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According to the venipuncture standard published by the Clinical and Laboratory Standards Institute, seated patients must be in a chair with at least two arm rests. Patients who cannot be comfortably seated on such chairs must be lying down.

The risk of improper positioning is when patients lose consciousness during or immediately after the procedure. When in a chair without side arm rests, injuries are more likely. Since studies show 2.5 percent of patients pass out during phlebotomy procedures, proper seating and positioning is critical. Positioning patients upright on exam tables or on hospital beds violate the standards and threaten the patient.

The inpatient's bedside tray provides no protection from falling forward and is not a substitute for a chair with arm rests. Instead, have inpatients who are sitting upright in bed lie in a recumbent  position. Have outpatients sitting on an exam table recline on the table or move to a chair with arm rests.