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Butterfly Blood Draw – Step-by-Step Guide

Phlebotomy Training Institute
9 Mins Read

Blood draws can feel intimidating, especially if you have thin veins or a fear of needles. But there’s a friendly tool in the phlebotomist’s (blood collector’s) arsenal called a butterfly needle that can make things much smoother.

Butterfly blood draws, also known as winged infusion sets, are a common method for drawing blood, especially in situations where traditional venipuncture may be challenging. This technique is often used for patients with small or fragile veins or when multiple blood samples are needed.

In this guide, we’ll walk you through the process of performing this special kind of blood draw step-by-step.

Cropped view of phlebotomist wearing sterile gloves injecting patient into a vein using a butterfly needle.

What’s a Butterfly Needle?

Imagine a regular needle with two wide, plastic wings on either side. That’s a butterfly needle! These wings help hold the needle steady once it’s in your vein, making it easier for the healthcare professional to collect your blood sample.

So, a butterfly needle, also known as a winged infusion or scalp vein set, is a special tool used to collect blood. It’s made of a thin hypodermic needle covered with —

  • a plastic sheath,
  • flexible wings,
  • transparent tubing,
  • and a connector.

This connector links to other medical devices like syringes or tubes for blood collection. Some butterfly needles have a Luer lock which secures it in its position.

Butterfly needles come in different sizes, measured in gauges. These sizes range from 18 to 27 gauges. Phlebotomists who draw blood choose the size depending on the procedure. The most common sizes used are 21 and 23 gauges because they can collect more blood quickly.

Cropped view of phlebotomist wearing sterile gloves drawing blood from a patient using a butterfly needle.

Why Use a Butterfly Needle?

Butterfly needles are especially helpful for:

  • Children and infants: Their veins are smaller and trickier to find.
  • People with thin or fragile veins: The wings help stabilise the needle and prevent it from slipping out.
  • Anyone who feels anxious about needles: The smaller size and gentler insertion can make the experience less scary.

A Step-by-Step Butterfly Blood Draw

Collecting blood is a simple medical process. First, make sure you know who the patient is and why they need their blood taken. This helps with labelling the blood correctly. Then, get ready to take the blood using a butterfly needle.

Let’s see how to do it step by step.

Preparing for a Butterfly Draw

Before bringing the patient in, gather all necessary supplies for safe, sterile venous access. This includes:

  • Butterfly needle and tubing: Size (gauge) will depend on the patient’s vein thickness.
  • Cleaning supplies: Alcohol pads and gauze for wiping the area.
  • Tourniquet: A stretchy band to help find the vein.
  • Blood collection tubes: Pick either a syringe or ETS holder for the blood sample.
  • Sharps container: A safe place to throw away used needles.
  • Centrifuge: This might be needed for some tests.
  • Gloves, goggles, etc.: Protective gear to keep everyone safe.
  • Labels and forms: To keep track of everything.
  • Extra butterfly needles: Just in case the first try isn’t perfect.

Cropped view of hand wearing a glove pouring a sanitiser to disinfect the other hand

Washing Up

Before drawing blood, it’s important to maintain proper hand hygiene guidelines by the WHO. Healthcare workers should wear gloves, lab coats, and goggles to stay safe from any blood-related infections.

Hello and Welcome!

When the patient comes in, check their identity by requesting their name and date of birth. Make sure they sign any forms needed. Take time to explain the process and answer any questions they have.

Calming Techniques

Some patients may feel nervous, so offer positioning options such as being able to lie down to help them feel more comfortable.

Hydration Station

Drinking some fluids before the blood draw can make the veins easier to find. Ask about any health conditions they might have, like anaemia or bleeding problems, that could affect the blood collection. Finally, pick a good vein that’s easy to see, big enough, and strong.

Cropped view of phlebotomist wearing latex gloves drawing blood from a patient using a butterfly needle.

Get Your Winged Infusion Set Ready for Drawing Blood

To get ready for drawing blood, gather all the things you need first. Make sure the butterfly needle is clean, and check if the blood collection tubes are still good to use.

If the tubes are expired, they will not work well to collect enough blood. Also, keep the needle covered until you’re ready to use it to preserve its cleanliness.

Find the Vein in the Patient’s Arm

Have the patient rest their arm comfortably on an armrest. You might need to ask them to bend their fingers or make a fist to help the veins stand out. Use a clean tourniquet at least 2 to 4 inches from where you decide to make the insertion site. This process will help build up blood pressure in the arm and make the veins easier to penetrate with the hollow needle.

Want to learn about the 8 sites of venipuncture? Visit our informative blog to get a detailed understanding of the sites

Clean and Disinfect Where the Needle Will Go In

Use a clean pad with alcohol (70% isopropyl alcohol) on it. Make sure to wear gloves while cleaning the skin where you’ll insert the needle. Start from the middle where the needle will go, and move the pad in circles outward. This helps get rid of any dirt.

Cleaning the spot where the needle goes is really important to avoid infections. Let the skin air dry for 30 seconds to a minute before puncturing the vein. After that, attach the butterfly needle to the ETS holder and insert the tube to get ready for the blood collection.

Cropped view of phlebotomist wearing latex gloves drawing blood from a patient using a butterfly needle.

Insert the Butterfly Needle into the Shallow Vein

Once the area is dry, re-apply the tourniquet to make finding the vein easier. Then, follow the below steps carefully.

  • Hold Steady: Grasp the butterfly needle’s wings (the wide plastic parts) between your thumb and index finger. Position the tubing and holder next to the patient’s arm. Peel off the plastic sheath and quickly check the needle for any damage.
  • Ready, Aim: Confirm the needle is clean and sterile. Gently pull the patient’s skin and stretch it lightly to aid the needle entry. The flexible tubing allows for a shallow insertion angle between 10 and 15 degrees.
  • Blood Flow Confirmed: You’ll see a brief flash of blood appear in the centre of the needle (hub), which means the needle has successfully entered the vein.
  • Collect the Blood: Attach a collection tube to the holder and twist it clockwise onto the needle to create a secure connection. This will start the blood flow into the tube.
  • Discard for Accuracy (if needed): If the blood test requires a clotting test, draw a small amount of blood into a separate “discard” tube first. This removes air from the tubing and ensures you get a full collection tube for the actual test.

Besides, check out our insightful blog to thoroughly learn about the correct order of blood draws.

Take off the Tourniquet and Needle Once the Tube is Full

Watch the collection tube and wait for it to fill up with blood. Once it’s full, loosen the tourniquet and take the tube out of the holder. Take a clean gauze pad and press it gently over the insertion site for a few seconds when you pull the needle out quickly.

Winged infusion sets have a safety feature to keep you from getting pricked by the needle accidentally. You can either press a push button or gently pull the tubing to activate this safety shield.

This whole process helps stop the probable bleeding issues when you take the needle out. Check for any swelling or leakage, which could mean hematoma. If it’s a large bruise, they might need a proper medical evaluation.

Remember, never place used needles on a surface – dispose of them safely in a specific sharps container. Then, perform hand hygiene according to recommended guidelines. This means either:

  • Washing hands with soap and water: If hands are visibly soiled with blood, wash using soap and water, making sure to scrub at a minimum of 20 seconds.
  • Applying an alcohol-based hand rub: If hands are not visibly soiled, apply an alcohol-based hand rub that covers all surfaces of your hands and rub them together until dry.

Lastly, label the tubes correctly and fill out any paperwork. Write down the whole procedure, what samples you got, and if anything went wrong in the patient’s records.

In addition, visit our latest blog post to get a thorough understanding of the best practices and procedures in Phlebotomy.

Wrapping Up

To sum it up, performing a butterfly blood draw may seem daunting at first, but with practice and following these simple steps carefully, you can safely and effectively collect blood samples from patients, especially those with delicate veins.

If you find the detailed steps overwhelming, don’t worry. It’s a good idea to get trained at a recognised institute that offers Basic and Advanced Phlebotomy Competency Training, which also covers Cannulation and Catheterisation techniques. Getting certified from a recognised program like the CPD-accredited and NHS-accepted one at the Phlebotomy Training Institute ensures that you learn both theory and practical skills. This certified training helps you become a skilled phlebotomist through a combination of hands-on practice and online learning.


1) What is the duration for blood collection with a butterfly needle?

Blood collection with a butterfly needle typically takes longer than with a regular needle. While blood collection with a regular needle can take less than 2 minutes, expect the process to be longer with a butterfly needle due to its smaller size and slower blood flow. Therefore, it may not be ideal for situations requiring immediate blood collection or transfusion. It still typically only takes a few minutes overall.

2) Butterfly needles are commonly used for which types of veins?

Butterfly needles are typically used for superficial or small veins, including those in the hands, feet, and scalp. They are particularly suitable for narrow or rolling veins found in older patients, where larger needles may be challenging to use.

3) Besides blood collection, when do you use a butterfly needle?

Aside from blood collection, a butterfly needle is also used for administering intravenous therapy, such as delivering IV medications or IV infusion therapies in wellness and aesthetic practices. However, it’s important not to leave a butterfly needle inside the vein for more than 5 hours if used for delivering IV fluid.

4) What’s the difference between a butterfly and a regular needle?

The key distinction lies in their size and design; butterfly needles are shorter with flexible tubing for accessing superficial veins at a shallow angle. They offer a less painful experience, often preferred by patients fearful of needles, and feature safety mechanisms to minimise risks such as bleeding and needlestick injuries.

Additionally, butterfly needles provide stability post-insertion, versatility for various medical procedures, transparent tubing for monitoring blood flow, and easily activated safety locks for enhanced safety during blood draws.


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