Newborn Screening Blood Specimen Collection

Summary

The Texas Department of State Health's Newborn Screening Team has created a tutorial video to guide healthcare professionals through the proper procedure for collecting newborn blood specimens. The video emphasizes the importance of accurate demographic information, correct positioning of the infant, and the use of specific equipment to ensure a successful collection. It provides detailed steps, including warming the heel, cleaning the puncture site, and properly applying blood drops onto the filter paper. The video also highlights the necessity of filling all five circles on the specimen card for comprehensive testing and proper aftercare. It concludes with instructions for drying and shipping the specimen to the state lab, ensuring the process is thorough and reliable.

Takeaways

• 📋 Complete all demographic information on the collection kit for accurate identification.
• 👶 Position the infant's feet below the heart to increase blood flow for easier blood collection.
• 🔍 Double-check the newborn's identity before starting the blood collection process.
• 🌡 Warm the heel to enhance blood supply using a moist cloth at a temperature not exceeding 41 degrees Celsius.
• 🧤 Clean hands and wear gloves before performing the heel puncture to maintain hygiene.
• 🦶 The heel puncture should be made on the sole of the foot, avoiding previous puncture sites to prevent damage to bones, nerves, or tendons.
• 🍷 Clean the heel with an alcohol pad and let it air dry to avoid diluting the blood specimen.
• 💉 Use a heel lancet with a specific depth and length for the heel stick to collect the blood specimen.
• 🩸 Discard the first blood drop and collect the second for the specimen to ensure accuracy of the test.
• 📝 Apply blood drops to only one side of the filter paper and fill each circle completely for sufficient testing material.
• ⏳ Allow the blood spots to dry for a minimum of three hours before sending the kit to the lab for analysis.

Q & A

What is the purpose of the video presented by the Texas Department of State Health Services Newborn Screening Team?

The purpose of the video is to demonstrate the proper procedure for collecting a newborn blood specimen and to provide tips and things to avoid during the process.

What is the significance of ensuring that every baby in Texas receives the best medical services possible?

Ensuring the best medical services for every baby in Texas is crucial for early detection and treatment of genetic disorders, which can lead to a healthier life and potentially save lives.

What are the necessary supplies mentioned in the script for collecting a newborn screening specimen?

The necessary supplies include a newborn screening specimen collection kit, a warm moist soft cloth or heel warmer, alcohol-wetted pads or cotton balls, gloves, a heel lancet with a specific tip depth, sterile gauze pads, and aftercare supplies like Band-Aids or gauze.

Why is it important to complete all the information on the demographic portion of the collection kit?

Completing all the information correctly and legibly is important for accurate identification of the specimen and ensures that the results can be properly associated with the correct infant.

What is the reason for positioning the infant's feet below their heart during the collection process?

Positioning the infant's feet below their heart increases blood flow to the area, facilitating the collection of the blood specimen.

Why is it necessary to warm the heel before collecting the blood specimen?

Warming the heel increases the blood supply to the area, making it easier to collect the blood and reducing the discomfort for the infant.

What is the recommended method for cleaning the heel before performing the heel stick?

The heel should be cleaned with an alcohol pad or alcohol-wetted cotton ball and allowed to air dry to avoid diluting the blood specimen with residual alcohol.

Why should the first blood drop be wiped away and not used for the specimen?

The first blood drop may contain tissue fluids that can dilute the specimen, potentially leading to inaccurate test results.

What is the correct procedure for applying blood drops to the filter paper in the collection kit?

The blood drops should be lightly touched to one side of the filter paper, allowing the blood to soak through. If the first drop doesn't fill the circle, another drop should be expressed and added to the same circle until it is completely filled.

Why is it important not to go back to partially filled circles and add more drops of blood?

Adding more drops to partially filled circles can lead to oversaturation, layering, or clotting of the blood, which makes the specimen unacceptable for testing.

What should be done after collecting the blood drops and before sending the kit to the state lab?

After collecting the blood drops, the collection kit should be placed on a dry, clean, flat, non-absorbent surface and allowed to dry for a minimum of three hours before being sent to the state lab.

Outlines

00:00

🩺 Newborn Blood Specimen Collection Procedure

This paragraph outlines the procedure for collecting a newborn's blood specimen as part of the Texas Department of State Health Services' newborn screening program. It emphasizes the importance of proper collection to ensure accurate testing for genetic disorders. Key steps include preparing the necessary supplies, completing demographic information, positioning the infant, warming the heel, cleaning the puncture site with alcohol, and performing the heel stick using a 1mm lancet. The first blood drop is discarded to avoid dilution, and subsequent drops are applied to filter paper until all five circles are filled. The video also advises against certain practices, such as using a previous puncture site or adding more blood to partially filled circles, to maintain specimen integrity.

05:02

📝 Post-Collection and Submission Instructions

The second paragraph provides instructions for after the blood specimen has been collected. It details the steps to ensure the blood spots dry for at least three hours on a non-absorbent surface before the kit is sent to the state lab. The paragraph also mentions the importance of handling the collection kit properly and reaching out to the DSHS Newborn Screening Lab for assistance in special situations or for any questions. The music playing at the beginning and end of the paragraph serves as a backdrop to the information being conveyed.

Keywords

💡Newborn Screening

Newborn screening is a public health program that tests newborn babies for certain genetic, metabolic, or functional disorders. The purpose of this process is to identify these conditions early so that treatment can be started as soon as possible. In the video, newborn screening is the main theme, as it discusses the procedure for collecting blood specimens from newborns to test for various disorders.

💡Blood Specimen Collection

Blood specimen collection refers to the process of obtaining a sample of blood for testing or analysis. In the context of the video, it is the method used to collect blood from a newborn's heel to screen for genetic disorders. The script outlines the proper procedure for this collection, emphasizing the importance of correct technique for accurate test results.

💡Heel Lancet

A heel lancet is a medical device used to puncture the skin, typically the heel, to draw a small amount of blood. The video script specifies the use of a heel lancet with a tip depth of 1 millimeter and a length no more than 2.5 millimeters for newborn blood specimen collection, highlighting the need for precision to minimize discomfort and potential injury.

💡Sterile Gauze

Sterile gauze is a type of medical gauze that has been sterilized to ensure it is free from bacteria or other contaminants. In the video, sterile gauze is used to wipe away the first blood drop during the heel puncture process, ensuring the blood specimen is not contaminated and maintaining the integrity of the test.

💡Filter Paper

Filter paper is a type of paper with a high absorbency and a fine texture, often used in laboratories for absorbing and spreading liquids. The script mentions using filter paper to collect blood drops from the newborn's heel, where the blood soaks through and is used for testing genetic disorders.

💡Heel Warmer

A heel warmer is a device or method used to warm the heel of a newborn, increasing blood flow to the area. The video script describes using a warm, moist soft cloth or a heel warmer to prepare the area for blood collection, which helps in obtaining a sufficient blood sample.

💡Alcohol-Wetted Pads

Alcohol-wetted pads are pads saturated with alcohol, used for disinfecting the skin before certain medical procedures. In the script, these pads are used to clean the newborn's heel before the heel stick, ensuring the area is free from germs that could cause infection.

💡Demographic Information

Demographic information refers to personal data about an individual, such as name, age, and other identifying details. The video script emphasizes the importance of accurately completing demographic information on the collection kit to ensure proper identification and tracking of the newborn's blood sample.

💡Aftercare Supplies

Aftercare supplies are items used to care for a wound or puncture site after a medical procedure. The script mentions Band-Aids or gauze as examples of aftercare supplies needed for the heel puncture site, illustrating the importance of post-procedure care to prevent infection and promote healing.

💡Genetic Disorders

Genetic disorders are diseases caused by abnormalities in an individual's DNA. The video script discusses the purpose of newborn screening, which is to test for genetic disorders so that affected babies can receive early intervention and treatment.

💡Drying Rack

A drying rack is a device used to hold items in an elevated position to allow them to dry. The script mentions using a drying rack for several blood collection kits, emphasizing the need to let the blood spots on the filter paper dry for a minimum of three hours before sending them to the lab for testing.

Highlights

Introduction of the Texas Department of State Health Services Newborn Screening Team and their mission to ensure every baby in Texas receives the best medical services for a healthy life.

Demonstration of the proper procedure for collecting a newborn screening blood specimen.

Importance of taking time to watch the video for support of babies and families affected by disorders identified through newborn screening.

Necessity of a newborn screening specimen collection kit, warm moist soft cloth, alcohol-wetted pads, gloves, heel lancet, sterile gauze pads, and aftercare supplies.

Emphasis on completing all demographic information correctly and legibly on the collection kit.

Positioning the infant's feet below the heart to increase blood flow for specimen collection.

Verification of the newborn's identity before starting the blood collection process.

Use of a heel warmer or warm wet cloth to increase blood supply to the heel for easier puncture.

Hand hygiene and glove use before starting the blood collection.

Identifying safe areas on the sole of the foot for heel puncture to avoid damage to bone, nerves, or tendons.

Cleaning the heel with an alcohol pad and allowing it to air dry to prevent dilution of the blood specimen.

Performing the heel puncture at a slight angle and wiping away the first blood drop to avoid dilution by tissue fluids.

Applying blood drops to only one side of the filter paper and filling each circle one at a time.

Expressing a second large blood drop to fill the circle if the first drop doesn't completely fill it.

Using gentle, intermittent pressure to help blood flow without milking the heel or puncture site.

Avoiding oversaturation, layering, or clotting of the blood specimen for accurate testing.

Filling all five circles completely to provide enough blood for testing all genetic disorders and potential retesting if needed.

Proper aftercare of the heel stick site and allowing the blood spots to dry for a minimum of three hours before sending to the lab.

Contacting the DSHS Newborn Screening Lab for assistance in special situations or questions.

Transcripts

[MUSIC PLAYING]

On behalf of the Texas Department of State Health

Services Newborn Screening Team, thank you for the work

that you do to ensure that every baby in Texas

receives the best medical services

possible for a healthy life.

This short video demonstrates the proper procedure

for collecting a newborn screen blood specimen.

We will also give you a few collection tips

and show you some things to avoid.

Thank you for taking the time to watch

and for your support of the babies and families affected

by disorders identified through newborn screening.

Your actions can save the lives of Texas babies.

Let's get started.

A successful blood specimen collection

begins with these necessary supplies--

a newborn screening specimen collection kit;

a warm, moist soft cloth or a heel warmer;

alcohol-wetted pads or cotton balls;

gloves; a heel lancet with a tip depth of 1 millimeter

and a length of no more than 2.5 millimeters; sterile gauze

pads; and aftercare supplies, such as Band-Aids or gauze.

To get started, make sure you complete all the information

on the demographic portion of the collection kit.

It's very important that all the information is correct

and it can be easily read.

Next, position the infant's feet below his or her heart

to increase blood flow.

Make sure you check the identity of the newborn

before you start the collection.

Then warm the heel with the heel warmer.

Or you may use a wet cloth that has been soaked in warm water

no higher than 41 degrees Celsius for 3 to 5 minutes.

We warm the heel because it increases the blood supply

to the area.

Once you've cleaned your hands and put on gloves,

you're ready to start the collection.

The heel puncture, also called a heel stick,

should be made on the sole of the foot.

These are the safe areas for getting the blood specimens.

Do not use a previous puncture site.

We use the safe areas to reduce the possibility

of causing damage to the bone, nerves, or tendons.

Before you do a heel stick, clean the heel

with an alcohol pad or alcohol-wetted cotton ball,

and let the skin air dry.

We do this because any alcohol left on the skin

may dilute the blood specimen.

This can cause test results that are not normal.

With the heel lancet, stick the heel at a slight angle.

Wipe away the first blood drop with a sterile gauze pad.

Allow a second large blood drop to form.

We do this because the first blood drop

is likely to contain tissue fluids that

will dilute the specimen.

You can use either side of the filter paper

for this procedure, but apply the blood drops

to only one side of the paper.

Lightly touch a large blood drop to the filter paper.

Let the blood soak through the paper.

If the first drop of blood doesn't completely

fill the circle, quickly express another blood drop

and continue to fill the same circle.

To help the blood flow, you may apply a very gentle

intermittent pressure to the area surrounding

the puncture site.

However, do not milk the heel or the puncture site.

It's important to follow these procedures.

Please do not go back to circles partially filled

and add more drops of blood.

The specimen is not acceptable for testing

if it is oversaturated, layered, or clotted.

Fill each circle one at a time until all five circles

are completely filled.

We do this because five completely filled blood spots

gives the state lab enough blood to test for all

of the genetic disorders.

And if a result comes back abnormal,

there will be enough to complete the testing before the result

is finalized and reported.

When you have finished collecting the blood drops,

follow your normal procedures for care of the heel stick

site.

After taking care of the infant, put the collection kit

on a dry, clean, flat, non-absorbent surface.

You can use a drying rack for several kits.

Let the blood spots dry for a minimum of three hours.

You are now ready to send the kit to the state lab.

When special situations arise or if you have questions,

contact the DSHS Newborn Screening Lab for assistance

whenever needed.

[MUSIC PLAYING]