The page below is a sample from the LabCE course Routine Venipuncture. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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When to Use Hand Veins to Obtain Blood

Sometimes the phlebotomist may decide that the antecubital area is not the best site for venipuncture. Reasons for this decision may include:

  • Extensive bruising (hematomas) in the antecubital area
  • Inability to "feel" a vein suitable for puncture
  • Presence of an intravascular line (IV) or vascular access device
  • Physical condition of the patient

When the veins in the antecubital area cannot be used, the phlebotomist may choose to use a vein on the top of a hand. The veins in the hand are very near the surface and often very small and thin so the procedure must be performed carefully and cautiously.