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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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H Pattern Forearm Veins

M Pattern Forearm Veins

Explore the Possibilities!

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. These include the top of the hand, the side of the wrist, and the forearm. These sites should only be considered after determining that the veins of the antecubital area cannot be accessed or cannot be used.
Reason for Choice
Median Cubital
Mid antecubital fossa
Vertical to diagonal
Musculature assists in stabilizing vein; very often largest; ease of access
Thumb side of antecubital fossa
Ease of access; few nerves and tendons in area
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.