Is external jugular venepuncture safe and effective


“Our aim was to assess the efficacy of an EJV service in a large district general hospital, led by a Hepatology Specialist Nurse.” Morris et al (2014).


Morris, L., Frayne, S., Wadsworth, J., Mansoor, M. and Reddy, Y. (2014) PTU-114 Hepatology Specialist Nurse Led External Jugular Venepuncture; Is It Safe And Effective? Gut. 63(Suppl 1), p.A89.


INTRODUCTION: Difficult venous access is a significant problem for a proportion of patients with chronic hepatitis C and a history of intravenous drug use. It can impede access to treatment and cause distress for the patient. Sampling blood through external jugular venepuncture (EJV) is highly successful. This enables more patients to be assessed and treated with antiviral therapy whilst participating in clinical trials. Our aim was to assess the efficacy of an EJV service in a large district general hospital, led by a Hepatology Specialist Nurse.

METHODS: Data was collected prospectively, recording the number of attempts needed to successfully complete EJV. All procedures were performed by an experienced hepatology nurse. Patients who underwent EJV were invited to provide feedback on overall satisfaction.

RESULTS: Between February 2012 and October 2013, external jugular venepuncture was attempted on 130 occasions in 57 chronic hepatitis C patients. The mean age of the patients was 39 (range 30-61) and there were 46 males and 11 females. Genotype distribution was mostly 3a (46%) and 1a (33%). 80% of EJV procedures (n = 103) were performed successfully on the first attempt, rising to 92% on the second attempt. In five patients (8%), EJV failed due to: previous neck surgery (1), vein thrombosis (3) and patient anxiety (1). No procedural complications were reported. Patient experience was 100% positive.

CONCLUSION: External jugular venepuncture is a useful method of blood sampling from patients with chronic hepatitis C and difficult venous access, allowing for monitoring of their therapy. A Specialist Nurse Led EJV service is safe, effective and is well received by patients. Due to this success, a number of our patients have been enrolled in clinical trials.


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