Blood Collection Site Selection

Antecubital Area (without locks or IVs)

The three veins in this area are the first choice for blood collection.

  • The median cubital vein is the first choice for blood collection.  This vein is usually large, visible, well anchored and does not bruise easily.

 

  • The cephalic vein is the second choice for blood collection.  This vein is not as well anchored and is usually more difficult to find.

 

  • The basilic vein is the third choice for blood collection.  This vein tends to roll away and bruise more easily. 
 

Antecubital Area Above a Lock

  • Tourniquet should be applied approximately 8 - 10 cm above the proposed site and should be applied only briefly.

Antecubital Area Above an IV

  • Use this site only if all other potential phlebotomy sites are unacceptable.
  • IV must be turned off by nursing staff for at least 3 minutes before blood collection begins.

Hand / Wrist (without locks or IVs)

  • Only the backside of the hand and the thumb side of the wrist should be used.

Hand / Wrist Below a Lock

  • Only the backside of the hand and thumb side of the wrist should be used.
  • Tourniquet may be applied above collection site and below IV / lock site provided there is a space of at least 6 cm between the tourniquet and IV / lock site.

Foot

  • For CLS staff, foot venipunctures are not performed unless a physician has authorized this type of collection and is noted on the patient's chart.
  • Use the top of the foot and side of ankle.  The preferred sit is the great saphenous vein.

  • To prevent medical procedures from being performed on affected limbs, new regional caution signs have been developed to improve communication between unit staff and laboratory staff performing collections.

 

Data Printing ordering numbers:  Lt arm #103257, Rt arm #103258

  • If both arms are not to be accessed, both signs should be used.
  • Signs are to be placed above the head of the bed using two-way tape (at FMC, hooks are provided on inpatient units).
  • The use of "homemade" signs is strongly discouraged.

Safety and Notes



  • CLS staff do not perform collections on limbs adjacent to certain known surgeries such as mastectomies unless requested to do so by physicians / nurses with a signed form.
  • CLS staff do not perform collections on limbs with indwelling access devices other than IV and locks without physician / nurse approval, and will never collect directly from an indwelling access device.
  • CLS staff obtain physician authorization for foot phlebotomies due to risks associated with diabetic patients or patients with risks of thrombosis.
  • CLS staff do not perform femoral artery collections.