the
pressure and elevation must be done by the medical specialist.
(b) Continued bleeding is a complication of a patient receiving
anticoagulant therapy. Anticoagulants are usually given to prevent the development of
blood clots in the circulatory system. Anticoagulant patients may bleed longer than
other patients. Manual pressure applied for a longer period of time will be required to
(c) A hematoma is a swelling caused by the collection of blood under
the skin or in damaged tissues as a result of an injured or broken blood vessel. They
are the most common complication of routine venipuncture for withdrawing blood. They
may result from puncturing and exiting the other side of the vein or from incomplete
insertion of the needle into the vein. Hematomas can also result from continued
application of the constricting band after a successful or unsuccessful attempt has been
made to draw blood. Hematomas most frequently result from insufficient time spent in
applying pressure following venipuncture and from flexing the arm.
s. Remove Specimen Tube from Vacutainer. Pull the tube out of the
Vacutainer and remove the needle from the holder using an approved safety device
such as a toothed grip on the sharps disposal box. Do not recap the needle. If the