External jugular venepuncture: Increasing access to diagnosis and treatment of viral hepatitis in people who inject drugs

Abstract

Phlebotomy is essential for diagnosis and assessment of disease progression and treatment response. Blood samples with traditional techniques can be difficult to obtain from or refused by those with hard-to-access peripheral veins, especially people who inject drugs (PWID). Many PWID are infected with the blood-borne viruses, such as hepatitis C, which can lead to cirrhosis, liver failure and hepatocellular carcinoma. Blood samples to support the diagnosis and management of these conditions can be taken using external jugular venepuncture (EJV), which avoids risks of multiple attempts, damage to the veins or accidentally accessing an artery. This article provides a step-by-step guide on how to prepare the patient for EJV, find the external jugular vein and safely collect a blood sample. It also assesses the limited evidence available to support its use by nurses. Copyright © 2019 MA Healthcare Ltd