Initial Preparation

1. Verify patient for the tests
2. Identify the patient: check the patient’s ID number and have him/her state his/her name
3. Identify yourself to the patient, explain the procedure, and secure his/her consent.
4. Palpate the veins in the antecubital fossa using your index finger.
5. Gather the necessary equipment
6. Wash hands; put gloves on
7. Tie the tourniquet; it should be applied 3-4 inches above the site where the venipuncture will be made. Ask the patient to make a fist or open and close his/her hand to help engorge the vein.
8. Palpate the vein while looking for the straightest point. Cleanse the area using a circular motion starting at the venipuncture site and moving outward in concentric circles.
9. Assemble the needle and tube holder while the alcohol is drying. Uncap the needle and examine it for defects such as blunted or barbed point.
10. Hold the patient’s arm, by placing four fingers under the forearm and your thumb below the antecubital area slightly pulling the skin back to anchor the vein.
11. With the bevel facing upward, insert the needle at an angle of 15-30 degrees.

Performing the procedure

1. Once the needle is inside the vein (you will feel a "give" as the vein is entered), push the collection tube into the holder to puncture the tube stopper with the back-end of the needle.
2. Release the tourniquet once blood flow has begun. The tourniquet should not be left for more than one minute (1) in order to prevent hemo-concentration.
3. Fill the needle tubes, according to the order of draw.
4. Pull out collection tube from the holder.
5. Place folded gauze over the venipuncture site and withdraw the needle. Then apply pressure until bleeding stops. This is done to prevent hematoma. Do not ask the patient to bend the arm. This may disturb the puncture site and cause further bleeding.
6. Discard needle while still attached to holder or syringe into the biohazards sharp container.
7. Label each collected specimen, writing the patient’s name and ID number, the time and date of collection, and your initials.
8. Place labeled tubes inside the biohazards transport bag.
9. Before leaving, check the venipuncture site. If it is still bleeding, apply pressure for another 2 minutes. If after this time, it is still bleeding, continue to apply pressure for another 3 minutes. If bleeding persists after a total of 8 minutes of applying pressure, call for help.
10. At any point when the bleeding stops, an adhesive bandage is applied over a folded gauze square. The patient should be instructed to remove the bandage within an hour.
11. Clean up everything and dispose of waste properly.
12. Leave the patients call light within his/her reach.
13. Thank the patient.
14. Remove gloves and wash hands.