Adapted from Vascular Access Network’s Structured Learning Programme - cannulation & venepuncture 2008
Jo Schofield clinical Skills, SGH
1.
Label and name the anatomical structures below and explain the differences that distinguish them. Identify the 3 main layers in each:
2.
Label the veins in the following diagrams:

3.
List the veins which can be used for venepuncture, stating which would be your first, second and third choice and why.
4.
What anatomical structures must be avoided when taking blood from the ante-cubital fossa?
5.
List 5 attributes of “good veins” for venepuncture:
6.
Which type of veins should you avoid when selecting a site for venepuncture?
7.
List 5 ways of encouraging veins to dilate:
8.
How long should the skin cleansing preparation be used on patients with socially clean skin?
3 seconds 3 minutes 30 seconds
9.
In order to ensure effective cleaning should you? wipe it dry blow it dry naturally air dry
10.
In which situations would you consider using a topical anaesthetic?

11.
For each Ametop, Emla, and Ethyl Chloride,
a) explain how and when (time prior to venepuncture) to apply them:
b) what are their side effects?
12.
The following factors affect how venepuncture is performed.
Describe why, and outline the appropriate course of action to be taken in
these situations: a) a patient with an intravenous infusion: b) an anxious or needle-phobic patient: c) a patient (or parent) who speaks no English, or cannot communicate easily: d) a patient who has refused the procedure: e) a patient on anti-coagulation therapy:
f) a patient who is going to receive 7 – 10 days of antibiotics:

13.
List the patient data that must be filled in on the blood bottle labels, noting the rationale for correct labelling:
14.
Describe how you take a blood culture in line with your trust/local guidelines:
15.
Note which colour vacuum blood collection bottle and/or paediatric blood bottle you would use for each of the following blood tests. How much blood is required for each and what is their order of draw?
Blood Test
Urea & Electrolytes
Blood Grouping mls Order of Draw Colour of bottle
Full Blood Count
Clotting Screen
Levels eg antiobiotics
Glucose
Viral Serology
Blood Cultures
16.
How would you recognise and manage the following complications during
venepuncture? a) arterial puncture: b) vaso-vagal reaction:

c) nerve injury:
d) haematoma:
17.
Describe how you would avoid, or trouble-shoot, each of the following
complications: a) missed vein on insertion: b) venous spasm: c) transfixation: d) thin/tortuous veins:
e) hitting a valve:
18.
List which size neonatal needle or butterfly you would use for a neonate
and child, and why:

19.
What is the maximum number of attempts at venepuncture would you
have and why? If you were unsuccessful what would you do?
20.
What infection control/ health and safety precautions should you take
before, during and after obtaining a blood sample.
Explain your actions / checks at each stage of the procedure.
Before:
During:
After:
21.
What action would you take if you sustained a needle stick/sharps
injury?
22.
Explain your understanding of your legal and professional accountability
when undertaking venepuncture: