DOCTOR INFORMATION

Venepuncture (OSCE)


Introduction  

  1. Greet patient and introduce yourself 
  2. Confirm patient details  
  3. Briefly explain the procedure in a patient friendly manner 
  4. Get patient consent  
  5. Check if the patient has any relevant allergies 
  6. Ensure the patient is sitting down and their arms are exposed 
  7. Check the patient is not in any pain 
  8. Wash hands  

 

Equipment  

 Gloves  

 Apron 

 Tourniquet 

 Sterile plaster 

 Sharps bin 🗑 

 Gauze/cotton wool 

 Blood sampling device 💉

 Blood specimen bottles 

 Labels and forms for the laboratory  

 Transportation bag 

 Clean procedure tray 

 

Choosing the most appropriate arm 

  1. Inspect arm for suitable venepuncture site (the antecubital fossa’s median cubital vein is commonly used, ensure the skin is intact and not at the joining of 2 veins) 💉
  2. Lay the arm in a comfortable position, giving you sufficient space for venepuncture 
  3. Apply to tourniquet 4 to 5 finger widths higher than your chosen venepuncture site 👉 
  4. Tap the chosen vein as the patient clenches and unclenches their fist to visualise it more easily ✊  
  5. Palpate the vein to assess whether it is suitable (feels springy not hard) 
  6. Release tourniquet  
  7. Wash hands and put gloves on  
  8. Clean site with alcohol swab for 30 seconds  
  9. Allow site to dry  

 



Needle insertion 

  1. Wash hands ✋  
  2. Put on clean gloves ✋  
  3. Reapply tourniquet   
  4. Attach needle to barrel of blood collection device if not preassembled 
  5. Uncover needle and prepare it 💉  
  6. Pull the skin beside the chosen venepuncture site tight with your non-dominant hand ✋  
  7. Inform patient you are ready to insert the needle and they should expect to feel a sharp scratch 
  8. Insert needle at a 30° angle or less 📐
  9. Flashback confirms you have punctured the vein successfully  
  10. Insert the needle approximately 2mm further to reach the vein’s lumen 
  11. Lower the needle and anchor it to the skin using the wings 
  12. Attach the blood bottles to the barrel, filling them with the appropriate amount of blood, in the specific order: Aerobic blood culture ➡ Anaerobic blood culture ➡ Light blue ➡ Gold/yellow ➡ Purple ➡ Pink ➡ Grey 
  13. Release tourniquet 
  14. Remove needle from arm 
  15. Apply pressure to venepuncture site with gauze/cotton wool 
  16. Ask patient to apply pressure as you have shown them 
  17. Appropriately dispose of sharps and waste 🗑
  18. Apply a dressing over the venepuncture site 
  19. Invert each of the blood bottles as appropriate: Pink, grey and purple bottles: invert 8 to 10 times, Gold/yellow bottles: invert 5 to 6 times, Light blue bottles: invert 3 to 4 times 

 

Completion 

  1. Tell the patient the examination is complete  
  2. Tell the patient to seek medical advice if they experience pain or inflammation 
  3. Thank patient 
  4. Wash hands  
  5. Write patient details on blood sample bottles  
  6. Send blood sample bottles to the laboratory for analysis 


Summary:

  1. Greet the patient and explain the procedure 
  2. Prepare by collecting equipment, putting on PPE and washing your hands
  3. Identify a suitable venipuncture site and apply the tourniquet 4-5 finger-widths above it
  4. Clean the site and insert the needle into the lumen of the vein
  5. Attach the blood bottles, filling them in the following order: Aerobic blood culture ➡ Anaerobic blood culture ➡ Light blue ➡ Gold/yellow ➡ Purple ➡ Pink ➡ Grey 
  6. Remove needle and tourniquet, then apply cotton wool/plaster
  7. Invert blood bottles 3-4 times
  8. Complete procedure by thanking patient and disposing of waste appropriately 


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