PROPER BLOOD COLLECTION AND HANDLING USING ROUTINE CAPILLARY PUNCTURE

Question 1

Advantageous in certain adult populations
whose veins are inaccessible: (7)

Answer 1

Severely burned.
Cancer patients
Obese
Geriatric patients
Point of care testing (POCT)
Patients performing tests on
themselves.
Special procedures that require
capillary blood

Question 2

Should NOT be used on patients who are
extremely __________ or _____.

Answer 2

dehydrated; COLD

Question 3

INDICATIONS FOR PERFORMING
CAPILLARY PUNCTURE: (adults)

Answer 3

-No accessible veins
-To save veins for chemotherapy
-Clotting tendencies
-POCT procedures such as glucose
monitoring

Question 4

INDICATIONS FOR PERFORMING
CAPILLARY PUNCTURE: (infant/children)

Answer 4

-To prevent anemia
-To prevent cardiac arrest from removal
of large quantities of blood
-Venipuncture too difficult
-To prevent injury

Question 5

EQUIPMENTS:

Answer 5

LANCET, MICRO-COLLECTION CONTAINERS, HEMATOCRIT TUBES, PLASTIC/CLAY SEALANT, MICROSCOPE SLIDES, WARMING DEVICES

Question 6

Sterile and disposable
Retractable blade
Either finger or heel

Answer 6

LANCET

Question 7

Collects tiny
amounts of blood.

Answer 7

MICRO-COLLECTION CONTAINERS

Question 8

Manual Hct

Answer 8

HEMATOCRIT TUBES

Question 9

To seal the tip of
capillary tubes.

Answer 9

PLASTIC/CLAY SEALANT

Question 10

Smearing

Answer 10

MICROSCOPE SLIDES

Question 11

Finger or heel equipment for blood flow improvement

Answer 11

WARMING DEVICES

Question 12

SITE SELECTION:

Answer 12

1. FINGER - palmar surface of the distal (end) segment of third (middle)/fourth (ring) finger.
2. Heel - Plantar surface medial to a line drawn posteriorly from the middle of the great toe to the heel. OR lateral to a line drawn posteriorly from between the fourth and fifth toes to the heel.

Question 13

CAPILLARY SPECIMEN MIXTURE:

Answer 13

Mixture of arterial, venous and capillary
blood.

Question 14

fluid outside of the
body’s cells (extracellular); fluid in the
tissue spaces between cells.

Answer 14

Interstitial fluid

Question 15

fluid within cells
from surrounded tissues; contains
water and dissolved solutes
(electrolytes) and proteins.

Answer 15

Intracellular fluid

Question 16

Puncture blood Higher result in ________;
Lower results in ______, _______,
and _____________

Answer 16

Glucose; Total Protein, Calcium, Potassium

Question 17

CAPILLARY ORDER OF DRAW

Answer 17

1. Gas tubes
2. Slides
3. EDTA (purple top tube)
4. Heparin- light or dark green top tube
5. Other additive micro-collection cont.
6. Serum - red top or amber tube with red top.

Question 18

CLEANING THE SITE:

Answer 18

• Clean the finger with 70% Isopropyl Alcohol
• Allow the area to air dry.
• Do not use Povidone-lodine (Betadine)

Question 19

SITES TO AVOID IN FOOT

Answer 19

• Medial or big toe side.
• Lateral or little toe side.
• Central arch area of the foot.

Question 20

DEPTH OF PUNCTURE FOR PREMATURE

Answer 20

0.65 - 0.85 mm

Question 21

depth of puncutre for full-term

Answer 21

2 mm

Question 22

depth of puncture for finger

Answer 22

3 mm

Question 23

depth of puncture for bleeding time

Answer 23

1 mm

Question 24

distant to bones and main nerves of the infant’s fingers is ?

Answer 24

1.2-2.2 mm

Question 25

depth of puncture for 6 months-8 yr old

Answer 25

1.5 mm

Question 26

depth of puncture for child over 8 years old

Answer 26

2.4 mm

Question 27

depth of puncture for adult

Answer 27

2.4

Question 28

PROCEDURE FOR CAPILLARY PUNCTURE OF THE FINGER:

Answer 28

1. Identify the patient and verify the collection orders. Wear PPE. 2. Choose a finger that is not cold or edematous for the puncture site. 3. Clean the puncture site with 70% Isopropyl alcohol and let it dry. 4. Prepare the equipment for capillary puncture. 5. Massage the lower portion of the finger to stimulate blood flow. 6. Puncture the skin while pressing the area below the puncture site. Dispose puncture device. 7. Wipe away the first drop of blood with a sterile dry gauze. 8. Collect the sample in the chosen container in a downward angle and a gentle pressure is applied to the finger. 9. Hold the gauze or have the patient hold gauze to puncture site until bleeding has stopped. 10. Invert the tube according to its requirement. 11. Apply bandage to the puncture site. 12. Label the collection containers.