The antecubital area of the arm is usually the first choice for routine venipuncture. This area contains the three vessels primarily used by the phlebotomist to obtain venous blood specimens: the median cubital, the cephalic and the basilic veins.
Although the veins located in the antecubital area should be considered first for vein selection, there are alternate sites available for venipuncture such as the veins on the top of the hand (Table 2). These sites should only be considered after determining that the veins of the antecubital area cannot be accessed or cannot be used.
Table 2. Choosing the Best Vein.
|Vein||Location||Reason for Choice|
| Median Cubital || Mid antecubital fossa || Vertical to diagonal || Musculature assists in stabilizing vein; very often largest; ease of access |
| Cephalic || Thumb side of antecubital fossa || Vertical || Ease of access; few nerves and tendons in area |
| Basilic || Body side of antecubital fossa || Vertical to diagonal || More difficult to access; proximity of artery, nerves and tendons. Use this vein only as the final alternative. |