Caplliary Blood Sampling
Summary
TLDRThis video script outlines the process of capillary blood sampling in newborns, highlighting its preference due to minimal invasion and similarity to venous/arterial samples. It details the equipment used, including a heel warmer for vasodilation, cleansing agents, and various lancets sized to infant weight. The script emphasizes proper technique to avoid complications like hemolysis, and the importance of pain control with sucrose. It concludes with instructions for post-sampling care, ensuring accurate and safe blood collection.
Takeaways
- 🩸 Capillary blood sampling is the most common and preferred method for obtaining blood in newborns.
- 👣 Capillary heel sampling is a minimally invasive technique that provides data similar to venous and arterial samples.
- 🏥 It preserves veins and arteries for future medical needs like intravenous or intra-arterial access.
- 🚫 Limitations include unsuitable use for blood cultures, coagulation studies, large volume requirements, or when hemolysis affects lab values.
- 🛠️ Equipment includes a heel warmer, chloroprep or alcohol swabs, blood collection microtainers, gauze, a pacifier, and a sucrose solution.
- 👶 The type of lancet used depends on the infant's size and subcutaneous tissue, with specific sets for different weight categories.
- 📋 Proper patient identification and medical necessity are confirmed before sampling.
- 🔍 A heel warmer is used for 5 minutes and oral sucrose for pain control prior to sampling.
- 📍 The preferred sampling site is the outer aspect of the heel to avoid complications like osteomyelitis.
- 💉 The first drop of blood is wiped away, and subsequent blood is collected for analysis.
- 🤲 Hand positioning is crucial, with fingers along the calf and thumb stabilizing the foot for effective blood flow.
- 🚫 Avoid squeezing the heel to prevent pain, lower blood yield, and cell lysis.
- 🩹 After sampling, the puncture site is tamponaded and covered with gauze or an adhesive bandage.
Q & A
What is the most common and preferred method for obtaining blood in the newborn period?
-Capillary blood sampling is the most common and preferred method for obtaining blood in the newborn period.
Why is capillary heel sampling considered a minimally invasive technique?
-Capillary heel sampling is considered minimally invasive because it is easily mastered and provides laboratory data similar to venous and arterial samples without the need for more invasive procedures.
What are the limitations of capillary blood sampling?
-Limitations of capillary blood sampling include situations where blood cultures or coagulation studies are required, the volume of blood exceeds 1.5 mL, or when minimal hemolysis can alter the validity of the laboratory value being assessed.
What equipment is required for capillary blood sampling in newborns?
-The equipment required includes a heel warmer, chloroprep or alcohol swabs for cleansing, appropriate blood collection microtainers or capillary blood tubing, gauze, a pacifier and sucrose solution for pain control, and an automated heel lancet.
What is the purpose of using a heel warmer during capillary blood sampling?
-A heel warmer is used to promote vasodilation and increase the blood supply to the heel region, making it easier to collect a blood sample.
What is the significance of using the correct size of lancet based on the infant's size and subcutaneous tissue?
-Using the correct size of lancet ensures that the incision created is appropriate for the infant's size and tissue depth, minimizing pain and injury while ensuring adequate blood flow for sampling.
Why should the end of the heel, or the calcaneum, be avoided during capillary sampling?
-The end of the heel should be avoided because the calcaneum is superficial at this site, and there is an increased risk for the development of osteomyelitis.
How is pain managed during capillary heel sampling in newborns?
-Pain is managed through the use of a pacifier and sucrose solution, as well as swaddling and intermittent administration of additional sucrose for continuous pain control.
What is the proper technique for applying pressure to the calf during blood collection?
-The fingers should be along the calf, and the thumb should stabilize the ball of the foot. Pressure is applied to the calf in a direction towards the heel to encourage blood flow without squeezing the heel, which can cause pain, lower blood yield, and increased cell lysis.
Why should the site be wiped with gauze if blood flow ceases during sampling?
-Wiping the site with gauze helps to disrupt clot formation if the blood flow ceases, allowing the capillaries to refill and the process to be repeated without causing additional discomfort or injury.
How should the puncture site be managed after capillary sampling is complete?
-After capillary sampling, the puncture site should be tamponaded and wrapped with gauze or an adhesive bandage to prevent bleeding and infection.
Outlines
🩸 Capillary Blood Sampling in Newborns
This paragraph discusses capillary blood sampling as the preferred method for obtaining blood in newborns, with a focus on capillary heel sampling. It is a minimally invasive technique that yields laboratory data comparable to venous and arterial samples while preserving veins and arteries for future needs. The limitations include situations where blood cultures or coagulation studies are necessary, or when the blood volume exceeds 1.5 mL or hemolysis could affect results. The required equipment includes a heel warmer for vasodilation, cleansing agents, blood collection microtainers, gauze, a pacifier with sucrose for pain control, and an automated heel lancet selected based on the infant's size. The process involves warming the heel, administering oral sucrose, cleansing the area, lancing, and collecting blood without squeezing the heel to avoid pain and cell lysis. Proper infant identification and medical confirmation are emphasized.
🛠 Post-Sampling Procedures and Considerations
The second paragraph outlines the steps to follow after capillary blood sampling from a newborn's heel. If blood flow is disrupted, the site should be wiped with gauze to prevent clot formation. If blood still doesn't flow freely, another site should be chosen. It's important not to scrape the heel with the microtainer to avoid hemolysis, which can lead to inaccurate lab results. The process of applying pressure to the calf, collecting blood, and allowing capillaries to refill is repeated until sufficient blood is collected. After sampling, the puncture site should be tamponaded and covered with gauze or an adhesive bandage to prevent infection and promote healing.
Mindmap
Keywords
💡Capillary Blood Sampling
💡Heel Warmer
💡Chlorhexidine (Chloroprep)
💡Blood Collection Microtainers
💡Gauze
💡Pacifier and Sucrose Solution
💡Automated Heel Lancet
💡Tenderfoot Lancet
💡Hemolysis
💡Calf Pressure
💡Tamponade
Highlights
Capillary blood sampling is the most common and preferred method for obtaining blood in newborns.
Capillary heel sampling is minimally invasive and provides laboratory data similar to venous and arterial samples.
Heel sampling preserves veins and arteries for future intravenous or intra-arterial access if required.
Limitations of capillary blood sampling include its unsuitability for blood cultures, coagulation studies, or when the blood volume exceeds 1.5 mL.
Hemolysis during capillary sampling can alter the validity of laboratory values.
A heel warmer is used to promote vasodilation and increase blood supply to the sampling area.
Chloroprep, Betadine, or alcohol swabs are used to cleanse the area before lancing, depending on institutional guidelines.
Different sizes of Tenderfoot Lancets are used based on the infant's size and the depth required.
The preferred site for sampling is the outer aspect of the heel to avoid damaging the calcaneum and risking osteomyelitis.
The first drop of blood is wiped away to ensure a clean sample, and subsequent blood is collected in a microtainer.
The infant is swaddled, and sucrose is administered for continuous pain control during the procedure.
Pressure is applied to the calf towards the heel to promote free-flowing blood, without squeezing the heel to avoid pain and cell lysis.
If blood flow stops, gauze is used to disrupt clot formation, and the process is repeated if necessary.
Scraping the heel with the microtainer should be avoided to prevent hemolysis and ensure accurate lab results.
After sampling, the puncture site is tampenaded and wrapped with gauze or an adhesive bandage.
Transcripts
this video is about capillary blood
sampling in the newborn
capillary blood sampling is the most
common and preferred route to obtain
blood in the newborn period
capillary heel sampling more
specifically is an easily mastered
minimally invasive technique that
provides laboratory data similar to
venous and arterial samples
capillary heel sampling preserves those
precious veins and arteries for future
reference if intravenous or intra
arterial access is required
limitations of capillary blood sampling
are encountered when blood cultures are
required coagulation studies are
required the volume of blood exceeds 1.5
MLS or when minimal amounts of hemolysis
will alter the validity of the
laboratory value being assessed
the equipment required for capillary
blood sampling is as follows
a heel warmer is utilized to promote
vasodilatation
and increase the blood supply to the
region
chloroprep Betadine or alcohol swabs are
typically used to cleanse the area prior
to Lancing the heel
the agent utilized will depend upon the
institutional guidelines
appropriate blood collection
microtainers or capillary blood tubing
a piece of gauze is used to wipe away
the initial drop of blood and to
tampenade the Hemorrhage when the
sampling is complete
a pacifier and sucrose solution for pain
control measures
an automated heel Lancet
the type of landsat is selected based
upon the size of the infant and the
subcutaneous tissue that must be
penetrated
the micro preemie Tenderfoot Lance set
is used for those infants less than 1000
grams
the preemie tender foot Lancet is used
for those infants greater than 1000
grams
the newborn Tenderfoot landsat is
typically used for those infants that
are termed through the first six months
of life
each Lancet varies in the length and
depth of the incision created
the infant's identity was assessed by
utilizing two of the approved Jayco
identifiers
and the blood sampling necessity was
confirmed with the medical provider
a heel warmer was in position for five
minutes and oral sucrose was
administered for two minutes prior to
initiating this video recording
a heel warmer is being utilized for a
visual confirmation of the appropriate
application
the preferred area for capillary
sampling is the outer aspect of the heel
do not use the end of the heel
the calcaneum is superficial at this
site and there is an increased risk for
the development of osteomyelitis
an alcohol swab is being utilized to
cleanse the future puncture site and the
surrounding tissue
the appropriately sized Tenderfoot
Lancet is being used to puncture the
heel
the first drop of blood is wiped away
with a piece of gauze
subsequent blood will be collected for
sampling
please note that the infant is swaddled
and additional sucrose is administered
intermittently for continuous pain
control
notice the hand positioning
the fingers are along the calf and the
thumb stabilizes the ball of the foot
pressure is applied to the calf in a
direction towards the heel
free-flowing blood is collected in a
microtainer
when the blood flow ceases calf pressure
is released the capillaries are allowed
to refill
and the process is repeated
do not squeeze the heel
squeezing the heel results in Greater
pain lower blood yield
and increased cell lysis
if the bleeding stops
wipe the site with gauze to disrupt the
cloud formation
if the blood still does not flow freely
choose another site and repeat the
procedure
be certain not to scrape the heel with
the microtainer
this will cause hemolysis and lead to
inaccurate lab results
once again pressure is applied to the
calf in a direction towards the heel
free-flowing blood is collected in the
microtainer
when that blood flow ceases calf
pressure is released
the capillaries are allowed to refill
and the process is repeated
people
when the capillary sampling is complete
tamponade the puncture site
and wrap with gauze or an adhesive
bandage
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