Caplliary Blood Sampling

Summary

This 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.