• Perform a venous assessment
• Set expectations—it may take more than one attempt to gain venous access
• Educate your patients about:
  • Hydration prior to apheresis
  • Exercise when possible (for example, flexing fingers)
  • Use of topical anesthetics

Select a needle or angiocatheter that will support the chosen flow rate.

Flow rates may vary based on the patient characteristics.

17 gauge: 80 mL/min and above

18 gauge: 70 mL/min and above

19 gauge: 60 mL/min and below

• Assess arms for potential venipuncture sites
• Palpate and visualize the vein for location, direction and depth
• Select a vein that will accommodate the needle size chosen

• Warm the venous site
• Position the patient’s arm in a natural position
• Use distraction techniques when inserting the needle
• Stay calm
• Secure the needle; do not tape butterfly wings
• Use an ultrasound-guided technique, if available

• Use a blood pressure cuff or a tourniquet
• Check the position of the patient’s arm and needle insertion sites
• Encourage the patient to squeeze a ball or squeezer
• Keep the patient warm
• Warm the patient’s arm above and below the access site

• Slow down the inlet pump flow rate
• Ask the patient to squeeze
• Check the pressure in the blood pressure cuff
• Reposition the patient’s arm or the needle position
• Verify the flow rate is appropriate for the vein and needle gauge
• Ensure the patient is comfortable, warm and calm
• Check for obstructions along the inlet/return line
• Establish alternate access