—To withdraw blood from the basilic vein the left arm should be employed, because of a more direct route to the right auricle. Make the incision in the middle or the upper third of the arm. The basilic vein lies in the upper arm and extends from the elbow to the shoulder, and can be found a short distance from the brachial artery, either above or below, but generally below and toward the body. Its position is not always the same, owing to the many anomalies that might occur. As a rule the vein is quite large and prominent and when secured, raise to the surface freeing it from the surrounding tissues.
Prepare two ligatures, make the incision in the vein and pass gently the basilic drainage tube upward toward the heart. Either a steel or rubber tube may be used. If the flexible rubber tube is used, it will find its way to the right auricle of the heart, its course is through the basilic, axillary, sub-clavian, innominate, superior vena cava, to the right auricle. Either the aspiration or the drainage methods may be used. If these fail try the displacement method.
The use of the basilic for the removal of blood is fast disappearing from general practice. Larger veins can be used, which will always insure greater success.
The Removal of Blood from the Internal Jugular Vein.
—The internal jugular vein is the largest tributary vein in the body, and accompanies the carotid artery. The operator will cut through the skin at a point from one half inch above the clavicle or collar bone and in the valley formed by the sterno-mastoid muscle to the outside and the muscles of the wind pipe to the inside, cut upward making the perpendicular incision. Raise both the artery and the vein according to the usual method. It seems best to raise the artery and the vein together, and by so doing this will tend to give added strength to the vein which is very large but has quite thin walls.
Direct the hook around the vein first then around the artery toward the wind pipe or trachea, raise both to the surface, place on the bone separator, and remove the sheaths. Use any of the drainage tubes. Insert the vein drainage tube and the arterial tube, the point of both tubes being directed toward the heart. The injection should be made slowly, which will cause the blood to flow from the vein through the tube and into the blood bottle.
This vein is not as much used as the axillary or the femoral for the removal of blood.
It is true that it is very close to the center of circulation and a gateway for the blood from the face. The chief disadvantage is that the vein lies quite deep, is very large and has such thin walls, that it is almost impossible to raise it without a rupture.
About one-thirteenth of the body's weight is calculated to be blood. Granting for the sake of argument that the average body that we would desire to draw blood from would weigh 208 pounds, then that average body would contain 16 pounds of blood. One pound of blood is practically equal to one pint, making the average body to contain about 16 pints of blood.
After death about one-fourth of the blood of the body is found in the portal system. The portal system has capillaries at both ends so that it is impossible to draw this blood.