Basics
When would you use capillary puncture over venipuncture?
For infants and children
Severely burned patients
Severely obese patients
Elderly patients
What should skin look like for dermal puncture?
Warm, pink, and free from scars, cuts, rashes or bruises.
What equipment is needed for capillary puncture?
Requisition slip
Gloves
Alcohol pad
Gauze
Bandaid
Sharps container
Computer label
Marker/pen
Lancet
Microspecimen containers
Skin should be stretched tightly for a dermal capillary puncture.
True/False
True
The first drop of blood should always be collected.
True/False
False. The first drop should be wiped away.
What does blood obtained through capillary puncture contain?
A mixture of venous blood, arterial blood, and interstitial.
What are the sites to consider for dermal puncture?
Distal regions of the middle finger and ring finger. Medial or lateral regions of the plantar surface of heel in infants.
What is the maximum puncture depth?
2 mm
A cut made between fingerprint lines will give _____ blood flow.
Lower.
What is the order of draw for dermal puncture?
EDTA (lavender/pink)
Heparin (green/light green)
Sodium Fluoride (gray)
Nonadditive (red/serum separator gold)
Capillary blood is higher in ____ and lower in _____.
Glucose
Potassium
What fingers should you not use?
Thumb, pointer finger, pinkie finger.
Where should heel punctures never be performed?
Center of the heel
Clean finger with alcohol and puncture immediately.
True/False
False. Alcohol must be completely dry to prevent hemolysis.
It is important ___ to puncture through a previous site.
Not
What is the drawback of capillary puncture?
The small amount of blood collected.
Should you puncture with or against the grain of fingerprint lines? Why?
Against the grain, to get an increased blood flow.
What safety devices are used to prevent needlesticks with dermal puncture devices?
Devices are frequently spring loaded and ensures blade retracts after use.
Can a device designed for glucose monitoring be used in a routine capillary puncture? Why?
No. These lancers produce a smaller puncture and only 2-3 drops of blood.
What will happen if you puncture through the same site on an infant/adult?
The site can become infected.
Which tests cannot be performed with capillary blood?
Blood cultures
Erythrocyte sedimentation rate (ESR)
When should you not perform a heel stick on an infant?
If they are walking.
What factors are used to determine which device to use?
Age and size
Why is it important to make the initial puncture deep enough?
To avoid a second puncture.
Puncturing the bone can cause ____.
Osteochondritis.