If blood does not appear in an evacuated tube during venipuncture, what should a phlebotomist do first?

When blood does not appear in an evacuated tube during venipuncture, the first step the phlebotomist should take is to slightly reposition the needle. This technique allows for the possibility that the needle might not be in the correct position within the vein. Proper needle placement is key to successful blood collection, and minor adjustments can enable the phlebotomist to access the vein appropriately without unnecessarily switching to a different site or vein.

Making a slight adjustment can involve carefully moving the needle within the same puncture site to find the optimal position in the lumen of the vein. This approach often resolves the issue quickly and efficiently without the need to introduce additional discomfort to the patient by re-puncturing or calling for assistance immediately. It is essential to be cautious and gentle to avoid damaging the vein or surrounding tissues.

Other options like calling for assistance may delay the process unnecessarily, and trying a different vein or replacing the needle can lead to additional discomfort for the patient and is typically considered only after attempting minor adjustments at the original site.