1. Select a sterile, dry, preferably plastic syringe of the capacity required, e.g. 2.5 ml, 5 ml, or 10 ml.
Attach to it a 19 or 20 SWG needle (preferably a disposable one). If the patient is a child or adult with small veins, use a 23 SWG needle.
Note: When not using a disposable syringe or needle, check the syringe for good suction and the needle for any blockage, directing the syringe and needle safely away from the patient.
Ensure all air is expelled from the syringe.
Whenever possible use a disposable needle and syringe.
2. Apply a soft tubing tourniquet or velcro fastening arm band to the upper arm of the patient to enable the veins to be seen and felt.
Do not apply the tourniquet too tightly for longer than 2 minutes. Ask the patient to make a tight fist which will make the veins more prominent.
3. Using the index finger, feel for a suitable vein, selecting a sufficiently large straight vein that does not roll and with a direction that can be felt.
If a vein cannot be felt, apply a pressure cuff above the elbow and raise the pressure to 80 mm (deflate the cuff once the needle is in the vein).
4. Cleanse the puncture site with 70% ethanol and allow to dry. Do not re-touch the cleansed area.
5. With the thumb of the left hand holding down the skin below the puncture site, make the venepuncture with the bevel of the needle directed upwards in the line of the vein. Steadily withdraw the plunger of the syringe at the speed it is taking the vein to fill. Avoid moving the needle in vein
If the plunger is withdrawn too quickly this can cause haemolysis of the blood and the collapse of a small vein.
6. When sufficient blood has been collected, the tourniquet and instruct the patient to open his or her fist. Remove the needle and immediately press on the puncture site with a piece of dry cotton wool. Remove the tourniquet completely. Instruct the patient to continue pressing on the puncture site until the bleeding has stopped.
7. Remove the needle from the syringe and carefully fill the container(s) with the required volume of blood. Discard the needle safely.
Do not attempt to re-sheath it because this can result in needle-stick injury.
Important: Do not fill a container with the needle attached to the syringe. Forcing the blood through the needle can cause haemolysis.
8. Mix immediately the blood in an EDTA or citrate anticoagulated container. When required, make a thick blood film from the blood remaining in the syringe. Immediately label carefully all the
blood samples.
9. Check that bleeding from the venipuncture site has stopped. Cover the area with a small dressing
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