locating and anchoring the veinlocating and anchoring the vein

Divine has created humans in a very complex hierarchical system. WebVeins are blood vessels located throughout your body that collect oxygen-poor blood and return it to your heart. Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. If things can move around it is more likely to infiltrate and possibly cause phlebitis. Phlebitis - an overview [ https://www.sciencedirect.com/t While it is important to know the best veins to access its also important to know which areas to avoid. f.style.transition="all 0.5s ease"; Veins also start contracting in old age. Alcohol is better than iodine because if the iodine gets into the blood it can alter values that the lab may be looking for. They should not be used for elderly patients because the skin is not as supple and does not support the veins as well. var zf_perma = zf_ifrm_data[0]; Remember that the tourniquet shouldnt be on for more than 1 minute because it can change the blood composition. [dropcap]6[/dropcap] Thou shalt attempt to collect specimens only from an acceptable site. This will prevent the vein from rolling. Additionally, dilation of the veins assists in anchoring them, making them less prone to rolling about. Materials Procedure 1. After two failed attempts, one should seriously consider sending in someone else. The point of the needle will go through the skin easier this way. *S`II)(wxj++G~ 0 *Md90JZcwNpd)M@aJLpJ;D|8ZM :/LGLE*Xzsi_!.w~dZ+ EqcsH|wEAq/Pn #$d@ xZ/,]rG^|4'-Sl=iPN_wnPDfqtJt3&B2l4jnU!(` ^|?O~-5P7Y1:y KZ $K6oSj1O% K`P-)d!T>Pt8Pw)SVAGS{$gG#r|l9a(2zRR h#h 9Es=4^1.Ok-2V+ There are several important steps a phlebotomist must use to successfully collect a blood specimen. I am totally not comfortable with this question. I can tell you exactly how to cut or puncture most any vein or artery in your body, but will refra The anchoring system is composed of two parts: Anchor 1 and Anchor 2. var options = { While the needle is still under the skin, adjust the angle so that it may be entered into the vein. An insertion that is to rapid could cause the needle to miss the vein or to go completely through it. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. } There can be multiple reasons for difficult veins. As a small thank you, wed like to offer you a $30 gift card (valid at GoNift.com). If youre trying to draw blood from a hard-to-hit vein, first, tie a tourniquet about 4 inches above where you want to insert the needle. Using your thumb, pull back on the skin and hold the vein down. 6. If one is not prominent enough to instill confidence, default to the cephalic vein on the lateral or thumb side of the arm as a second choice. You can increase the temperature of your body in a variety of ways. Foot and ankle veins can be acceptable sites for venipunctures in some facilities and on some patients. Swing your arm like a pendulum. var f = document.createElement("iframe"); Even those who elevate phlebotomy to an art form can have difficulty from time to time. Anchor. endobj With a vein finder, venipuncture becomes so convenient. << /Im1 12 0 R >> >> if ( zf_ifrm_data.length == 2 ) { The proximity of underlying nerves and the brachial artery make punctures in the area of this vein highly risky. Copyright 2023 Quick-Advice.com | All rights reserved. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. var evntData = event.data; Warn the patient that they will experience a sharp scratch. There are two reasons for this first is for safety. f.style.transition="all 0.5s ease"; Pulling down on the skin from below the intended puncture site with the thumb of your free hand anchors the vein and stretches the skin through which the })(); First, palpate the patients arm for a vein. By clicking Accept All, you consent to the use of ALL the cookies. Anchor the vein. His/Her fingers should support the back of the arm slightly below the elbow. First, gather all of your supplies and discuss with your patient what you are going to be performing. It will evaporate in a minute or two. One of the steps requires the phlebotomist to anchor the The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. Without proper specimens, unhelpful or even harmful medical treatment could happen. Case in point: At a small Midwestern hospital, a lab tech drew a specimen of blood to determine the blood type of a patient. Who invented Google Chrome in which year? a. What is the importance of locating and anchoring the vein? Intermittent IV bolus, 200 mL. Typically the order of choice in vein selection is as follows: 1. cubital vein: This vein is usually the with both hands. try{ Research at Oxford University shows that bigger, thicker needles hurt less than smaller thinner ones. Anchor 2 is most important to the phlebotomist during the blood draw. Anchor 2 maintains the device as steady as possible, which allows the phlebot The more venipunctures you successfully obtain, the more successful you will become. Next use a tourniquet to anchor the vein. This article was medically reviewed by Shari Forschen, NP, MA. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. However, puncturing these veins can lead to thrombophlebitis and clot formation in patients with coagulopathies or to tissue necrosis in diabetics. WebLocating and anchoring the vein or any blood vessel, is required to appropriately puncture the vein without slicing or severing it while trying to start an IV or draw blood. Alcohol is preferable over iodine because if iodine enters the bloodstream, it can change the numbers that the lab is searching for. In fact, nearly 75% of your blood is in your veins. Infrared light Projected Vein Finder is now the most popular kind of vein finder, its mostly light-weight and handy. When tying the tourniquet, it is better to start loose then get tighter if need be. Guidelines: To hold the needle, grasp the plastic wings between your thumb and first finger. Include your email address to get a message when this question is answered. thumb is 1-2 inches below the intended site and pulling the skin toward the wrist. Remove the tourniquet as the last amount of blood is drawn. The thumb should be placed a minimum of 1 to 2 inches below the and to the side of the intended venipuncture site, as the skin is pulled taut toward the wrist. Single use materials such as needles should never be reused. Intake as much water as you can. 6 0 obj Starting with Anchor 1, when we watch the video, we can see the thumb on the nondominant hand of the phlebotomist is used to pull the skin taut at the draw site. Venipuncture is the process of collecting or draw- ing blood from a vein and the most common way to collect blood specimens for laboratory testing. Why Are Complex Carbs Better Than Simple Carbs? The angular vein is a vein located between the top of the nose and the eye. Pulling down on the skin from below the intended puncture site with the thumb of your free hand anchors the vein and stretches the skin through which the needle will pass. if ( zf_ifrm_data.length == 2 ) { (function() { ", precisely with the diagram as well as mentioning the names of the veins and how the patients gets bruised if the needle is injected into hard veins. Minor vein damage such as a blown vein can usually repair itself in 10-12 days. Most textbooks agree that a 15-30 degree angle of insertion is optimal.6 This low angle of entry allows for a greater margin of error in judging the depth of penetration and greatly reduces the risk of passing through the vein and provoking underlying structures such as nerves, tendons and arteries. The number of venipuncture attempts to insert a short peripheral catheter is a critical factor in the ultimate health of your patients veins. Coffee, teas, caffeinated beverages, and alcohol can cause dehydration and the veins to shrink. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. Properly label the tubes and send to the laboratory for analysis. [dropcap]9[/dropcap] Thou shalt know when to quit. 5 How many times can a phlebotomist stick a patient? [dropcap]4[/dropcap] Thou shalt glorify the medial vein. MLO, 30(7), 30-31, 34-36, 88. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Insert the needle at a 15 to 30-degree angle into the vessel. For additional information on this or related content, please email, Sexual Assault Nurse Examiner (SANE) Core Course, http://www.cap.org/html/lip/benchmarks/phlebotomy_toc.html, Now Available: The 2021 Holiday Guide for Healthcare Professionals, Self-Care 2021: An Elite Learning Resource Guide, Immunization Awareness and Adult Vaccinations, COVID Fatigue, FAQs, and Vaccine Hesitancy, Healthy Lifestyles and Managing Heart Disease Risk, Cardiac Rehabilitation for Therapy Professionals, Nursing Rated Most Trusted Profession in Recent Gallup Poll, Symptoms and Treatments for Major Depressive Disorder, Understanding the Risks of Heart Disease in Women, Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health Care Workers During Phlebotomy Procedures. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. The 2016 Infusion Therapy Standards of Practice call for no more than 2 attempts per clinician with a limit on the total number of attempts to 4. Keep the basilic vein (located on the medial or inside aspect of the antecubital area) as a last resort. var zf_perma = zf_ifrm_data[0]; Procedure 2. Veins hold most of the blood in your body. Furthermore, they protect the nurse or healthcare professional from a potential needle stick. The median antecubital vein is the most common for blood draws. Enjoy! The maximum horizontal distance traveled by a projectile is called the range. Since 10 is a popular number for commandments, lets comply with tradition even though the list is admittedly much longer. What deficiency causes a preterm infant respiratory distress syndrome? True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. That is not to say the basilic vein should not be punctured. A blood pressure cuff that is inflated to 4060 mm Hg also works well. WebThe process of recording in the order recieved. Keeping the bevel side up allows for smooth piercing of the skin and induction of the medication into the dermis. WebUse these techniques to find veins and make veins more prominent: 1. WebThe correct way to anchor a vein without blocking blood flow in the vein, is to compress the vein distal to the access point. Our courses are designed to provide students with the skills and knowledge necessary to work in a variety of medical settings including: Hospitals, Clinical Laboratories, Clinics, Physicians Offices, Blood Banks and much more. Anchoring the vein is particularly important when drawing from the cephalic or basilic veins. if ( (iframe.src).indexOf('formperma') > 0 && (iframe.src).indexOf(zf_perma) > 0 ) { Are you kidding me? If you don't know how to locate a vein then you have absolutely no business working as a phlebotamist. Go back to school. The 1620 four-color graphic can be viewed and ordered at http://www.phlebotomy.com/poster.htm. f.style.height="352px"; Anchor the vein by pulling the skin below the vein taut. The anterior, or palm side, of the forearm is particularly susceptible to injury because of the close proximity of nerves and tendons to the surface of the skin and should not be considered. The range R of a projectile on level ground launched at an angle 0 above the horizontal with initial speed v 0 is given by [latex]R=\\frac{{{{v}_{0}}^{2}}\ext{\\sin}{2\heta }_{0}}{g}\\\\[/latex]. I found this very informative and helpful! Now perform venipuncture draw blood. % of people told us that this article helped them. Youll be the first to know about nursing news, trending topics and educational resources. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. In this way, the vein dilates for a short time, making it simpler to locate. It is in the inner arm, anterior of the elbow joint. These veins are found above the hand, near the wrist, and by the thumb. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. Clean the area for at least a half minute. WebThe median cubital vein, also known as the antecubital vein, is the most common vein for phlebotomy. equally, but do you know which nurses are making the most money in 2023? endobj Lower the patients arm for a few minutes before applying the tourniquet. Drawing blood quickly and cleanly is an important skill for doctors, nurses, lab personnel, or phlebotomists. The nurse will tell you to open up the fist of the arm they're getting blood from at some point during the drawing, but keep your other fist under that elbow. If the needle is advanced too slowly the patient may experience discomfort. All valid questions, especially for a phlebotomist. Anchor 2 is most important to the phlebotomist during the blood draw. Additionally, these steps only apply to the adult and pediatric population and not neonates. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Some of these rules are so fundamental they could be collectively referred to as the commandments of phlebotomy. This will create centrifugal force that will increase the blood flow in your arm. When confronted with a problematic vein, ask the individual if there has been an area that has worked in the past. The horizontal displacement is horizontal velocity multiplied by time as given by where is equal to zero: The horizontal motion is a constant velocity in the absence of air resistance. Once the vein is anchored on the arm or hand, the needle can be inserted. wikiHow is where trusted research and expert knowledge come together. Any other site should be approached with great trepidation. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; var zf_ifrm_data = evntData.split("|"); PhlebotomyU is dedicated to providing our students an engaging and rewarding educational experience. This cookie is set by GDPR Cookie Consent plugin. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Adding a warm compress to the vein for a few minutes may also help. Then measure the distance of center of the spot to the start line (=a). Doing so increases risk of bleeding under the skin. All Rights Reserved. If you do use iodine, follow it with a 70% alcohol swab. By signing up you are agreeing to receive emails according to our privacy policy. ", obtaining blood with a lot of ease. Insert the beveled needle at a 30-degree angle into the vessel. f.style.width="100%"; Measure the distance of the start line to the solvent front (=d). Anchoring the vein is particularly important when drawing from the cephalic or basilic veins. Figure 1. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. }); What if the veins are nearly finished in your arm or hand? Some people are generally inclined to have troublesome veins genetically. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site. As a result, veins become dilated. (function() { Superficial veins. The median cubital vein runs between the muscles and may be clearly visible as a blue bulge in the inside of your elbow. increasing blood flow to your arm and hand, I have read and agree to the terms & conditions. ACNP- American College of Nurse Practitioners, Advanced Practice Nurses of the Permian Basin, Pros & Cons of Getting a Master's Degree in Nursing (MSN), Nursing Schools With the Highest Acceptance Rates, Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks. Massage the area where you want to cannulate. Phlebotomist: How to Anchor a Vein and Insert a Needle, 8 Schools That Can Help You Turn Your BSN into a Master's Degree in Nursing, High-paying health care careers you can do with a bachelor's degree. A tourniquet helps to block the blood temporarily from exiting and allowing it to flow in your arm. Analytical cookies are used to understand how visitors interact with the website. Last Updated: January 20, 2022 Which of the following actions should the nurse take? This is not to say that we all must start carrying around protractors to measure our angles, but inserting the needle at as low an angle as possible minimizes the risk to the patient and facilitates a successful puncture. One of the steps requires the, phlebotomist to locate and anchor the patient's vein while inserting the. Pull the skin taut just below the entry site to support the vein for needle entry and this also lessens the pain the patient may feel upon insertion. ", Unlock expert answers by supporting wikiHow, https://nurse.org/articles/how-nurses-professionally-draw-blood/, https://www.guideline.gov/content.aspx?id=37621, http://www.ncbi.nlm.nih.gov/books/NBK138665/, https://www.unitekcollege.edu/blog/stick-like-a-pro-tips-for-mastering-the-art-of-venipuncture/, Tirar Sangue de Veias Difceis de Encontrar. Jagger, J. As we see in the following video, Anchor 2, which is the index and ring fingers of the dominant hand, are positioned so that during the blood draw they can steady the device being used. In doing so, this will enable students to learn basics prior to graduation. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. >> 1 What is the importance of locating and anchoring the vein? You have to locate a vein to be able to draw from it or run fluids into it. Extremely rare to have to get blood draw from artery unless looking at As the body temperature rises, the blood flow increases. No other methods are acceptable. Bob, Gary, and Bob, who share profits and losses in the ratio of 4:4:2, respectively, decide to liquidate their partnership on December 31, 2019. Blood specimen collection is one of the most underestimated procedures in health care. If these three steps did not work, finding a new draw site may be necessary. var prevIframeHeight = iframe.style.height; Pull the needle back a little bit without removing it from the skin. So that, you would not face any difficulty in the hour of need. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. The WHO has best practices that are key to preventing infection and being successful during blood draws. While not commonly taught in nursing school programs, many recommend that nursing students take extra courses in how to take blood to hone this skill. The skin should be pulled toward the wrist and stretched taut. Explain the procedure and reason for the blood draw to the patient. !k=5oqy.n"5B8XFN=a}Ww0l3-^5VxM{TsJArKV7m~%c k"F 1^ ?#0e*3 z|Um#{Z&lj?O0CU(MYru!"4-U|OsYdX#0^]*K4pk[n6-yeB7K1: How far away should your wheels be from the curb when parallel parking? var evntData = event.data; Thank you, would highly recommend this. I learned several tips from reading this article, also some, "The step-by-step guide is very clear to read and understand with the diagrams. Apply a tourniquet approximately 3-4 inches above the selected site. } A Difficult veins are veins that easily collapse or roll, are too thin, or are hard to find. Similar to a workout, the veins will become more visible and are often easier to access. })(); Are you interested in receiving high-quality phlebotomy training? Thanks. If the patient pulls the arm back when the needle is inserted the needle may recoil as it comes out of the arm, springing back into your finger. Located on the lateral portion of the arm, the cephalic vein is the second most common draw site choice. Best practices in phlebotomy involve the following factors: *This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. Antecubital site venipunctures chould be inserted at a 15 to 30 degree angle, depending on the depth of the vein. The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. Knowledge of vein selection, the order of draw, test-specific handling, storage and transportation requirements, anatomy of the antecubital area, safety precautions, alternative sites and other factors make phlebotomy a highly technical procedure that takes months to learn and apply. var iframe = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas").getElementsByTagName("iframe")[0]; It is how we find a good vein. If we went around poking needles in people, we would get very little blood and a lot of angry patients! Feeling the 1. } In many cases it is the prominent vein in the antecubital area. Sanitize your hands with soap and water or 70% alcohol. Advances in Exposure Prevention, 1(1). There are four common sites phlebotomists use for blood draws: median antecubital, cephalic, basilic and dorsal hand. 4 0 obj var zf_ifrm_data = evntData.split("|"); That purpose is to make the blood draw less painful for the patient and easier for the phlebotomist. 7 Easy Ways to Figure Out Your Blood Type (With or Without a Test). Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. window.ClickTable.mount(options); Insert the needle with the bevel side up at an angle usually 15 to 30 degrees with the surface of the arm. When you think of health care jobs, physicians and nurses may be the first workers to come to mind. If you do use iodine, make sure to follow it up with a 70% alcohol swab. Consequently, your veins start to dilate. Approved. Each healthcare system has its own requirements prior to nurses performing blood draws. [dropcap]5[/dropcap] Thou shalt invert tubes containing anticoagulants immediately after collection. So that, you would not face any difficulty in the Do not blow on or fan it with your hand as this will contaminate the area. Have the patient lower their arm and make a fist to make the veins more obvious. WebWhen properly anchoring a vein, the. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. Position the patient and hyperextend the patients arm. The bottom line is without exception: label the specimen completely at the bedside. "Good article. Emails full of tips, news, resources and advice will be sent your way soon. [dropcap]3[/dropcap] Thou shalt puncture the skin at about a 15 degree angle. Apply PPE. Regardless of how you think your life led you to hold a position as a health care professional, consider yourself assigned by a higher authority because of the comfort you can offer to the sick and injured in your own unique and compassionate way. Depending on the healthcare facility, there may be protocols in which other medical personnel must assist. The anchoring system is composed of two parts: Copyright 2023 - PhlebotomyU | Website Design & SEO by, Personal Protective Equipment (PPE) for Phlebotomist. How many lines of symmetry does a star have? ~TmSCv l4cK'[d dH1R_wg@42IiI4j-%dp{l>c^~/~^/[J%%,yXVt&y{&e)smiDjult_Ioq_n836NlaOIPqRQS+-9CI`pV4Mhh>K|=C|Yb;:{P?+!A0Xu-pJjgg[G=/;{f]NXU? 6,j*Y(c.&o9^u:Rnr@-@^ ]xj[6(4AKHf8Y+,U!&-miYOsrM! Use in-text citation and collate all the references at the end. For hydrating your body, you should drink shakes, fluids, juices, etc. If it hurts, it is too hot. It can be done by palpating the vessel or via transillumination with a special light. The statement of financial position of the partnership as of December 31, 2017 includes the, Case: A 20-year-old man, height 5.8 ft and weight 65 kg, with no past medical history presented to a primary stroke center with sudden left sided weakness and imbalance followed by decreased level of. Stretching the skin is the single most effective way to minimize the pain Check out these twelve health care careers that pay above the national average and require 4 years of school or less. Without extracting the needle from the skin, slide back a little. (d) The x and y -motions are recombined to give the total velocity at any given point on the trajectory. This one question could save everyone time and energy throughout this process. You don't need to drink so much that you are uncomfortable, but enough that you are urinating a light straw color. As a phlebotomist, hard stick patients may be frustrating to handle. There is usually a slight decrease in resistance when the needle enters the vein. Once blood flow is established, you may release the tourniquet. true /ColorSpace 14 0 R /Intent /Perceptual /SMask 15 0 R /BitsPerComponent Copyright 2020 Alliedhealthworld.com. Whether your veins are narrow or dilated, it is very important to know some tips and tricks to locate difficult veins. Nursing schools do not teach this skill due to legality issues. try{ These cookies track visitors across websites and collect information to provide customized ads. Not only will this make it difficult to evacuate the specimen through the needle and into the tubes, but if the clots are small enough to go undetected they can affect the accuracy of the results. Make it a habit to drink more water on a regular basis. With PhlebotomyUs five tips on finding problematic veins, this process can become much more manageable. }catch(e){} Is there some kind of exercise to help improve your veins or make them bigger and more visible? The basilic vein runs along the ulnar side. This cookie is set by GDPR Cookie Consent plugin. This reduces the occurrence of hematomas. Veins are never blue, purple, or green. Theyre white, actually. Heres why they look blue when we view them through the skin surface. Blood in the On one ward at a large hospital, collectors scrawled patients last names on the caps of the tubes to facilitate complete labeling at a later time. } 5 0 obj In order for the nurses to be successful when drawing blood, there are several key things they must know including. WebAt the arms normal position the skin of the arm is loose making it easy for the vein to move when the needle is inserted but extending the arm to a 180 degree angle will taut the skin naturally and make the vein more stable. It forms from a junction of the supratrochlear vein and the supraorbital vein. Give the patient some water and try again later to minimize injury. Shallow veins usually need a closer angle and deeper veins usually require a closer angle. "This article is very helpful because it is clearly mentioned how to draw the blood from the patients, explaining, "I am a nurse and found the article to be very good. But what makes Infrared light Projected Vein Finder so popular is that the device can project the vein images right on the surface of patients skin. Avoid drawing blood from a place where your veins divide or join together. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Vein finder has a built-in white light that helps in the examination of a patients veins. This article received 15 testimonials and 93% of readers who voted found it helpful, earning it our reader-approved status. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); If no veins can be accessed, find the metacarpal veins on the back of the hands. The phlebotomist should warn the patient when the needle will be inserted so that they are not surprised. We also use third-party cookies that help us analyze and understand how you use this website. This means complete identification, not just temporary identifiers to remind you when you find time to label them completely later. This article has been viewed 689,873 times. {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/b\/b4\/Draw-Blood-from-Hard-to-Hit-Veins-Step-1.jpg\/v4-460px-Draw-Blood-from-Hard-to-Hit-Veins-Step-1.jpg","bigUrl":"\/images\/thumb\/b\/b4\/Draw-Blood-from-Hard-to-Hit-Veins-Step-1.jpg\/aid9214-v4-728px-Draw-Blood-from-Hard-to-Hit-Veins-Step-1.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"