
Phlebotomy (Blood Collection) – Bevel Up Technique
When inserting a needle for phlebotomy, always keep the bevel facing up for a smoother and less painful insertion.
To practice, use a phlebotomy arm model.
Needle choices:
Orange (25G fine needle) – Suitable for delicate veins and pediatric use due to its smaller size.
Green (21G needle) – Preferred for standard venipuncture as it allows faster blood flow.
Difference Between Cannulation & Phlebotomy
Phlebotomy: The process of drawing blood using a needle and vacutainer system. The needle is inserted, blood is collected, and the needle is removed.
IV Cannulation: Involves inserting a cannula (a thin plastic tube) into a vein for medication, fluids, or IV drips.
IV Cannulation Process
Insert the needle with the bevel up.
Once the flashback (blood return) is visible in the chamber, advance the plastic cannula further into the vein.
Withdraw the needle, leaving the plastic cannula in place for IV access.
Recommended Cannula for IV Drips
The Braun Introcan Safety 3 Cannula is highly recommended for IV drips because:
It features automatic needle safety, covering the bevel after use to reduce the risk of needlestick injuries.
It has a double-bevel design, helping prevent excess blood flow and making the procedure cleaner.
Other cannulas require manual pressure on the arm to stop bleeding, which can be messy and difficult to control.
For best results in IV therapy, always choose the Braun Introcan Safety 3 Cannula to ensure safety and efficiency.
Step-by-Step Guide to Phlebotomy Application
1. Practicing with a Rubber Arm and Syringe
Before performing venipuncture on a real patient, practice locating veins using a rubber arm model. This helps develop confidence in identifying vein locations, handling the syringe, and understanding the correct insertion technique.
2. Tourniquet Application
Proper tourniquet application is essential to make the veins more prominent for easy access. Follow these steps:
Positioning the Tourniquet: Wrap the tourniquet around the upper arm, approximately 3-4 inches (7-10 cm) above the intended puncture site.
Tightening the Tourniquet: Apply firm but comfortable pressure—tight enough to restrict venous blood flow without stopping arterial circulation. Do not leave the tourniquet on for more than 2 minutes to prevent complications such as hemoconcentration or patient discomfort.
Patient Preparation: Ask the patient to make a fist, which helps enlarge the veins, making them easier to locate.
3. Locating the Vein
Palpation: Use your index and middle fingers to gently feel for a vein. A suitable vein should feel firm, elastic, and bouncy to the touch.
Common Vein Choice: The median cubital vein (inside of the elbow) is commonly used due to its size and stability.
4. Preparing the Injection Site
Cleaning the Area: Using an alcohol swab or antiseptic wipe, cleanse the injection site in a circular motion, starting from the centre and moving outward. This reduces the risk of infection.
Allowing Drying Time: Wait a few seconds for the site to dry completely before proceeding.
5. Needle Insertion
Patient Positioning: Ensure the patient keeps their arm extended and steady.
Inserting the Needle: Once the needle is inserted into the vein, maintain steady control. Do not move the needle unnecessarily after insertion.
Proceed with Blood Collection: Once the needle is correctly placed, follow the appropriate blood collection protocol, ensuring minimal patient discomfort.
By following these steps precisely, phlebotomy can be performed safely and efficiently while ensuring patient comfort and minimizing risks.
Step-by-Step Guide for Butterfly Needle Insertion & Blood Collection
Prepare Your Equipment
Ensure you have a butterfly needle, tourniquet, alcohol swab, collection tube, and sharps container ready.
Wash hands and wear gloves for hygiene and safety.
Apply the Tourniquet (If Needed)
Apply the tourniquet around the upper arm to make veins more visible.
Ask the patient to make a fist to help with vein engorgement.
Identify and Clean the Vein
Select a suitable vein (median cubital vein is preferred).
Clean the area with an alcohol swab in a circular motion and let it dry.
Insert the Butterfly Needle
Hold the skin taut with one hand below the insertion site to stabilize the vein.
Position the needle bevel up and insert at a 10-15 degree angle.
A sharp scratch will be felt upon insertion.
Once you see flashback (blood in the tubing), you’re in the vein.
Relax Your Hand
Once the needle is in place, let go of the skin and hold the butterfly wings gently to keep it stable.
Release the Tourniquet
If blood is flowing well, remove the tourniquet before continuing collection.
If the flow is slow, you can reapply the tourniquet to improve speed.
Some patients with large veins may not require a tourniquet at all.
Adjust for Patient Comfort
If the patient is nervous, leave the tourniquet applied to avoid any discomfort.
If they are a slow bleeder, keeping the tourniquet on can help speed up the process.
Blood Collection
Attach the collection tube and allow blood to flow.
Once the tube is filled, gently invert it a few times if needed (do not shake).
Needle Removal & Disposal
Once the blood collection is complete, remove the tourniquet first (if still on).
Carefully withdraw the needle and apply gauze with light pressure.
Dispose of the needle in a sharps container immediately.
Blood Handling & Disposal
For training purposes, collected blood is discarded as medical waste.
If working with a lab, follow proper protocols for sample handling.
By following these steps, you can perform a safe and efficient blood withdrawal using a butterfly needle while ensuring patient comfort and safety.
Stabilize the Needle Site – Gently place a sterile cotton pad over the insertion site without applying excessive pressure. This helps absorb any initial blood while keeping the area clean.
Remove the 23G BD Butterfly Needle – Slowly and smoothly withdraw the 23-gauge BD butterfly needle, ensuring minimal discomfort to the patient. A butterfly needle is commonly used in phlebotomy due to its thin, flexible tubing, which allows for a more controlled blood draw, especially for patients with delicate or small veins. The 23G size is ideal for reducing vein trauma and ensuring smoother blood flow.
Apply Pressure & Secure the Site – Immediately press the cotton pad firmly onto the site to help prevent blood leakage and promote clotting. Secure it with medical plaster (adhesive tape) to keep the pad in place, ensuring proper wound care and preventing infection.
This method ensures a safe, hygienic, and efficient needle removal process while minimizing patient discomfort and complications such as bruising or hematoma.
Understanding the Fill Line – The BD Vacutainer red collection tube is designed to collect a specific volume of blood. The blood should not exceed the black fill line marked on the tube. This ensures accurate sample collection and prevents overfilling, which could lead to clotting issues or difficulty in processing.
Risk of Overloading – If blood continues to flow beyond the black line, the tube may overfill, affecting the sample's quality. This happens because the vacuum inside the tube is designed to pull in a set amount of blood. If used improperly, any excess blood can enter, disrupting the required ratio for testing.
Proper Disposal – Once the blood has been collected, immediately discard the used tube into a yellow medical waste bin. This ensures safe disposal of biohazardous material, preventing contamination and maintaining clinical hygiene standards.
IV Drip Setup
1. Equipment:
Saline (100 ml or 250 ml):
100 ml is good for training to practice connecting and observing how things can go wrong.
For clients paying more, 250 ml offers more value, but avoid going over 250 ml to maintain correct concentration.
Plastic bottles are cheaper, but bottles are safer for training as they’re less likely to be punctured compared to bags.
Intrafix Air P 150 cm Infusion Set:
Choose this if you want a basic connection setup (without a pump). It’s easy and effective for training.
2. Procedure:
Mix Pabrinex with 100 ml saline and connect to the infusion set.
Prime the tube by filling it with saline (to remove air bubbles) until it reaches the end of the tube, then stop.
Insert the cannula (Introcan Safety 3 22g) carefully into the vein, using a sterile saline flush syringe (BD 10ml PosiFlush) to ensure the cannula is in the right place. Push half the saline to confirm, then connect the drip.
Secure the cannula with TegaDerm film dressing to prevent movement.
3. Glutathione & Vitamin C:
Glutathione should be given as a push (not mixed in saline with Vitamin C), as they can make each other ineffective if combined.
Mix Glutathione: Reconstitute the powder with waterfall injection (never saline). After mixing, inject into saline for the IV drip.
Prime the IV drip and make sure no air bubbles are left before use.
Dispose of sharps properly in the sharps bin.
By following these steps, you ensure safe and effective IV drip administration. Always prioritize safety and double-check everything before starting!
IV cannula & drip – step-by-step (overview)
Prepare – hand hygiene, gloves, check prescription, gather sterile equipment.
Vein selection – choose a suitable vein and clean the skin.
Insert cannula – vein accessed, needle removed, soft cannula left in place.
Secure – cannula flushed (if required) and dressed to prevent movement.
Connect drip – IV line attached and fluid bag hung.
Set flow – drip rate adjusted as prescribed.
Monitor – observe site and patient for pain, swelling, or leakage.
What is priming?
Priming means filling the IV tubing with fluid before connecting it to the cannula, so no air remains in the line.
Why it’s important:
Removes air bubbles from the tubing
Prevents air entering the bloodstream
Ensures smooth, uninterrupted fluid flow
Confirm the IV line is working properly before use
Improves patient safety and comfort
In one line:
Priming prepares the IV line safely so only fluid—not air—enters the vein.
Benefits of B12: Helps in the creation of hemoglobin, so more B12 boosts hemoglobin levels.
Steps to Prepare:
Apply Tourniquet: Creates space to find a bouncy vein.
Clean with Cutisoft Wipe: Disinfect the area.
Prepare PosiFlush:
Remove the cap, push out air to prime (get rid of bubbles).
This is important because you don’t want air in the vein.
Cannula Prep:
Separate the wings of the cannula and remove the white plastic.
Ensure bevel is up and the butterfly wings are flat.
Insert Cannula:
Gently insert the cannula into the vein, hold the wings and remove the needle.
Apply the Tegaderm dressing over the cannula to keep it in place.
Flush with PosiFlush:
Inject 5ml of saline from the PosiFlush syringe.
Make sure the client is not in pain (this confirms correct placement).
Connect IV Drip:
Attach the IV drip to the cannula and control the flow using the orange part.
You can give the drip in 10-15 minutes or slower for better results.
Reminder:
If the drip doesn’t flow, flush with the Posi Flush again. Starting with injections helps you understand the IV drip process better.Search our vitamin injection course with the title:Mastering Vitamin Injections techniques for health course' on this platform.
Pabrinex IV Drip
Which IV Drip?
Pabrinex is a high-dose vitamin B and C infusion used to treat deficiencies and improve overall well-being.
Benefits of Pabrinex
Rich in B Vitamins – Pabrinex contains essential B vitamins, including B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), and B12 (cyanocobalamin). These vitamins play a crucial role in energy production, brain function, and red blood cell formation.
Boosts Metabolism – B vitamins help the body break down carbohydrates, fats, and proteins into energy. This enhances metabolism and supports overall vitality.
Energy Production – The vitamins in Pabrinex contribute to the synthesis of ATP (Adenosine Triphosphate), the body's main energy source. This helps reduce fatigue and improve stamina.
DNA and RNA Production – Pabrinex supports cell growth and repair by assisting in DNA and RNA synthesis. This is essential for healthy skin, muscles, and organs.
Nervous System Support – B vitamins play a key role in maintaining a healthy nervous system, improving cognitive function, and reducing stress and anxiety.
Immune System Boost – Vitamin C in Pabrinex strengthens the immune system, helping the body fight infections and heal faster.
Detoxification & Recovery – Often used for individuals recovering from alcohol dependence or vitamin deficiencies, Pabrinex helps replenish lost nutrients and restore balance in the body.
Who Can Benefit?
Individuals with fatigue, low energy levels, or metabolic imbalances.
People recovering from nutrient deficiencies or alcohol-related conditions.
Those who need a boost in immune function and overall wellness.
How is Pabrinex Administered?
Given as an IV infusion over 30-60 minutes for maximum absorption and effectiveness.
How to Prepare and Mix Pabrinex with Saline for IV Drip Administration
What You Need:
Pabrinex Ampoules (Pair of vials – No.1 & No.2)
250ml Normal Saline (0.9% Sodium Chloride Solution)
Syringe (50ml or larger)
Drawing-up needle (18G recommended for easier extraction)
Sterile alcohol wipes
IV Giving Set
Gloves
Step-by-Step Guide to Mixing Pabrinex with Saline
Step 1: Preparation
Sanitize your hands and wear gloves to maintain hygiene.
Check the Pabrinex ampoules (Pair of vials) for expiry date, clarity, and any signs of contamination.
Clean the rubber stoppers of both ampoules with alcohol wipes.
Prepare your syringe by attaching a drawing-up needle (18G) to it.
Step 2: Drawing Up Pabrinex
Using the syringe, draw 50ml of air and inject it into Vial No.1 to equalize the pressure (this makes drawing easier).
Invert the vial and slowly draw up the entire content (usually 25ml).
Repeat the same process for Vial No.2, drawing up its full content into the same syringe.
Now you have around 50ml of Pabrinex solution in your syringe.
Step 3: Mixing with Saline
Take the 250ml Saline Bottle and clean the rubber stopper with an alcohol wipe.
Insert the syringe needle into the saline bottle and slowly inject the 50ml of Pabrinex solution into it.
Gently mix the solution by swirling the bottle—do not shake to avoid air bubbles.
Step 4: Setting Up for IV Administration
Attach the IV Giving Set to the saline bottle.
Prime the IV line by allowing a small amount of fluid to flow through to remove air bubbles.
Connect the IV line to the patient’s cannula and begin administration over 30–60 minutes (depending on the patient’s tolerance and medical guidance).
Final Checks & Safety Measures
Ensure the IV flow rate is controlled using the roller clamp.
Observe for any adverse reactions like dizziness, rash, or breathing difficulties.
After infusion is complete, flush with normal saline to ensure the full dose is delivered.
Dispose of sharps & ampoules safely in the clinical waste bin.
Important Notes:
Never inject Pabrinex directly into a vein—it must be diluted in saline.
Always check for any allergic reactions in the patient before administration.
Recommended drip duration: 30–60 minutes (not too fast to avoid side effects).
For intramuscular (IM) use, Pabrinex should be injected deep into the muscle (consult clinical guidelines).
Step 1: Prepare the Site
Apply the tourniquet – This helps make the veins more visible and accessible.
Feel for a good vein – Look for a bouncy, straight vein to ensure smooth insertion.
Clean the injection site using a Cutisoft wipe – Allow it to dry before proceeding.
Step 2: Insert the Cannula
Hold the cannula needle with the bevel facing up for easy vein entry.
Insert the needle into the vein while holding onto one of the butterfly wings.
Look for the first flash of blood – This confirms that you're inside the vein.
Slightly remove the needle, then push the cannula further in (this ensures correct placement).
Look for a second flash at the insertion site – This means the cannula is fully inside the vein.
Push the plastic cannula fully in while removing the needle completely.
Step 3: Secure the Cannula & Flush with Saline
Remove the tourniquet – This prevents excess pressure on the vein.
Attach a 10ml PosiFlush syringe and inject 5ml of saline in a clockwise direction to ensure the vein is open.
Remove the PosiFlush syringe.
Step 4: Secure the Cannula with Dressing
Use a Tegaderm plaster to hold down the butterfly wings of the cannula.
Apply a full Tegaderm dressing over the insertion site.
Peel off the sides of the plaster to secure everything in place.
Step 5: Attach the IV Drip
Once the cannula is secure, attach the IV drip tube to the blue cannula hub.
Double-check everything – Ensure the IV line is properly connected and that the saline is flowing correctly.
This setup ensures a smooth and safe IV drip administration! ??
Getting Ready
Tourniquet: Wrap it around the arm, pushing into the white compartment. Tighten to expose veins.
Client Comfort: Let them rest their arm on a pillow if needed.
PosiFlush Prep:
Remove the cap.
Let in a little air first, then push out the bubbles.
Put the cap back on to keep it sterile.
Clean the Injection Site with Cutisoft.
Choose a Vein: Look for a bouncy vein and avoid areas where veins branch (valves).
Have Your Tegaderm Open & Ready.
Cannula Preparation & Insertion
Separate the Wings – Remove the white plastic.
Ensure the bevel is up and the plastic is down.
Make sure the needle tip is visible – not covered by plastic.
Why? If the plastic is covering the tip, you’ll push the plastic into the skin instead of the needle, which will hurt.
Insertion
If veins are superficial, don’t go too deep.
Hold the skin down with one hand.
Insert 2-3 fingers below the tourniquet area for space.
Push the plastic cannula in while simultaneously removing the needle.
Once the needle is out, release the tourniquet.
Quickly flush 5ml of PosiFlush into the vein (clockwise to tighten).
Check for pain – if there's no sting, it's in the right place.
Securing the Cannula
Remove the PosiFlush, and recap it.
Apply Tegaderm dressing:
Stick the wings down first.
Remove both film layers and stick over the cannula.
Adjust the Tegaderm arch.
That’s the fiddly part done!?
Benefits: B12 helps in haemoglobin production, boosting oxygen levels in the body.
Preparation
Apply Tourniquet – Find a bouncy vein.
Clean the Area – Use a pre-injection wipe (Cutisoft).
Prime the PosiFlush –
Remove the cap, add air, and push until the fluid reaches the top.
This prevents air bubbles from entering the vein.
Prepare the Cannula (22G Introcan Safety 3) –
Separate the wings and remove the top plastic.
Ensure the bevel is up, the wings are flat, and the bottom part is properly positioned.
Insertion
Insert the needle into the vein, bevel up, holding one wing.
Push in the plastic part while removing the needle.
Dispose of the needle safely and remove the tourniquet.
Secure with Tegaderm dressing and check for comfort.
Connecting the IV Drip
Flush with half a 10ml PosiFlush to check placement.
Attach the IV drip tube to the blue cannula.
Adjust the flow:
Slow (30 min) = Better absorption.
Fast (10-15 min) = Fully open.
If the drip stops: Flush again with PosiFlush to clear the line.
Tip: Completing an injection course first makes IV therapy easier to understand!?
Close the Drip – Roll the orange clamp down.
Remove the Tube – Gently detach it to prevent spillage.
Secure the Tube – Place the tube end back into the orange roller and pull it down.
Flush the Line – Use the PosiFlush to clear any remaining fluid.
Stop Any Bleeding – Wipe under the cannula if needed.
Remove the Dressing – Take off the Tegaderm.
Remove the Cannula –
Press the area with a beauty wipe.
Hold the butterfly tip and tilt upwards while pressing down.
Ask the client to keep pressure on the area with a hygiene wipe.
Disposal
IV drip tube → Sharps bin
Saline bottle → Clinical waste bin (orange/yellow)
Other sharps → Sharps bin
Done! Make sure the client is comfortable before they leave.
At the end of an IV drip, there may be some blood coming out. To properly finish the procedure and flush the vein, follow these steps:
Step 1: Remove the IV Drip
Unscrew the IV drip tube (Intrafix) anti-clockwise – This disconnects the IV from the cannula.
Attach a PosiFlush syringe clockwise – This prepares for the final saline flush.
Step 2: Flush with Saline
Slowly inject BD saline using the PosiFlush syringe – This clears the vein and prevents clotting.
Remove the PosiFlush syringe once the vein is properly flushed.
Step 3: Remove the Cannula & Secure the Site
Peel off the Tegaderm dressing carefully.
Apply gentle pressure with a hygiene wipe over the insertion site.
Remove the cannula (Introcan) by tilting it upwards while applying pressure.
Dispose of all used items in the correct medical waste bins.
Step 4: Adjust IV Drip Flow Rate (For Future Use)
If using a 250ml IV drip, adjusting the roller clamp to the middle allows it to drip over 30 minutes.
If a faster drip is needed, rolling the clamp to the top will finish the drip in 10-15 minutes.
Final Step: Aftercare & Discharge
Check with the client to ensure they feel fine.
Give aftercare advice (hydrate, rest, and report any discomfort).
That’s it—you’re done!
Now the client can go home, and you can prepare for your next session! ??
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You’ll learn:
Core Techniques: Master IV insertion, preparation, and administration.
Pharmacology Essentials: Understand the benefits, contraindications, and interactions of vitamins, minerals, and amino acids.
Patient Safety Protocols: Assess suitability, manage complications, and follow best practices.
Industry Insights: Explore the growing demand for IV therapy in clinical and wellness settings.
IV Site Selection: Learn how to choose the best vein for the infusion.
Sterile Techniques: Understand proper sterilization practices to avoid infections.
IV Equipment and Supplies: Familiarize yourself with the tools and devices used in IV therapy.
Infusion Speed and Duration: Learn how to adjust infusion rates based on patient needs.
Hydration and Electrolyte Balance: Explore the role of hydration and electrolyte management in patient health.
Vitamin and Nutrient Protocols: Tailor infusions for specific health conditions, such as fatigue, immunity, or detox.
Legal and Ethical Considerations: Understand the legal aspects of IV therapy, including informed consent and patient confidentiality.
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Handling Adverse Reactions: Recognize and manage potential side effects like allergic reactions or complications.
Patient Communication: Learn how to explain the benefits and risks of IV therapy to patients.
Post-Infusion Care: Provide aftercare to ensure patient comfort and monitor for any side effects.
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