Phlebotomist: How to Anchor a Vein and Insert a Needle
There are several important steps a phlebotomist must use to successfully collect a blood specimen. One of the steps requires the phlebotomist to anchor the patients hand while inserting the needle.
To anchor the antecubital veins, the phlebotmist should grasp the patient's arm with his free hand. His fingers should support the back of the arm slightly below the elbow. 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.
A hand vein can be anchored by a phlebotomist by using his free hand to hold the patient's hand just below the knuckles. The phlebotomist can use his thumb to pull the skin taut over the knuckles while bending the patient's fingers.
Once the vein is anchored on the arm or hand, the needle can be inserted. To do this the phlebotomist will hold the needle in his dominant hand. The bevel of the needle should be facing up and the needle should be positioned above the vein and parallel to or following its path. The phlebotomist should be positioned directly behind the needle to prevent an awkward insertion angle. The phlebotomist should warn the patient when the needle will be inserted so that they are not surprised.
Antecubital site venipunctures chould be inserted at a 15 to 30 degree angle, depending on the depth of the vein. Shallow veins usually need a closer angle and deeper veins usually require a closer angle. A smooth steady forward motion is best. If the needle is advanced too slowly the patient may experience discomfort. An insertion that is to rapid could cause the needle to miss the vein or to go completely through it.
There is usually a slight decrease in resistance when the needle enters the vein. Once it is in the vein it should be anchored and the blood collection device should be held steady so that there is minimal needle movement. The skin should be pulled toward the wrist and stretched taut. This helps to anchor the vein and keep it from moving or rolling to the side when the needle is inserted. Ensuring that the skin is held taut helps the needle to pass through more easily and with less pain.