STEP 3: Perform the puncture.
Replace the tourniquet.
Ask the patient to pump the hand three to four times and then to make a
Anchor the vein by pulling the skin with the thumb of the left hand in
order to stabilize it, since some veins roll aside at entry. This is
especially true in elderly or debilitated patients.
Puncture the skin at a 30-degree angle while keeping the bevel of the
needle in an upward position and parallel to the vein.
Thread the vein (place the needle in the vein) for a short distance.
Figure 2-1c. Guide needle
Figure 2-1d. Insert needle into
toward the vein.
The puncturing, entering, and threading of the vein should be performed in
STEP 4: Collect the blood.
Syringe method. Aspirate the blood by slowly retracting and slightly
rotating the plunger until the required amount of blood is collected.
Vacutainer procedure. Insert the vacutainer tube into the holder until the
stopper is even with the guide- line. The rear needle should puncture
the stopper, but must not penetrate completely across the membrane
(the vacuum will be lost if the needle penetrates). Once the needle has
been threaded into the vein, push the test tube completely into the
holder without jerking the holder or moving the needle. If more blood is
needed, withdraw the test tube after it is full with blood and replace with