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Questions and Answers
What is the primary reason for following the order of the draw for capillary blood collection?
What is the primary reason for following the order of the draw for capillary blood collection?
Why is it important to collect blood gases first in capillary blood collection?
Why is it important to collect blood gases first in capillary blood collection?
What type of additive is present in purple, lavender, pink, or pearl cap tubes?
What type of additive is present in purple, lavender, pink, or pearl cap tubes?
Why is it important to collect EDTA tubes as close to first as possible?
Why is it important to collect EDTA tubes as close to first as possible?
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What type of additive is present in green cap tubes?
What type of additive is present in green cap tubes?
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What is the purpose of collecting serum specimens last in the order of the draw?
What is the purpose of collecting serum specimens last in the order of the draw?
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What is the primary purpose of following the CLSI order of the draw for capillary blood collection?
What is the primary purpose of following the CLSI order of the draw for capillary blood collection?
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What happens to the blood as soon as the flow begins in a dermal puncture?
What happens to the blood as soon as the flow begins in a dermal puncture?
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What is the recommended depth of a lancet for a child weighing less than or equal to 1 kg?
What is the recommended depth of a lancet for a child weighing less than or equal to 1 kg?
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What is the primary reason for not using the back of the heel for a heel stick?
What is the primary reason for not using the back of the heel for a heel stick?
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Why should you not squeeze the heel for a long time or use excessive pressure during a heel stick?
Why should you not squeeze the heel for a long time or use excessive pressure during a heel stick?
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What should you do if the flow of blood stops during a heel stick?
What should you do if the flow of blood stops during a heel stick?
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What is the purpose of wiping away the first drop of blood during a heel stick?
What is the purpose of wiping away the first drop of blood during a heel stick?
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Why should you not use a site that was recently used or has a hematoma or scratch for a heel stick?
Why should you not use a site that was recently used or has a hematoma or scratch for a heel stick?
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What is the recommended time for applying the heel warmer before a heel stick?
What is the recommended time for applying the heel warmer before a heel stick?
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What should you do after filling the collection tubes during a heel stick?
What should you do after filling the collection tubes during a heel stick?
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Why should adhesive bandages not be used on infants after a dermal puncture?
Why should adhesive bandages not be used on infants after a dermal puncture?
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What is the purpose of a heel warming device in a heel stick procedure?
What is the purpose of a heel warming device in a heel stick procedure?
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Why should the first drop of blood be wiped away during a dermal puncture?
Why should the first drop of blood be wiped away during a dermal puncture?
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What should be done to the filled tubes after capping?
What should be done to the filled tubes after capping?
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Why is a heel stick used for infants younger than 12 months?
Why is a heel stick used for infants younger than 12 months?
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What should be done to prevent bleeding after a dermal puncture?
What should be done to prevent bleeding after a dermal puncture?
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What should be done to the puncture site after bleeding has stopped?
What should be done to the puncture site after bleeding has stopped?
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Why should the equipment be assembled before performing a heel stick?
Why should the equipment be assembled before performing a heel stick?
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When is a capillary blood collection preferred over a venipuncture in adults?
When is a capillary blood collection preferred over a venipuncture in adults?
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Where should a dermal puncture be performed on an infant up to 1 year old?
Where should a dermal puncture be performed on an infant up to 1 year old?
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What is the first step in the dermal puncture procedure?
What is the first step in the dermal puncture procedure?
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What should you avoid performing a finger stick on?
What should you avoid performing a finger stick on?
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What is the purpose of washing hands before the dermal puncture procedure?
What is the purpose of washing hands before the dermal puncture procedure?
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What should you check before performing a dermal puncture on an adult?
What should you check before performing a dermal puncture on an adult?
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Why should you avoid using the thumb for a dermal puncture?
Why should you avoid using the thumb for a dermal puncture?
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What should you do to position the patient before the dermal puncture procedure?
What should you do to position the patient before the dermal puncture procedure?
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Why is a capillary blood collection preferred for infants younger than 1 year old?
Why is a capillary blood collection preferred for infants younger than 1 year old?
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What is an advantage of using capillary blood collection for patients who are underweight?
What is an advantage of using capillary blood collection for patients who are underweight?
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What is a characteristic of a dermal puncture blood specimen?
What is a characteristic of a dermal puncture blood specimen?
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Why is it important to document the use of a dermal puncture on the medical requisition?
Why is it important to document the use of a dermal puncture on the medical requisition?
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Which of the following is a common use for capillary blood collection?
Which of the following is a common use for capillary blood collection?
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In which situations may a capillary collection be necessary?
In which situations may a capillary collection be necessary?
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What is a reason why capillary blood collection may be preferred over venipuncture?
What is a reason why capillary blood collection may be preferred over venipuncture?
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Why may a capillary collection be used for older adults?
Why may a capillary collection be used for older adults?
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You should use a lancet that punctures the skin to a depth of 2 mm for a child weighing less than or equal to 1 kg.
You should use a lancet that punctures the skin to a depth of 2 mm for a child weighing less than or equal to 1 kg.
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After filling the collection tubes during a heel stick, you should release the pressure on the puncture site.
After filling the collection tubes during a heel stick, you should release the pressure on the puncture site.
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The best site for a heel stick is the back of the heel.
The best site for a heel stick is the back of the heel.
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You should use a lancet with a depth of 1 mm for infants.
You should use a lancet with a depth of 1 mm for infants.
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You should squeeze the heel for a long time to get a sufficient blood sample.
You should squeeze the heel for a long time to get a sufficient blood sample.
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You should apply the heel warmer for 1 minute before a heel stick.
You should apply the heel warmer for 1 minute before a heel stick.
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In capillary blood collection, the order of the draw is followed to prevent additive cross-contamination.
In capillary blood collection, the order of the draw is followed to prevent additive cross-contamination.
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The blood gas collections are collected last in the capillary order of the draw.
The blood gas collections are collected last in the capillary order of the draw.
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EDTA tubes contain the additive heparin.
EDTA tubes contain the additive heparin.
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Serum specimens are collected before EDTA tubes in the capillary order of the draw.
Serum specimens are collected before EDTA tubes in the capillary order of the draw.
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The order of the draw is the same for both venipuncture and capillary blood collection.
The order of the draw is the same for both venipuncture and capillary blood collection.
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The blood begins to clot immediately after the flow begins in a dermal puncture.
The blood begins to clot immediately after the flow begins in a dermal puncture.
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The lancet should puncture the skin to a depth of at least 3 mm for a heel stick.
The lancet should puncture the skin to a depth of at least 3 mm for a heel stick.
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Adults can use a heel stick for capillary blood collection.
Adults can use a heel stick for capillary blood collection.
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Gloves should be removed before washing hands after the dermal puncture procedure.
Gloves should be removed before washing hands after the dermal puncture procedure.
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A heel warming device is required for a heel stick procedure.
A heel warming device is required for a heel stick procedure.
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The first drop of blood should be collected and used for testing during a dermal puncture.
The first drop of blood should be collected and used for testing during a dermal puncture.
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A capillary blood collection is preferred for patients who are overweight.
A capillary blood collection is preferred for patients who are overweight.
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The order of draw for capillary blood collection is the same as for venipuncture.
The order of draw for capillary blood collection is the same as for venipuncture.
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Adhesive bandages should be used on all patients, regardless of age, after a dermal puncture.
Adhesive bandages should be used on all patients, regardless of age, after a dermal puncture.
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Study Notes
Heel Stick Procedure for Infants
- Choose a lancet that punctures the skin to a depth of 0.65 mm if the infant's weight is equal to or less than 1 kg.
- Position the infant supine, if possible, and check with the nurse or provider for any restrictions on positioning.
- Apply a heel warmer for 3 to 5 minutes.
- Wash your hands and don gloves.
- Select a site on the lateral or medial sides of the heel, avoiding the back of the heel.
- Cleanse the site and place the lancet on the skin to make the puncture.
- Gently squeeze the heel to collect blood, but avoid excessive pressure or squeezing for too long.
Capillary Blood Collection
- Also known as dermal puncture or finger stick
- Used for tests requiring a small amount of blood, when a patient has no accessible vein, or when the test requires capillary blood
- Preferred method for infants younger than 1 year old due to small vein size and risk of iatrogenic anemia
Order of Draw for Capillary Collection
- Blood gas collections: collect first to ensure accurate representation of patient's blood
- EDTA tubes (purple, lavender, pink, or pearl cap): collect early to prevent clotting
- Heparin tubes (green cap): collect after EDTA tubes
- Any other additive specimens: collect after heparin tubes
- Serum (red or gold cap): collect last, as blood starts to clot immediately
General Procedure for Dermal Puncture
- Introduce yourself and identify the patient using at least two methods
- Position the patient sitting or lying down, with their hand below heart level
- Wash hands and don gloves
- Assemble equipment: gloves, isopropyl alcohol swabs, adhesive bandage, gauze, lancet, and microcollection tubes
- Check the warmth of the hand chosen and identify the site (middle or ring finger for adults and children over 1 year)
- Perform the dermal puncture and collect blood
Heel Stick Procedure for Capillary Blood Collection
- When performing a heel stick on an infant, choose a lancet that punctures the skin to a depth of 0.65 mm if the child's weight is equal to or less than 1 kg.
- A common size used for infants is a 1 mm depth lancet, and never use a lancet that goes deeper than 2 mm.
- Position the patient supine, if possible, and check with the nurse or provider for any restrictions on positioning.
Site Selection and Preparation
- The best sites for a heel stick are the lateral or medial sides of the heel.
- The skin between the lateral and medial sides should be considered a secondary site.
- Avoid using the back of the heel, as it has too little skin/tissue and a lancet puncture can damage the bone.
- Do not use a site that was recently used or has a hematoma or scratch.
Blood Collection and Processing
- Apply the heel warmer for 3 to 5 minutes.
- Wash your hands and wear gloves.
- Cleanse the site and make the puncture.
- Gently squeeze the heel to collect blood, but avoid squeezing for a long time or using excessive pressure.
- Wipe away the first drop of blood and collect the sample in a microcollection tube.
- If the flow of blood stops, wipe away any surface clots with a gauze pad and stop squeezing the heel.
Capillary Blood Collection Order
- The order of the draw is important for dermal punctures to ensure the sample is collected in an order that has the least negative effect on the blood test.
- The CLSI order of the draw for capillary collection is:
- Blood gas collections
- Purple, lavender, pink, or pearl cap tubes (EDTA)
- Green cap tubes (heparin)
- Any other additive specimens
- Serum (red or gold cap tubes)
Post-Collection Procedures
- Apply pressure to the puncture site with a gauze pad for several minutes to stop bleeding.
- Label every specimen before leaving the patient's bedside.
- Observe for any complications and collect all garbage from the area.
- Remove gloves and wash hands.
- Thank the patient.
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Description
This quiz covers the steps involved in collecting blood samples, including preparing the patient, filling tubes, and caring for the puncture site.
