The product used most often to cleanse and disinfect the site prior to venipuncture is 70% isopropyl alcohol in towelette form. Alternative cleansing agents available are chlorhexadine gluconate (chloraprep) and povidone-iodine which are used mainly for collection of blood cultures, blood alcohol specimens, or when the patient is sensitive to alcohol. Chloroprep or povidone-iodine with alcohol may not be used for blood alcohol collections since they both contain alcohol.
The 2017 CLSI standards no longer recommend using a circular target motion method for cleansing the arm. Their studies suggest that the back and forth friction is superior to the circular concentric cleansing. The CLSI standards recommend cleansing the site with friction using a clean gauze pad with 70% isopropyl alcohol solution or a commercially prepared alcohol pad. The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid discomfort for the patient.
Gauze should be used when applying pressure to the venipuncture site immediately after the needle is withdrawn. Adequate pressure to stop bleeding is crucial to avoid formation of a hematoma or bruise. Cotton balls should not be used to apply pressure to stop bleeding because the clot formed may be dislodged by residual cotton fibers as the cotton ball is pulled away from the site.
Paper tape or a bandage is used to cover the wound after bleeding has stopped to prevent disruption of the clot.
