22.1.5  Selecting the venipuncture site

On the left is an image of the veins in the forearm and on the right is an image of the veins in the hand.
Figure 22.2  Common venipuncture sites in the hand and forearm.

The next step is identifying a good venipuncture site, that is the site where you will ‘puncture a vein’ by inserting the IV cannula. Figure 22.2 shows some commonly used sites in the hand and forearm.

In selecting the site for venipuncture:

  • Ask the patient which is the hand she most often uses, e.g. to hold a knife or a tool. If she says she is ‘right handed’, this is her ‘dominant’ hand and her left is her ‘non-dominant’ hand.
  • Look first at possible venipuncture sites on her non-dominant hand and then look higher up the arm.
  • Select a vein which is large enough for the cannula, avoiding sites near to joints like the wrist or the elbow.
  • Make sure that when you insert the cannula, it will not interfere with woman’s ability to move her hand or arm.
  • Avoid a site which is painful to touch.

The visibility of the veins can be improved by encouraging the woman to close her hand into a fist and then open it again several times, lowering the arm and stroking the chosen venipuncture site. As you become more experienced, you will find it easier to choose a suitable vein which is easily visible, not twisted, where you think you can enter your cannula easily.

22.1.4  Selecting the IV cannula

22.1.6  Inserting the IV cannula