Capillary Collection
Why is capillary collection preferred for infants and small children?
Their veins are smaller and blood volume is lower.
What is the capillary order of draw?
Blood gases → Lavender → Green → Other additives → Serum (red).
When should routine phlebotomy rounds be scheduled?
Early morning
What is the preferred site for capillary collection in children under 1 year?
Heel puncture
What should you do if a patient faints during venipuncture?
Stop procedure, protect patient, call for help if needed.
Which sites are best for ADULT dermal puncture?
Distal segments of the 3rd and 4th fingers.
What safety feature is required for lancets by OSHA?
Retractable blades
Name one patient condition that can affect test results
Dehydration, exercise, fasting, medications, posture, etc.
What % of a child’s blood volume can safely be removed in 24 hours?
No more than 5%
Why should tourniquets not be applied for more than 1 minute?
Can cause hemoconcentration and altered results.
What is the maximum depth for infant heel puncture?
2 mm
What is the maximum depth for adult finger puncture?
3 mm
What is the phlebotomist’s responsibility regarding preanalytical variables?
Minimize variables and ensure accurate specimen collection
What is the most reliable method of identifying newborns?
Hospital ID number on bracelet
Name one long-term complication of venipuncture.
Iatrogenic anemia
nerve damage
infection
compartment syndrome.
Why do we wipe away the first drop of capillary blood?
It may contain tissue fluid that can affect results.
What type of containers hold dermal puncture specimens?
Microcollection tubes (color-coded by additive)
What is the most common cause of hemolysis?
Drawing blood too quickly / using too small a needle
What challenges are common in geriatric patients?
Fragile veins, thinner skin, hearing/vision loss, memory issues.
What are two reasons specimens are rejected by the lab?
Wrong tube, clotted specimen, unlabeled, underfilled, hemolyzed, expired tube
What test has largely replaced the bleeding time test?
Platelet function assay (PFA).
Why must capillary specimens not be overfilled?
To prevent dilution errors, especially with anticoagulants
What are two tests seriously affected by hemolysis?
Potassium and lactate dehydrogenase.
What is a special consideration for pediatric venipuncture supplies?
Use smaller needles, butterfly sets, and partial-fill tubes.
What should you do if you hit an artery instead of a vein?
Apply firm pressure, notify nursing staff, document incident