How to draw blood
How to draw blood
How to Draw Blood using smooth circles and lines
Before learning how to draw blood: some fun facts before starting sketching!
Step 1
Knowing how to draw cartoon blood that look convincing is not easy. A splash of blood on a wall will never look like another one. You can see on the image on your left that sometimes the blood can be ticker (1) or clearer (2).
Liquids are unpredictable so it’s important that your drawing look spontaneous. Take a good look at this image to really understand how this splash of blood was created.
Step 2
The shapes behind this image are really basics. Circles for the drops of blood and lines for the splash effect. Notice that some small drops of blood are made of circles while others are made of ovals. It’s impossible in this example to represent every single blood stain since they are too many!
Step 3
Someone has been murdered! First, draw some lines to give the impression of a splash on a wall. Then, draw a circle in the middle. Now sketch some lines to represent drops of blood going towards the floor. Finish your drawing by adding particle effect and by altering the color of the blood a little bit.
Step 4
The example above taught us how to sketch a simple splash of blood on a wall (6). But this fluid can also comes in drops (4) (3), trails (5) or stains (2). Remember to keep it spontaneous, organic and irregular. Don’t hesitate to drop some liquid on a floor if you need more inspiration or examples.
How To Draw Blood: A Step-By-Step Guide
Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. 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.
Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. Without proper specimens, unhelpful or even harmful medical treatment could happen. Nursing schools do not teach this skill due to legality issues. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. In doing so, this will enable students to learn basics prior to graduation.
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 fact, the majority of intensive care units require their nurses to possess these skills. 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.
How to Learn How to Draw Blood
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. It’s important to speak to your supervisor to learn the steps in order to become certified in your hospital. Each healthcare system has its own requirements prior to nurses performing blood draws.
The World Health Organization’s Blood Draw Guidelines
The World Health Organization’s (WHO) best practice guidelines for blood draws include the following:
The overall purpose of establishing the guidelines is to,
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,
How to Draw Blood
Drawing blood from a patient can be a daunting task but it also is a necessity for nurses. Here are the basic steps to drawing blood:
Step 1: Identify The Vein
The first step in drawing blood correctly is to identify the appropriate veins to puncture. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein.
This is an extremely large vessel and if stuck properly can yield excellent blood results. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws.
For novice phlebotomists, this vein is the first choice because it is close to the skin’s surface and tends not to roll when punctured. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands.
Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. If the antecub has already been accessed there are great options for venipuncture.
Other commonly used veins include:
Avoid Puncturing These Areas
While it is important to know the best veins to access it’s also important to know which areas to avoid.
These areas include:
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Step 2: Gather Supplies
These supplies include:
Step 3: Venipuncture
After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. 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.
Additionally, these steps only apply to the adult and pediatric population and not neonates.
Don’t be discouraged if at first, you don’t access the vein. Venipuncture is a skill that takes time and practice to master. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills.
Things Nurses Should Know About Drawing Blood
In order for the nurses to be successful when drawing blood, there are several key things they must know including,
Blood Draw Best Practices
The WHO has best practices that are key to preventing infection and being successful during blood draws. Furthermore, they protect the nurse or healthcare professional from a potential needle stick.
Best practices in phlebotomy involve the following factors:
Drawing Blood FAQs:
What are the steps in drawing blood?
What are the 3 main veins to draw blood?
How do you draw blood easily?
How do you find the vein to draw blood?
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How to Draw Blood
Introduction: How to Draw Blood
I have been a phlebotomist for the past year and a half and I love my job. The purpose of this is to have greater confidence and show correct methods of drawing blood to those who are new to the profession. There are many correct ways, but there are also many incorrect ways to draw blood (i.e. positioning of your hands, what to say to the donor/patient, how not to miss the vein, etc.) and I will show you how I have had good experiences drawing blood on people. Needles cause a great deal of anxiety to people, but if you show confidence in your abilities and know what to say, you will be able to ease those who are terrified of needles. There is no greater feeling as a phlebotomist when a donor/patient requests you to draw their blood because they had a good pain-free experience. This will help you get those ‘requests’.
*All images were from Google images*
Step 1: Make Sure You Have All Your Supplies
Though it may not seem as a step, it is; and it’s an important one. Having all your supplies all at once and knowing where they are shows you know what you are doing; this has a domino effect to the donor/patient and starts to put trust in you. You shouldn’t be taking no more than 15 minutes drawing blood and out of the patients room.
List of supplies (refer to picture (minus gloves)):
*keep in mind this list may vary*
-needle (straight or butterfly)
-tube to put blood in
-bag to put blood filled tube
-If needed, a transfer device and syringe if using butterfly needle
Step 2: Introduce Yourself
Tell the person you’re drawing the blood from that you’ve been doing it for awhile. If you haven’t, let them know you’re still confident. For example, when I first started I would say, » I won’t stick you if I don’t feel confident». The purpose of this is so the patient knows that you know what you are doing. If you notice the donor/patient still anxious keep talking with them about anything. This puts their mind somewhere else that isn’t a needle.
Step 3: Apply Tourniquet
Put on gloves. Ask the patient if they prefer their left or right arm. If they don’t care, apply where it looks like the best donor vein. Tourniquet should be applied mid-upper arm. Feel free to go to the other arm to check for better veins if necessary. Apply the tourniquet so it’s tight to restrict blood flow but not too tight. Ask the patient if it is too tight, if so, re-apply but looser. Ask the donor to make a fist. The purpose of the tourniquet and the fist makes pressure build up in the veins which makes them «pop» better and more visible.
Step 4: Check for the Veins
Step 5: Clean Puncture Area
Clean the puncture area with your alcohol pad. Clean area for 15-20 seconds with pad. Apply alcohol to finger, ( the finger that feels for the vein) just in case you may have to re-feel for the vein and won’t get the cleaned puncture site dirty.
Step 6: Use Needle to Puncture Vein
Make sure skin is tight before applying the needle. Pull the skin with your non-dominant hand ( dominant hand holds the needle). Applying the needle with skin that isn’t taunt causes greater pain. Tighter the skin, less painful the puncture will be. Puncture the skin and vein with the needle. When using a butterfly with a syringe, a «flash» of blood will appear in the tubing. When using a straight needle, not until you apply the tube, will you see the «flash» of blood. SUCCESS!
If there isn’t a flash after applying the needle, pull back ( but make sure the needle doesn’t leave the skin, if it does the needle is dirty and you need a new one), re-feel for the vein and redirect. Don’t start to «fish around» and blindly poke for the vein, if you no longer feel the vein, pull it out, and look for another donor site. Fishing around causes the most pain for the patient.
Step 7: Remove Needle
Remove needle. Immediately cap the needle. Apply bandaid to puncture site. Bandaid should be left on for 15-20 mins or till blood has clotted.
Step 8: Apply Labels to Tubes
Take off the tourniquet. People who run tests on the blood can’t do anything without a label on the blood filled tube. If you are using a butterfly needle with a syringe, this is when you use the transfer device to transfer the syringe filled with blood to the tube.
Step 9: Clean Up Used Materials
Clean up the used materials. Put needle in sharps container and bloody materials in biowaste.
Step 10: Send Blood
Make sure patient is okay for you to leave. Thank them. Send blood to where it needs to go.
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How to Draw Blood – The Definitive Guide
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Drawing blood is one of the most important medical procedures. It represents basis of diagnostics and it helps establish the current health condition of a patient. But, even though it is a routine procedure, it may represent quite a task on occasion. In a sense, how to draw blood is a really specific process given that it can be used both for your benefit (when performing analysis) and other people’s benefit (when donating blood).
Like with other body parts, veins differ from patient to patient. Some individuals have visible veins while in others, they are barely noticeable. On top of that, different people react differently when they need to draw blood. There are those that are afraid of needles. Some people faint at sight of blood. All of these things can pose quite a problem and may even represent a threat to a patient.
With this guide, we will give you some tips and instructions as to how to draw blood from a vein and most importantly, how to do it safely.
Initial instructions
There are numerous steps of phlebotomy. You start by preparing a patient before he comes to a laboratory. If a person is performing biochemical analysis, such as determining sugar level, cholesterol, triglycerides, iron, he needs to avoid eating any food 12 hours before the procedure.
The day before drawing blood, the patient needs to eat lighter food up until 18h. After 18 o’clock, it is possible to drink liquids, except for alcohol, coffee, and sweet beverages. This is a must, given that food intake can increase the level of measured parameters.
Sometimes, for the best results and based on doctor’s recommendation, blood should be taken when the patient stops his therapy and after the medicine passes through his organism. Therapy can have a big impact on levels of different substances in patient’s blood. In order to get the best measurement, patient’s entire therapy needs to end so that we can determine the basic values. Precautionary measures are especially necessary if the patient has previously received iron or vitamin therapy.
All of these instructions are crucial when analyzing blood. In case of blood donation, a bit different rules apply. Donor should have a proper level of iron in his organism. Good night sleep is a must giving that the procedure can drain a person. Similarly, it is important to drink a lot of water and have a nice, big meal beforehand. Fatty food should be avoided. Also, person shouldn’t have any traces of medicines or aspirins in his organism.
Preparation for the procedure
Venipuncture starts by introducing yourself to a patient. Although this is a routine procedure, it is necessary to establish trust. As we previously emphasized, some people have a hard time with needles or blood. This is why you, as a medical professional, need to help circumvent these fears. At the same time, it is a good way to start a conversation and relax a patient.
After that, it is customary to explain the procedure. This step is especially important for little children and those who are doing venipuncture for the first time. Drawing blood lasts for less than 3 minutes. It is necessary information that has to be highlighted. Point out that the procedure is really quick and that a patient will feel a slight prick followed by mild discomfort. Avoid telling patient that phlebotomy is performed without pain. For someone who fears needles or blood, this can have quite a negative effect occasionally resulting in panic.
Sanitization is the next step of the process. Make sure to wash your hands and put on a pair of gloves.
Now, you are ready to confirm requisition. It has to have patient’s information such as date of birth and medical record number. Requisition has to be stamped! It is necessary for requisition and labels to match with patient’s identification. The last piece of the puzzle is determining patient’s identity. This can be done either by checking his wristband or by asking him the question directly.
When donating blood, establishing the blood type is crucial unlike during analysis. As a doctor, you need to make sure that a person is eligible for blood donation. The individual has to be well rested and he mustn’t have any disease which can be transferred through blood (such as STD’s).
It is your duty to make sure that the procedure is properly done and that donor can leave the facility on his own power. Full anamnesis has to be performed, both by talking with a person and by performing the necessary analysis. Toxicology needs to be done so that you can determine if the person has alcohol or drugs in the blood.
Next step of the process is gathering all of your supplies and equipment in one place. You will require blood collection tubes, cotton balls, bandage, a tourniquet, alcohol wipes and medical adhesive tape. As an additional precautionary measure, you will have to check the date on blood culture bottles and blood tubes.
If there are any additives on the walls of the tubes, you will have to dislodge them by tapping on the tube itself. In case they have expired, it may jeopardize the integrity of the seal. The last thing that you have to do is to choose the needle. Based on patient’s physical characteristics, his age and amount of required blood, type of needle may vary.
Start of the venipuncture
When you are certain that you have all the necessary equipment at your fingertips and that you identified the patient, you can have him seated. Given the procedure, it is necessary for a chair to have armrests. The arm should be straightened. In case that a patient is lying in bed, make sure to place a pillow under his arm. It will provide more support.
Pick the arm from which to collect blood. Tourniquet needs are tied around individual’s arm. Place it at 3” to 4” above the venipuncture site. In order for veins to be more visible, the patient needs to clutch his fist. Fist shouldn’t be pumped, just clutched. When the vein is ready and the patient has done everything to make it more noticeable, you will have to use your index finger and start taping it. This will further encourage dilation.
Wipe covered in alcohol needs to be used on the venipuncture site. It will disinfect the area. When using the wipe, you will have to make circular motions. At the same time, if you already covered certain area with alcohol, you shouldn’t cover it twice. Given that alcohol interacts with blood and can cause a stinging sensation, it is necessary for a doctor to wait for 30 seconds until it evaporates.
Drawing blood
Get the needle. Make sure that it is intact. Broken needle can endanger patient. You should be looking for any type of obstruction or hook that might restrict the flow of blood or hurt the person. Put it in a holder. Now, you need to make sure that the needle is secure in place. You will have to use needle sheath for this.
Blood collection tube needs to be placed into a holder. Take the patient’s arm. Thumb needs to pull the skin taut for 1” to 2” bellow the puncture site. The arm needs to be pointing downwards. Depending on a patient, it will be harder or easier to find the vein.
In most cases such as with patients that have low body fat, the vein will be noticeable in sight. Nevertheless, touch is necessary as the way to find the vein and safely perform the procedure. After finding it, you need to know how to hold a needle when drawing blood. Bevel needs to go upwards.
Sometimes, veins on the surface will be hard to notice. In those situations, there are several ways to stimulate the veins and increase the influx of blood. This will be discussed in details in following chapters.
Finally, you have reached the insertion point. Upon introduction of the needle, collection tube needs to be pushed until it’s in place. In this situation, blood will start flowing downwards. This is why the tube needs to be below the insertion site. Wait for a bit until the tube is full after which you may discard tourniquet.
When the entire procedure is finished, the tube needs to be removed from the holder. Be careful not to shake the tube. Same procedure needs to be repeated for other tubes as well. The samples shouldn’t be mixed in any way. The patient can now stop clutching his hand as you remove needle and place gauze over the insertion point.
Bleeding needs to be stopped after this step. By holding the gauze in place and pressing it, you are able to do this.
Order of draw
When drawing blood for analysis, you will have to take several samples. You need to perform this in a certain order that will prevent cross-contamination of additives between tubes. Here is the best order of tubes:
Always remember; when using tubes with additives, they have to be thoroughly mixed.
Cleaning the working area
Similarly to other medical procedures, it is necessary to uphold the highest standard of hygiene which will protect not only patient’s health but yours as well. This will prevent any type of contamination. You need to start by putting the needle and syringe into a container. Have in mind that you need to discard different items in appropriate containers. For example, items that are not contaminated with blood can be placed into general waste. Be careful with objects that have blood on them; they are the real cause for concern. Forms and labels need to be double checked just in case there is some inconsistency. You can easily make a mistake by putting a wrong name or date of birth. This can cause quite a problem for the laboratory team.
Naturally, after discarding is over, you will have to perform hand hygiene. Tell the patient that venipuncture is over and ask him how he feels. Drawing blood can cause nauseating feeling and it can even lead to patient fainting. Instruct him to leave the gauze in place for at least 15 minutes. This is the necessary time that will allow coagulation to start.
After the patient leaves your office, make sure to clean the armrest with germicidal wipes. When the person leaves your office, you are ready to submit samples to the laboratory (in case that you are taking them for analysis).
How to behave during the procedure
Again, even though this is a routine procedure, there is a common practice for a medical professional. It is necessary to create a solid relationship with a patient and to instill trust. Medical procedures can be really troubling. To be honest, there are a lot of people who hate going to a doctor’s office. For them, venipuncture represents a really stressful procedure.
The most important thing which you can do for your patient is to talk to him. Doctors usually neglect this as they automatically start drawing blood from a patient. In these situations, it is easy to lose track of a person who is being analyzed. However, talking to the patient can have multiple purposes. If his veins are hard to hit, the patient may give you a good advice and point you to a vein that is more noticeable.
Communication is very important when performing the analysis. Unlike blood donors who are small in numbers and are used to giving blood, many people who are performing analysis are not accustomed to it. By talking to them, you may distract them thus relaxing them. If blood makes a person nauseous, instruct him to look away from the needle and insertion point.
That being said, your duty as a professional is to make the entire experience as pleasant as possible. Have in mind that some of the patients are particularly difficult to deal with. Occasionally, pleasantries will not do you much good. This is when you have to find a balance between professionalism and politeness. No matter what happens, you shouldn’t be flustered by the patient’s behavior. You have to keep a level head and concentrate on the process. Otherwise, you are risking of missing the vein and endangering patient’s health. As someone who is doing this job, you have to prepare for such patients in advance.
Finding the proper insertion point
The best way to draw blood is to select larger median cubital and cephalic veins. However, it is a normal practice to use dorsal hand veins and basilic vein on the dorsum. It is always better to draw blood from arms. Feet are the last resort given the possibility of complications.
There are certain areas which need to be avoided at all costs such as:
How to draw blood from a patient if you cannot find a vein
First thing that you wish to try is placing a tourniquet. It constricts the arm, increasing the available amount of blood within the veins. This way, they will be much easier to spot. However, you shouldn’t overdo it because you do not wish to cut off the circulation. The tourniquet has to be placed four inches above the vein.
Another good way to do it is by placing warm pack or bottle cloth over the area. It will lead to dilation and expansion of veins. It is very important to put a pack before disinfection. If you put it after, you will have to disinfect once again. Warm pack shouldn’t directly touch the skin. If it turns out that the bottle or a pack are too hot, it may lead to burns. Naturally, you should try to do entire process of phlebotomy without pain or with minimum pain possible. This is why you should wrap it in a towel before placing on arm.
Relaxation can also be used to your advantage. People who have phobias involuntary constrict their muscles due to stress. This will make it harder to take a blood from a vein. By relaxing the patient, it will be much easier for you to draw blood.
Rubbing the vein is another good method that may help you to locate the vein. Slowly go over the arm, trying to find the right place where you can insert the needle. Here, you have to use your index finger. Thumb has a pulse of its own and it may be confusing for you to find a proper vein due to this fact. Patient shouldn’t slap his arm or do anything else to forcefully stimulate the vein. It can lead to bruising.
In certain situations, needle will penetrate the skin and at the last moment, vein will move away. If this happens, patient needs to remain perfectly still. Best thing that you can do is change the entry angle until you hit the vein. During this, needle shouldn’t be removed from under the skin. This can be very uncomfortable for patient but it is the best and quickest solution. Again, this is a thing of practice.
If all of this doesn’t help and you still miss the vein (even with all the preparation), you can still try again. Try hitting the vein just below the initial insertion point. Have in mind that you can miss again. This may be a result of dehydration or some other issue. If you do not have enough experience, it is best if you ask senior college or supervisor for help.
Additional things to have in mind
Besides mentioned issues, there are other things which may happen during the venipuncture. Because of that, you have to take preventive measures that will protect individual’s health.
How to Draw Blood | Drawing Blood Clinical Nursing Skills for RNs
As nurses enter the clinical setting, they will have to know how to draw blood as part of their clinical skills experiences. It may be necessary to draw a patient’s blood for a number of reasons, and it is necessary to draw blood from patients in a manner in which does not cause them any pain or complications.
Introduction on the Purpose of Drawing Blood
There is no way that nurses will be able to get around drawing blood during their clinical skills nursing experiences. The process of drawing blood may look easier than it is, but there is a precise manner in which to draw blood from patients. The process of drawing blood can be very dangerous for patients when their nurse lacks precise blood drawing skills. Taking the proper steps to draw blood protects the health and safety of patients and the nurse assigned to draw their blood. A successful blood drawing begins with a nurse using precision in their blood drawing skills.
Steps on How to Draw Blood
Video on How to Apply a Tourniquet to Draw Blood
Video on How to Find a Vein in order to Draw Blood
Video on How to Draw Blood Venipuncture
Tips on Drawing Blood As a Nurse
Complications with Drawing Blood
One of the most common complications is when some patients faint during the blood collection procedure. Another common complication is bruising around the needle insertion area a few days after the collection.
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Other complications that are less common include tendon injury, delayed bleeding, allergic reactions, nerve irritation, thrombophlebitis, arterial puncture, nerve injury, hemolysis, hematoma formation, and hemoconcentration. There is also the risk of having blood collected using reused equipment. Situations such as these are not very likely but possible.
It is also possible that the blood collector can contract a disease from the patient with transmissible diseases. This complication is not likely when patients follow the infection control policies in place.
Nurses must be very precise when it comes to collecting the blood of patients. The process is quick and nearly painless for patients when experienced nurses collect blood specimens. Blood collection is a skill that nurses will use throughout their nursing careers.
As long as special care is taken, the risk of complications can be minimized.