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Capillary Blood Collection

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capillary blood collection is indicated

in adult patients in cases of severe

burns extreme obesity hyper coagulated

of fragile veins needs to preserve veins

for therapy home testing apprehensive

patients and point of care testing tests

commonly performed on capillary blood

our blood smear for microscopic

assessment of cell morphology

preparation for malarial parasites

estimation of platelet number white

blood cell morphology rapid tests dried

blood spot for early infant diagnosis

blood glucose monitoring pre blood

donation biochemistry tests available in

the capillary mode analyzers

for example bilirubin and thyroid

function tests hematology tests

available in the capillary mode

analyzers bleeding time by IVs method

blood culture should not be performed on

capillary blood equipment and supplies

lancets specimen collection equipment

filter paper for dry blood spot or DBS

capillary tube test specific equipment

blood smear slides rapid test devices

micro collection tubes lancets manual

lancets single-use lancets are available

but the depth of penetration cannot be

controlled safety lancets single-use

lancers for different depths are

available which activate only when it is

positioned and pressed against the skin

the depth will never exceed two point

four millimeters facilitating a

consistent punch a depth for easier

sampling puncture depths

less than two millimeters for all heel

punctures less than 1.5 millimeters for

finger punchers on children over 12

months less than two millimeters for

finger punchers on children over eight

years less than two point four

millimeters for finger punctures on

adults verify information on requisition

form and select micro collection devices

assemble the supplies and choose the

appropriate buncha site site selection

for capillary collection conditions

influencing the choice of heel or finger

prick heel prick is recommended in units

from birth to about six months with a

weight of approximately 3 to 10 kgs

finger pricks are recommended in infants

over six months weighing more than 10

kgs the recommended fingers are the

middle and the ring finger a wide the

thumb and index finger because of

calluses and avoid the little finger

because the tissue is thin for heel

buncher use plant a surface of the heel

medial to a line drawn posteriorly from

the large toe to the heel or lateral to

a line drawn posteriorly from between

the fourth and fifth toes to the heel

the placement of Lancet should be on the

side of the ball of the finger

perpendicular to the lines of the

fingerprint procedure worming if

possible gently warm the puncture site

as warming can increase blood flow by

seven fold a warm moist arbol of warming

device may be used for this which should

be heated higher than 42 degree

centigrade and a contact time of three

to five minutes is to be given site

cleansing all precautions as mentioned

in the Venus collection are to be

followed do not use betadine or

povidone-iodine

skin puncher forefinger inform groan a

patient about imminent pain hold the

finger and firmly place a new sterile

Lancet and the selected site on the

finger if using self-retracting safety

Lance's

activate the Lancet if using manual

Lancet perform single puncture with one

smooth motion skin puncher for heel hold

the foot with a form grip grasp the heel

and place the index finger over the arch

hold intended puncture site firmly and

completely depress the trigger of The

Lancet if using a safety Lancet or

perform single puncture with sport

motion if using a manual Lancet puncture

the site at a 90 degrees angle to the

length of the foot discard the first

drop of blood to avoid specimen dilution

by tissue fluid the excess of tissue

fluid would dilute the sample and reduce

the concentration of all the analytes

thus affecting the results never milk or

scrape the puncture site collect the

sample beginning with the second drop

using any of the collection devices

blood flow is enhanced by holding the

puncture side downward and gently

applying intermittent pressure to the

surrounding tissue

continue until desired volume has been

collected follow recommended order of

draw for micro collection tubes while

collecting blood in micro collection

tubes collect EDTA tube before serum

tube mixed anticoagulant containing

micro collection tubes continuously

during collection when blood collection

is complete apply pressure with a clean

dry gauze pad until bleeding stops label

specimens immediately after the draw

do not use adhesive bandages on children

less than two years old as it may

irritate the infant's skin ensure proper

disposal of the lancets and other

consumables as per guidelines heel

puncher precautions do not puncture deep

do not puncture through previous

punctures do not puncture outside the

medial and lateral aspects of the heel

as previously described do not puncture

the posterior curvature of the heel do

not puncture in the

do not puncture areas of the foot

other than the heel complications of

capillary blood collection collapse of

veins can occur if the tibial artery is

lacerated from puncturing the medial

aspect of the heel

osteomyelitis of the heel bone contact

with the heel bone may cause

osteomyelitis

osteomyelitis could go undetected for

long periods and could result in serious

complications for young children nerve

damage if the fingers of neonates are

punctured hematoma scarring localized or

generalized necrosis skin breakdown from

repeated use of adhesive strips

particularly in very young or very

elderly patients this can be avoided if

sufficient pressure is applied and the

puncture site is observed after the

procedure

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