Caplliary Blood Sampling

bauervapors

20 Sept 201207:00

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

00:00

🩸 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.

05:02

🛠 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

Capillary blood sampling is a minimally invasive procedure to collect blood from the capillaries, typically performed on the heel of a newborn. It is the most common and preferred method during the newborn period due to its ease of mastery and similarity in laboratory data to venous and arterial samples. In the video, this technique is highlighted for its ability to preserve veins and arteries for future use, such as in cases where intravenous or intra-arterial access is needed.

💡Heel Warmer

A heel warmer is a device used to promote vasodilation and increase blood supply to the heel area, facilitating the capillary blood sampling process. In the script, it is mentioned as an essential piece of equipment, applied for five minutes prior to sampling to ensure adequate blood flow to the puncture site.

💡Chlorhexidine (Chloroprep)

Chlorhexidine, often referred to by its brand name Chloroprep, is an antiseptic agent used for cleansing the area prior to lancing the heel. It is part of the standard procedure to prevent infection during capillary blood sampling, as indicated in the script where it is listed among the items used to prepare the puncture site.

💡Blood Collection Microtainers

Blood collection microtainers are small, sterile containers designed to collect and store small volumes of blood. They are used in the video for capillary blood sampling to collect the blood after the initial drop has been wiped away with a gauze.

💡Gauze

Gauze is a type of absorbent material used in medical settings to wipe away blood or other fluids. In the context of the video, a piece of gauze is used to remove the first drop of blood and to tampenade the hemorrhage once the sampling is complete.

💡Pacifier and Sucrose Solution

A pacifier and sucrose solution are used as pain control measures during the blood sampling process. The script mentions administering oral sucrose for two minutes prior to the procedure and intermittently during the sampling for continuous pain control.

💡Automated Heel Lancet

An automated heel lancet is a device used to puncture the heel for blood sampling. The type of lancet selected depends on the size of the infant and the amount of subcutaneous tissue to be penetrated, as described in the script for different types of infants.

💡Tenderfoot Lancet

The Tenderfoot lancet is a specific type of lancet designed for use on newborns, with variations such as the micro preemie, preemie, and newborn Tenderfoot lancet sets. The script specifies the use of these lancets based on the weight of the infant, ensuring minimal discomfort and appropriate incision depth.

💡Hemolysis

Hemolysis refers to the breakdown of red blood cells, which can affect the validity of laboratory values. The script warns against certain practices, such as squeezing the heel or scraping the microtainer on the heel, as they can cause hemolysis and lead to inaccurate lab results.

💡Calf Pressure

Calf pressure is a technique used during capillary blood sampling to facilitate blood flow. The script describes applying pressure to the calf in a direction towards the heel to promote free-flowing blood and releasing the pressure to allow the capillaries to refill when the blood flow ceases.

💡Tamponade

Tamponade refers to the process of stopping bleeding by applying pressure or a dressing. In the video script, it is mentioned as the final step after capillary sampling to manage the puncture site, ensuring proper healing and preventing further bleeding.

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.