1. Drawing blood samples for serum total cholesterol, HDL cholesterol and plasma glucose, HbA1c and DNA extraction

2. Based on EHES Manual, Part B. Fieldwork Procedures, 2nd edition (2016)
Available at:
These slides can be used freely, translated and adapted to national use (e.g. concerning the equipment). However, it is important to keep in mind that no changes should be made to the measurement techniques, which need to be standardized.

3. Equipment Blood sampling vacuum tubes Needle for vacuum tubes
Needle holder/adapter
Needle disposal container
Stasis
Disinfection solution, swabs, gauze pads, skin tape
Disposable gloves

4. Blood collection tubes
Serum evacuated tubes containing gel or plain serum tubes (red cap)
For lipids
Fluoride-citrate plasma tube (grey cap)
For glucose
EDTA plasma tubes (violet cap)
For HbA1c

5. Exclusion criteria Blood samples are not taken, if participant
Has a chronic illness which restricts taking blood samples
Has anemia (Hb below 10 g/l)
Doubts about the blood volume to be taken
Refuses

6. Preparing for the blood collection
Ask and record length of time from the last meal in full hours
Participant rests minutes
Use gloves or disinfect hands

7. Posture Sitting position, hand downward, palm upwards
Before blood collection, ask the participant to remove tight clothes that might constrict the upper arm
If participant tells that he/she easily faints, supine posture due to safety of the participant may be needed (this exception needs to be recorded)
Take blood from the arm not used for BP measurement
usually left arm

8. Protocol 1/8
Gently tap top of the fluoride citrate plasma tube if it contains granules
Release cover from the end of the needle and connect the holder and sample needle
Apply tourniquet (if needed) to search a vein
Limit the use of the tourniquet to less than one minute at a time

9. Protocol 2/8
Place the arm in a supported downward position and disinfect the puncture site
Remove the protector case from the needle
Perform the venipuncture

10. Protocol 3/8 Collect blood first into the 2 plain serum tubes
Press the tube to puncture the stopper and start filling
Loosen the tourniquet when the bloodstream runs
Support the tube during filling

11. Protocol 4/8
When the bloodstream stops, take the tube out of the holder
Check that the tube is filled to the accurate volume
Mix the plain serum tube 5 times by inverting the tube completely top-down immediately after taking the tube out of the holder

12. Protocol 5/8 Fill the fluoride-citrate plasma tube
Immediately after taking the fluoride-citrate tube out of the holder, mix 15 times by inverting the tube completely top-down

13. Protocol 6/8 Fill the 3 EDTA tubes
Mix the plain EDTA tubes 5 times by inverting the tube completely top-down immediately after taking the tube out of the holder
Store all tubes in a vertical position until sample handling

14. Protocol 7/8 Remove the needle from the vein
Apply pressure immediately on the puncture site with a gauze pad until bleeding stops

15. Protocol 8/8
Label the successfully filled tubes according to the sampling chart
Discard needles into a needle dispose container and all other materials contaminated with blood into a biological waste container

16. Recording Deviations from the blood drawing protocol, if any
Your initials/personnel code to identify who draw the blood samples

17. Acknowledgements Slides prepared by: Laura Råman
Photographs: Hanna Tolonen
Blood sample drawing demonstrations by Saara Vallivaara and a voluntary participant
Experiences and feedback from the EHES network have been utilized in the preparation of these slides
Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in through SANCO/2008/C2/02-SI EHES and Grand Agreement number , and in through Grand Agreement number /BRIDGE Health

18. Disclaimer
The views expressed here are those of the authors and they do not represent the Commission’s official position.