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Infant Blood Collection

Collecting Blood on Newborns
 
Here's a quick refresher on collecting blood on babies. The recommended location for blood collection on a newborn is the bottom of the heel - it has the best capillary bed.
 
After positively identifying the patient, pre-warm the infant's heel (no hotter than 42 degrees Celsius for 3 to 5 minutes) to increase the flow of blood. The blood specimen must be collected immediately after the warming, to avoid rapid skin cooling.
 
Clean the site to be punctured with an alcohol sponge. The antiseptic should remain on the skin for at least one minute and should be rubbed off with a dry, sterile swab.  If the site is not dried well, the antiseptic can mix with the specimen and the blood will not bead up at the puncture site.
 
Place the infant on his or her stomach. With scrubbed hands and arms, and then gloves on, puncture the bottom heel with a sterile blood lancet at a 45 degree angle.  Do not use the central portion of the heel because you might injure the underlying bone, and do not use a previous puncture site.  Make the cut across the heelprint lines so that a drop of blood can well up and not run down along the lines. The National Committee for Clinical Laboratory Standards states that the depth of puncture on the infant's heel should be 2 mm or less.
 
Wipe away the first drop of blood with a piece of clean, dry cotton. Since newborns generally do not bleed immediately, use gentle pressure to produce a rounded drop of blood.  Do not knead the area heavily because the blood may become diluted with tissue fluid.
 
Fill the tubes or micro-collection devices. Finally, elevate the heel, place a piece of clean, dry cotton on the puncture site, and hold it in place until the bleeding has stopped.
 
Discard contaminated materials, and label the specimens.  Remove gloves and wash hands.
 
To keep up on the latest standards, visit www.clsi.org.

By Neil Whitehall
Get Phlebotomy Jobs, Contributing Editor

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