Which of the following should be the first test to be collected in a dermal puncture?
Capillary Puncture Procedure ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES CAPILLARY PUNCTURE NOTE MATERIALS 1. Lancets 2. Microtainer Blood Collection Tubes. 3. Recommended order of collection for microtainer
specimens: 4. Filter paper ( if required) 5. Gloves-latex free 6. Warming device 7. Antiseptic. Individually packaged 70% isopropyl alcohol wipes. 8. 2×2 Gauze 9. Sharps Disposal Container. An OSHA acceptable, puncture proof container marked 10. Bandages or tape SAFETY
1. Observe universal (standard) safety precautions. Observe all applicable isolation 2. PPE’s will be worn at all time. 3. Wash hands in warm, running water with an appropriate hand washing product, or if not 4. Gloves are to be worn during all blood collection procedures, and changed between 5. A lab coat or gown must be worn during blood collection procedures. 6. Lancets are disposed of in an appropriate ‘sharps’ container as one unit. 7. Gloves are to be discarded in the appropriate container immediately after the blood 8. All other items used for the procedure must be disposed of according to proper 9. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. All 10. In the case of an accidental stick, immediately wash the area with an antibacterial soap, PROCEDURE 1. Identify the patient. Two forms of active identification are required. Ask the patient or 2. Reassure the patient that the minimum amount of blood required for testing will be drawn. 3. Select the appropriate microtainers for the specimens to be collected. Any microtainers 4. Wash hands and put on gloves. 5. Position the patient with the arm extended to form a straight-line form shoulder to wrist. 6. Do not attempt a capillary puncture more than twice. Notify your supervisor or patient’s HEEL STICK 1. Position the infant with the head slightly elevated. 2. Warm the heel from which blood is to be obtained. A commercial heel warmer may be used. 3. Cleanse the heel with alcohol prep, then dry with a sterile 2×2 as alcohol can influence test 4. Using a sterile lancet, puncture the most medial or lateral portion of the plantar surface of the 5. Puncture no deeper than 2.4mm (approximately 0.1 inches). 6. Punctures to the posterior curvature of the heel cab cause damage to the bones. 7. Previous puncture sites should be avoided. Avoid bruising the infant’s heel when obtaining 8. Wipe away the first drop of blood with sterile 2×2 gauze. 9. Allow another large drop of blood to form. Lightly touch the microtainer
capillary collection 10. Cap, rotate and invert the microtainer to mix the blood collected. 11. When finished, clean the site and apply pressure with clean gauze to stop the bleeding. Apply an adhesive bandage. 12. Label all specimens per accepted guidelines. 13. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. FINGER STICK 1. Position the patient so that the hand is easily accessible. 2. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. Allow the 3. Using a sterile lancet, puncture the fingertip in
the fleshy part of the finger, slightly to the side 4. Wipe away the first drop of blood with a sterile 2×2 gauze. 5. Allow another large drop of blood to form. Lightly touch the microtainer
capillary collection 6. Cap, rotate and invert the microtainer to mix the blood collected. 7. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Apply 8. Label all specimens per accepted guidelines. 9. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. FILTER PAPER SPECIMEN COLLECTION 1. Allow the blood to soak through and completely fill the pre-printed circle on the filter paper. 2. Filter paper should touch only the blood and not the heel or finger. 3. Apply only ONE drop of blood per circle. Do not add blood to a circle already filled or 4. Apply blood to the printed side of the filter paper. 5. Make certain that the blood completely saturates all four (4) circles and is visible from both 6. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. 7. Allow filter paper to air dry for two (2) hours at room temperature. Avoid placing sample on 8. Forward completed/dry collections to the laboratory as soon as possible. What are the steps for dermal puncture?Obtaining the Specimen. Patient Identification.. Site Preparation.. Let Gravity Be Your Friend.. Finger Puncture.. Heel Puncture.. Properly Filling and Mixing a Microcollection Container.. Order of Draw.. Positioning the Puncture Device for a Fingerstick.. Which of the following tubes should be drawn first?The correct order of draw follows: Blood culture tube or bottle. Sodium citrate tube (eg, blue closure) Serum tubes, including those with clot activator and gels (eg, red, red-speckled, gold closures)
Which test can not be collected by dermal puncture?Capillary punctures are not suitable for blood culture testing and most coagulation tests.
Why should the first drop of blood be wiped during a dermal puncture?Wipe off the first drop of blood – it is contaminated with tissue fluid and therefore it will dilute the specimen. 3. Gently squeeze finger and let the capillary blood flow freely down into the tube.
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