Podcast
Questions and Answers
What does the composition of capillary blood include?
What does the composition of capillary blood include?
Dermal punctures may be best for which of the following patients? (Select all that apply)
Dermal punctures may be best for which of the following patients? (Select all that apply)
Situations that may require dermal punctures include which of the following? (Select all that apply)
Situations that may require dermal punctures include which of the following? (Select all that apply)
Which tests can be performed on blood collected by dermal puncture?
Which tests can be performed on blood collected by dermal puncture?
Signup and view all the answers
Which analytes are typically higher in venous blood than capillary blood? (Select all that apply)
Which analytes are typically higher in venous blood than capillary blood? (Select all that apply)
Signup and view all the answers
What impact does switching from venous sampling to dermal punctures during a glucose tolerance test have?
What impact does switching from venous sampling to dermal punctures during a glucose tolerance test have?
Signup and view all the answers
What equipment is required for dermal puncture sample collection for bilirubin testing on a newborn? (Select all that apply)
What equipment is required for dermal puncture sample collection for bilirubin testing on a newborn? (Select all that apply)
Signup and view all the answers
What controls the dimensions of a dermal puncture?
What controls the dimensions of a dermal puncture?
Signup and view all the answers
Which features are characteristic of dermal puncture devices? (Select all that apply)
Which features are characteristic of dermal puncture devices? (Select all that apply)
Signup and view all the answers
What does the term 'bullet' in blood collection refer to?
What does the term 'bullet' in blood collection refer to?
Signup and view all the answers
What is used when collecting a Natelson pipette?
What is used when collecting a Natelson pipette?
Signup and view all the answers
What is a dilution system used for cell counts in hematology?
What is a dilution system used for cell counts in hematology?
Signup and view all the answers
What is the maximum temperature that any warming device for dermal punctures should not exceed?
What is the maximum temperature that any warming device for dermal punctures should not exceed?
Signup and view all the answers
What is needed when collecting a Caraway micropipette?
What is needed when collecting a Caraway micropipette?
Signup and view all the answers
Which are characteristics of a good dermal site? (Select all that apply)
Which are characteristics of a good dermal site? (Select all that apply)
Signup and view all the answers
What should the phlebotomist ensure during a dermal puncture to avoid puncturing the calcaneus?
What should the phlebotomist ensure during a dermal puncture to avoid puncturing the calcaneus?
Signup and view all the answers
What could result from puncturing the bone during a dermal puncture procedure?
What could result from puncturing the bone during a dermal puncture procedure?
Signup and view all the answers
What is the puncture depth of a device used for dermal puncture on a preemie?
What is the puncture depth of a device used for dermal puncture on a preemie?
Signup and view all the answers
What is the maximum depth of puncture for a heelstick?
What is the maximum depth of puncture for a heelstick?
Signup and view all the answers
What should the width of a puncture not exceed?
What should the width of a puncture not exceed?
Signup and view all the answers
Why does puncture width play an important role in establishing blood flow in a dermal stick?
Why does puncture width play an important role in establishing blood flow in a dermal stick?
Signup and view all the answers
Dermal puncture sites in adults and children older than 1 year include which of the following? (Select all that apply)
Dermal puncture sites in adults and children older than 1 year include which of the following? (Select all that apply)
Signup and view all the answers
When performing a dermal puncture on the finger, where should the puncture be made?
When performing a dermal puncture on the finger, where should the puncture be made?
Signup and view all the answers
Why are dermal punctures performed on heels for children younger than 1 year?
Why are dermal punctures performed on heels for children younger than 1 year?
Signup and view all the answers
Dermal puncture sites on an infant include all of the following: (Select all that apply)
Dermal puncture sites on an infant include all of the following: (Select all that apply)
Signup and view all the answers
What determines the selection of the type of skin puncture device?
What determines the selection of the type of skin puncture device?
Signup and view all the answers
What does the acronym BURPP represent?
What does the acronym BURPP represent?
Signup and view all the answers
In which order should specimens be collected for H & H, BUN, and creatinine?
In which order should specimens be collected for H & H, BUN, and creatinine?
Signup and view all the answers
Which represents proper dermal puncture technique on an adult? (Select all that apply)
Which represents proper dermal puncture technique on an adult? (Select all that apply)
Signup and view all the answers
Why must the first drop of blood be wiped away after the puncture?
Why must the first drop of blood be wiped away after the puncture?
Signup and view all the answers
What is involved in the proper collection of microcollection tubes? (Select all that apply)
What is involved in the proper collection of microcollection tubes? (Select all that apply)
Signup and view all the answers
Why did the CBC have to be recollected for a lethargic, febrile newborn?
Why did the CBC have to be recollected for a lethargic, febrile newborn?
Signup and view all the answers
Why should bandages not be applied on children under the age of 2 years?
Why should bandages not be applied on children under the age of 2 years?
Signup and view all the answers
What is the proper technique for filling a hematocrit?
What is the proper technique for filling a hematocrit?
Signup and view all the answers
What is the screening test that involves the vascular system and platelet function?
What is the screening test that involves the vascular system and platelet function?
Signup and view all the answers
What is the normal range for bleeding time results?
What is the normal range for bleeding time results?
Signup and view all the answers
What might indicate an abnormal bleeding time test? (Select all that apply)
What might indicate an abnormal bleeding time test? (Select all that apply)
Signup and view all the answers
What orientation of the blade produces the most accurate results in a bleeding time test?
What orientation of the blade produces the most accurate results in a bleeding time test?
Signup and view all the answers
What pressure should the blood pressure cuff be inflated to during a bleeding time?
What pressure should the blood pressure cuff be inflated to during a bleeding time?
Signup and view all the answers
When does the phlebotomist start the timer during a bleeding time test?
When does the phlebotomist start the timer during a bleeding time test?
Signup and view all the answers
What is included in the proper technique for wicking away the blood during a bleeding time? (Select all that apply)
What is included in the proper technique for wicking away the blood during a bleeding time? (Select all that apply)
Signup and view all the answers
What must the phlebotomist ensure before performing ancillary blood glucose testing?
What must the phlebotomist ensure before performing ancillary blood glucose testing?
Signup and view all the answers
Study Notes
Capillary Blood Composition
- Capillary blood consists of venous and arterial blood components.
Ideal Candidates for Dermal Puncture
- Dermal punctures are suitable for children, geriatric patients, and obese individuals.
Situations Indicating Dermal Punctures
- Recommended for patients on IV therapy, those requiring only a single blood test, and patients at risk for cardiac complications.
Tests Feasible via Dermal Puncture
- Blood urea nitrogen (BUN) can be tested using samples obtained from dermal punctures.
Analyte Levels in Blood
- Potassium, calcium, and total protein levels are generally higher in venous blood compared to capillary blood.
Impact of Switching to Dermal Puncture During Glucose Test
- Using dermal samples for a glucose tolerance test may compromise results since capillary glucose levels are higher than venous levels.
Equipment for Newborn Bilirubin Testing
- Essential tools for bilirubin tests include a lancet, an amber-colored microtainer tube, and a warming device.
Controlling Dermal Puncture Depth
- Depth and width of the puncture are critical factors in dermal punctures.
Features of Dermal Puncture Devices
- Modern devices have a retractable blade, are single-use, and feature automatic puncturing mechanisms.
Blood Collection Terminology
- "Microcollection tubes" are often referred to as "bullets."
Special Collection Tools
- A flea or metal filing is used for collecting samples with a Natelson pipette.
Dilution System for Hematology
- The Unopette system is utilized for cell count dilutions.
Safe Temperature for Warming Devices
- Warming devices used during dermal punctures should not exceed 42°C.
Additional Equipment for Micropipette Collection
- Plastic caps are necessary for Caraway micropipette collections.
Characteristics of Good Dermal Puncture Sites
- An effective dermal site should demonstrate good venous flow.
Avoiding Bone Damage During Dermal Punctures
- When puncturing the heel, care must be taken to avoid the calcaneus bone.
Consequences of Bone Puncture
- Puncturing a bone during the procedure can lead to osteomyelitis, an infection of the bone or marrow.
Appropriate Puncture Depth for Preemies
- Suitable devices for dermal punctures on premature infants should have a puncture depth of 0.65 to 0.85 mm.
Maximum Puncture Depth for Heelsticks
- The maximum allowable depth for heelsticks is 2.0 mm.
Puncture Width Specifications
- The width of a dermal puncture should not exceed 2.4 mm.
Importance of Puncture Width
- A wider puncture enhances blood flow by severing more capillaries.
Dermal Puncture Sites in Older Children
- Acceptable puncture sites for children older than one include the middle finger, big toe, and ring finger.
Technique for Finger Puncture
- Punctures on the finger should be made perpendicular to the fingerprint ridges.
Infants' Dermal Puncture Site Considerations
- Derma punctures in infants under one year are preferentially performed on the heel due to minimal flesh on fingers.
Proper Infant Dermal Puncture Sites
- Acceptable puncture locations for infants include medial and lateral borders of the plantar surface, as well as the plantar surface of the big toe.
Device Selection Criteria
- The choice of skin puncture device hinges on the patient's age.
BURPP Test Considerations
- The BURPP acronym denotes tests that cannot be performed using povidone-iodine.
Collection Order for Blood Tests
- For collecting H&H, BUN, and creatinine, the order is lavender followed by gold.
Proper Dermal Puncture Techniques
- Correct technique includes selecting the middle or ring finger, making cuts perpendicular to fingerprints, and wiping away the first blood drop.
Importance of Wiping First Blood Drop
- The initial drop of blood is wiped away to prevent contamination from tissue fluid.
Techniques for Microcollection Tubes
- Proper technique involves touching the scoop to blood, allowing it to flow freely, and gently tapping it to move the blood into the tube.
Possible Collection Failure
- An extra blood spill during a CBC due to an aspirating needle displacing the sample necessitated recollection.
Bandage Safety for Young Children
- Bandages are not recommended for children under two years due to choking hazards.
Hematocrit Collection Technique
- Hematocrit tubes should be filled via capillary action by touching the drop.
Screening Tests for Hemostasis
- Bleeding time tests assess the vascular system and platelet function for primary hemostasis integrity.
Normal Bleeding Time Range
- Typical bleeding time results should fall between 2 to 10 minutes.
Causes of Abnormal Bleeding Time
- An abnormal test can suggest platelet disorders, skin conditions, or medication interferences.
Bleeding Time Test Blade Orientation
- The blade should be parallel to the antecubital crease for the most accurate bleeding time results.
Blood Pressure Cuff Pressure for Bleeding Time
- Maintain a pressure of 40 mm Hg when inflating the blood pressure cuff.
Wicking Technique During Bleeding Time
- Proper wicking involves touching filter paper to the drop, repeating every 30 seconds until the drop vanishes.
Pre-testing Protocol for Blood Glucose Devices
- Ensure the performance of the instrument by running controls alongside patient samples before commencing glucose testing.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Explore the nuances of capillary blood composition, ideal candidates for dermal puncture, and the various situations where this method is beneficial. Learn about the tests that can be done and the implications of using dermal samples in specific tests, particularly in relation to glucose measurements.
