Blood collection is a fairly simple and straightforward medical procedure. Generally, the first step involves verifying the patient’s identity and reviewing their request to know the purpose of the blood collection. This will also help you to properly label the blood specimen and prepare it for lab testing once the extraction is complete.
After patient identification, you can start preparing for the venipuncture procedure. Here’s an overview of how to properly administer blood collection with a butterfly needle:
1. Prepare your winged infusion set for blood draw
First, you need to get all the equipment you need for the blood collection process. This includes the butterfly needle and vacutainer holder for the specimen. Always check the sterility of the butterfly needle and inspect the validity of the blood collection tubes.
If it’s way past the expiration date, the vacuum tube may not be able to draw the required amount of blood. Additionally, you should also keep the sheath or cover of the needle to keep its sterility before use.
2. Look for the vein in the patient’s arm
Take the patient’s arm and gently position it on an armrest for support. You may have to ask the patient to bend their fingers or make a fist to make the veins more visible. Apply a clean tourniquet at least 2 to 4 inches from where you plan to make the insertion site. This will help build up blood pressure in the arm and make the veins easier to penetrate with the hollow needle.
3. Cleanse and disinfect the needle insertion site
The next step is to disinfect the needle insertion area with a clean pad and 70% isopropyl alcohol. Make sure you’re wearing hand gloves as you wipe the skin where you plan to pierce the butterfly needle. The recommended way to cleanse the area is by starting at the center point of the needle entry and moving the alcohol-soaked pad in a circular motion going outward to push the dirt and debris.
Cleaning the insertion site is an essential step in venipuncture procedures to reduce the risk of infections from microorganisms that may enter the skin. Allow the skin to air dry for 30 seconds to a minute before puncturing the vein. Attach the butterfly needle to the ETS holder and insert the tube to get ready for the blood collection.
4. Insert the butterfly needle into the superficial vein
Once the insertion area is dry, re-apply the tourniquet on the patient’s arm to make the needle entry easier. Hold the winged portion of the needle with your index and thumb fingers and position the tubing and holder next to the patient. Remove the plastic sheath and inspect the butterfly needle for defects.
Upon checking that the needle is clean and sterile, grasp the patient’s skin and stretch it lightly to aid the needle entry. Thanks to its flexible tubing, you can puncture the needle into the vein at a shallow angle of at least 10 to 15 degrees. You’ll notice a flash of blood in the needle hub which indicates successful venous access.
Place a collection tube in the holder and push it onto the needle with a clockwise twist to start the blood flow. If you’re doing a coagulation test with a clot activator, you should draw a discard tube first to withdraw the air in the tubing to avoid getting an underfilled tube.
5. Remove the tourniquet and needle once the tube is full
Monitor the collection tube and wait for the blood to fill it from the bottom up. Once it’s complete, release the tourniquet and remove the tube from the holder. Get a clean gauze pad and place it over the insertion site so it can immediately cover the skin and control bleeding once the butterfly needle is removed.
Pull the needle in one swift motion and quickly place the gauze and apply pressure for a few seconds to stop the bleeding. Winged infusion sets have a safety device that allows them to safely retract the needle to avoid accidental needle sticks.
Normally, you have to press a push button to activate the retraction mechanism and withdraw the needle. You can also manually pull the tubing by hand to retract the needle. Avoid placing the used needle on the work table and discard them in the sharps container.