The cephalic vein is a safe secondary option if the median cubital vein is not working. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area.
Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery.
While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. Patients who are dehydrated, obese, terminally ill, or ‘hard sticks’ often get their blood drawn in other locations rather than the antecubital fossa.
The dorsal venous network is the next most common vein site for phlebotomists. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. However, drawing blood from the hand is affiliated with higher levels of pain and less control. As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw.