NHA Certified Phlebotomy Technician (CPT)Collection RoutineMedium
A phlebotomy technician is performing a venipuncture on a patient who has an IV infusion running in the left arm. The physician's order specifies that the blood must be drawn from an arm without an IV. Which of the following is the most appropriate site for the venipuncture?
- AThe right antecubital fossa.
- BAbove the IV site in the left arm.
- CDistal to the IV site in the left arm.
- DThe left wrist.
Show answer & explanationAnswer & explanation
Correct answer: A. The right antecubital fossa.
If an IV is present in one arm and the order specifies drawing from an IV-free arm, the technician should select a site in the opposite arm. The antecubital fossa of the right arm is a primary venipuncture site and would be appropriate, assuming no other contraindications.
Why the other options are wrong
- B. Drawing above an IV site is also prone to contamination or dilution and is generally avoided.
- C. Drawing distal to an IV can still lead to dilution or contamination from the IV fluid.
- D. The wrist is generally a less preferred site due to potential nerve damage and smaller, more fragile veins, and should only be considered if antecubital sites are unavailable.
Venipuncture with IV
Guidelines for selecting a safe and accurate venipuncture site when a patient has an intravenous (IV) infusion running.
- Avoid drawing from the arm with an active IV.
- If necessary, draw below the IV (distal) after stopping the IV and discarding first tubes.
- Preferably, use the opposite arm or alternative sites.
Memory trick: IV in one arm? Find a clean vein in the other one!