Capillary blood collection has been around for decades. It is important to understand the common causes of pre-analytical errors and reduce their impact on the haemoglobin result. Venous blood is most commonly used, but capillary samples can also be used, depending on the analyte and method to be used for the measurement. However, venous and capillary blood may differ in glucose concentration by up to 70 mg/dL, depending on time of blood collection after food intake. Capillary blood gas sampling is an intermittent procedure and should be performed when a documented need exists. A small drop of capillary whole blood is collected by skin puncture from the finger or heel (in infants). Lancet Size. Capillary blood gas and the big picture. Due to the fact that anemia is one of the world’s most common blood disorders, affecting around 25% of the global population, hemoglobin testing is among the most frequently performed procedures that make use of capillary blood samples collected at the point of care. The following may assist the clinician in assessing the need for capillary blood gas sampling: 8.1 History and physical assessment;(23) In adults, it may be done for people who are having trouble hearing because of a buildup of fluid in the middle ear or have experienced barotrauma due to extreme air pressure changes. With the bevel facing up, allow the blood droplet to enter the capillary tip and drip into the sample container. PROCEDURE MANUAL FOR THE i-STAT SYSTEM 3 REV. Figure A–2 Site selection. Print Phlebotomy Final Exam Practice flashcards | Easy Notecards. Capillary puncture of the heel. A capillary puncture is typically performed on an adult when? Capillary Puncture Principles (cont ’d) • Indications for Capillary Puncture in Adults & Older Children – Available veins are fragile or must be saved for other procedures – Several unsuccessful venipunctures have been performed – Patient has clot-forming tendencies – … The heel-stick test is a simple method to collect a newborn baby’s blood by pricking their heel to screen for certain diseases. Why would a capillary puncture be performed? Red cap with Gel barrier - no additive - used for most chemistry tests. What are the usual puncture sites for adults and infants? Description Blood glucose monitoring is a method of assessing the concentration of glucose in the blood. Phlebotomy. Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Below is a list of common tests performed on capillary blood specimens some of which are point-of-care tests or home self-testing: Blood smears for manual white blood cell count. A young child is typically held in the lap by a parent or guardian 6. Available veins are fragile or must be saved for other procedures. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Blood volume requirements vary by the type of test being performed and the number of tests being performed. Also know, what is the correct depth of capillary puncture in adults? The 10 or 20 microliters can be used to look for anemia, check blood sugar or even to evaluate thyroid function. Definition. 3. Patient Preparation and Specimen Collection: Figure A–1 Site selection. Punctures done on the plantar surface can damage cartilage or bone. The puncture … Capillary puncture blood contains : Arterial blood, Venous blood, and Interstitial fluids. Phlebotomist. Determination of certain analytes. However, because capillary and arterial blood samples are not identical with respect to blood gases, results must be interpreted differently. The finger is usually the preferred site for capillary testing in an adult patient. Capillary puncture of the heel. Hold the puncture site downward and apply gentle, intermittent pressure proximal to the puncture site : Edema at the puncture site . Standard enzyme laboratory method. Skin puncture or capillary blood collection involves puncturing the dermis layer of the skin to access the capillary beds which run through the subcutaneous layer of the skin. List three areas to avoid for microcollection and the reason for each. Capillary blood sampling, which refers to sampling blood from a puncture on the finger, heel or an earlobe, is increasingly common in medicine. If the capillary puncture is cyanotic, edematous, or swollen what does this mean? MA role in phlebotomy. of the puncture site and the required blood volume should be taken into account. Patients have thrombotic tendencies c. Veins are saved for chemotherapy d. All of the above 6. Whenever a small amount of blood is required for the tests, instead of venipuncture, a capillary puncture is done to collect the sample. puncture site with sterile gauze. For children aged below 8 years, the penetration depth should not exceed 1.5 mm. List the order of draw for collecting capillary specimens. Determine if the … Patients have thrombotic tendencies. If the capillary puncture is cyanotic, edematous, or swollen what does this mean? Number of paired (capillary/arterial) samples. The test is usually performed using a drop of whole blood obtained by finger puncture. Be sure to check the A sample of venous blood or capillary blood may be collected for this test. is a person trained to obtain blood specimens by venipuncture and capillary puncture techniques. d) the test uses very little blood. Then a needle is inserted into your spinal canal — in your lower back — to collect cerebrospinal fluid for testing. Types of punctures: Finger puncture heel stick. B. CAPILLARY BLOOD GAS. Capillary sampling from a finger, heel or (rarely) an ear lobe may be performed on patients of any age, for specific tests that require small quantities of blood. Blood sample - capillary; Fingerstick; Heelstick. Phlebotomist. Define venous, arterial and capillary blood. Adult capillary puncture may be performed when a) there are no accessible veins, b) the patient has thrombotic tendencies, c) veins must be saved for chemotherapy. May give a falsely low glucose result . Figure A–5 Venipuncture needle placement at insertion. 1. The site of choice is the distal lateral aspect of the fingertip, usually the 2nd (middle) finger or 3rd (ring) finger on the non-dominant hand. If the capillary puncture is cyanotic, edematous, or swollen what does this mean? This will result in a better blood flow and a more accurate analysis. With a diameter of just 8 µm, capillaries are the smallest blood vessel. Capillary blood gas sampling is recommended for adult patients only in situations when arterial blood puncture cannot be performed (patients with severe burns, tendencies to thrombosis, obese and geriatric patients). I) BLOOD COLLECTION BY FINGER PUNCTURE C. Distal phalanx. Locate the acceptable sites for puncture and collection of capillary blood on a finger and infant heel. A heelstick capillary blood collection also requires the collector to consider the clinical condition of the patient as well as age and weight when choosing this site and when choosing a lancet that offers the depth of the puncture. For the adult patient, the arterial blood is sampled either by arterial puncture or from an indwelling catheter. • Cephalic vein : Located in the lateral aspect of the antecubital area, it is the second- choice vein for venipuncture in the H- Remove the protective cap from the lancet 6. Cutaneous oximetry … Blood sampling is one of the most common diagnostic methods for the treatment and assessment of pediatric diseases and conditions (Plebani, 2006).In addition, children may find blood sampling to be the most anxiety-causing procedure experienced during their hospital stay (Hands et al., 2010).The success of blood sampling strongly depends on the technical, psychological, … Finger Puncture is generally performed in children or adults. Capillary blood collection involves puncturing the dermis layer of the skin to access the capillary beds that run through the subcutaneous layer of the skin. It is usually performed on an infant’s/newborn’s feet or on the fingertips of an adult. • Do not puncture fingers on side affected by mastectomy. Standard enzyme laboratory method. Time between sampling capillary and arterial blood. To use one of the other areas, an order should be obtained. Step 3: Verify diet restrictions and latex sensitivity. They are the connection between Serum specimens Procedure for Selecting the Puncture Site and Collecting Capillary Specimens from Adults, Infants, and Children. b) a light blue top tube is needed. The specimen is then collected with a pipette, placed on a glass slide or a piece of filter paper, or is absorbed by the tip of a microsampling device. Tests are performed rapidly and easily by using a reagent strip (e.g. In a finger-prick, the depth should not go beyond 2.4 mm, so a 2.2 mm lancet is the longest length typically used. 2. A swollen or previously punctured site is unacceptable because the increase tissue fluid may contaminate the blood samples. The HbA1c filter paper system enables capillary blood sampling at home, eliminates the need of vein puncture in children and adults, and provides the diabetologist with an HbA1c value when the patient visits the clinic without a need for a previsit phlebotomy. Alternative Names. Capillaries are tiny blood vessels near the surface of the skin. The detailed answer, of course, is not so simple. 1. for patients in whom venous access is difficult, 2. when small quantities of blood are sufficient for testing. Lumbar puncture must only be performed once a thorough neurologic examination is done. Blood gases are measured from an arterial blood sample to evaluate the respiratory adequacy and oxygen status of the critically ill patient. MA role in phlebotomy. Capillary sampling from a finger, heel or (rarely) an ear lobe may be performed on patients of any age, for specific tests that require small quantities of blood. Acquiring a good quality capillary blood sample is essential to ensuring results are precise and accurate when conducting point of care tests. CSF testing is performed to evaluate the level or concentration of different substances and cells in CSF in order to diagnose conditions affecting the brain and spinal cord (central nervous system). Order of Draw for a Capillary Puncture: Proper collection of tubes when. Time between sampling capillary and arterial blood. Due to the fact that anemia is one of the world’s most common blood disorders, affecting around 25% of the global population, hemoglobin testing is among the most frequently performed procedures that make use of capillary blood samples collected at the point of care. The source of the blood effects the results. rashes. Capillary blood gas sampling is recommended for adult patients only in situations when arterial blood puncture cannot be performed (patients with severe burns, tendencies to thrombosis, obese and geriatric patients). Phosphorus. Adam Jones 07/28/2019 Phlebotomy Lecture 10 Chapter 10: Capillary Puncture Equipment and Procedures Objectives Define the key terms and abbreviations listed at the beginning of this chapter. There is the risk that the person collecting the capillary sample starts to milk the finger by squeezing, scooping, scraping and trying to cross out the blood of the finger. A laboratory report form should state that a specimen has been collected by capillary puncture: Because results can vary by specimen source: Blood collected by puncturing the skin is called capillary blood because: It is from the dermal capillary bed: This test is typically performed on capillary blood: Newborns: PKU - Phenylketonuria The removal of blood is called phlebotomy. When run alone, HbA1c tests require very low blood volumes (1-5ul)3 that are typically achieved with thin lancets at shallow puncture depth (i.e., 30G x 1.5mm or 28G x 1.8mm). small amounts of blood are acceptable for testing. 2. unless testing for BGL. who is severely burned. Between these test which one is collected first in a capillary puncture? Objectives. Adults/Children - Finger The puncture is usually made on the palmar surface of the third or fourth finger of either hand. 2. 3. Capillary specimens are collected in microtainers with colored caps that are used to In the medical office, medical assistants perform venipunctures and skin punctures. This increases arterial blood flow to the site up to sevenfold reducing the difference between the arterial and venous gas pressures. The most likely pediatric indication for CSF analysis is for diagnosis of meningitis. Blood obtained via skin puncture is a mixture of undetermined proportions of blood from arterioles, venules, capillaries, plus interstitial and intracellular fluids. 1.85 to 2.25mm is recommended for adults, depending on the thickness of the skin. Capillary lactate method. 3. Step 4: Sanitize hands and put on gloves. 2. Fingers of infants younger than 1 year old may not contain enough tissue to prevent contact with the bone. It enjoys several advantages over venous blood sampling : it is less invasive, it requires smaller amounts of blood volume and it can be performed … Capillary Puncture Steps Step 1: Review and check accession test request. It is usually performed as soon as possible after the baby’s birth. 4. 1. for patients in whom venous access is difficult, 2. when small quantities of blood are sufficient for testing. • Several unsuccessful venipunctures have been performed and the requested test can be collected by capillary puncture. Don gloves 5. Locate the acceptable sites for puncture and collection of capillary blood on a finger and infant heel. A capillary sample is a blood sample collected by pricking the skin. Punctures 2.0 mm deep or less will provide adequate blood flow without risking bone injury. For an adult, use a 20-gauge, 2.5-inch needle for a femoral sample and a 22 gauge, 1.25 inch needle for a radial artery puncture. before the puncture is made. Anything deeper in the allowable depth will present the risk of nerve/bone damage. Capillary puncture is typically performed on adults when : No accessible veins can be located, patients have thrombic tendencies, and veins are saved for chemotherapy. Wipe away the first drop of blood during capillary puncture to 1 INTRODUCTION. The skin should be warm, pink, and free from bruises, scars, or. The task of collecting blood samples from patients for diagnostic testing is know as phlebotomy. Ear lobe - The ear lobe has been used for capillary blood sampling, but is no longer recommended. Heels are preferred for capillary puncture in infants less than 1 year of age. The heels are used for capillary punctures of infants. Capillary puncture is typically performed on adults when: a. Small amounts of blood can be obtained from the cephalic veins (on the medial aspect of the front legs) or tarsal veins (on the dorsal aspect of the rear feet). Between these test which one is collected first in a capillary puncture? Small Samples - Collection Of Capillary (Fingertip) Samples From Adults. 16 Cap the needle using the provided safety device. Capillary blood sampling has several advantages over drawing blood from a vein: It is easy to obtain (it can be difficult to obtain blood from the veins, especially in infants). 3. In Children and Adults, finger puncture is done to collect the blood sample whereas, in Infants, Heel puncture is done to obtain the specimen. Step 2: Approach, identify, and prepare patient. HLab1-11. The flashcards below were created by user CTEPBA on FreezingBlue Flashcards . The correct depth in adults should not go beyond 2.4mm, 2.2mm is the longest length typically used. front 2. Finger - Usually the third or fourth finger is preferred in adults and children. Objectives. What is the correct depth of Capillary puncture in adults? You are not likely to be using arterial blood but you will be comparing capillary blood ( finger stick sample) to venous blood that is usually … Cleanse site with alcohol prep pad – allow to air dry. Complete blood count (CBC) Hemoglobin & hematocrit (H&H) Electrolytes. Dispose of the needle in the sharps container. • The recommended site is the palmar surface of the distal phalanx (end seg ment of the finger) of the middle or ring finger of the non-dominant hand. It is the least invasive and safest blood collecting technique and can be performed by all healthcare personnel after minimal training [9]. after the puncture is performed : Milking the puncture site to obtain the blood drop . b. front 1. A tourniquet (large rubber strap) may be secured above the vein. Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The common sites for capillary puncture are the :- Finger tip – the inner aspect of palmer 5. • Cephalic vein : Located in the lateral aspect of the antecubital area, it is the second- choice vein for venipuncture in the H-

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