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SKIN PUNCTURE/ CAPILLARY PUNCTURE
A fingerstick to obtain blood for routine laboratory analysis and usually preferred for children.
Dermal Puncture
SKIN PUNCTURE/ CAPILLARY PUNCTURE are also known as __________.
1.75mm
Length of the lancet: _______.
<2.0mm ; <2.5 mm
The depth of the incision should be ______ for children and ________ for adults.
across the fingerprints or perpendicular
The cut should be oriented _________ to generate a large drop of blood using single deliberate motion.
Lateral plantar heel surface
- the preferred site for newborns and infants
Palmar surface of the non dominant fingers (3rd and 4th fingers)
- the most common site for adults
Earlobes
- the least used site
Enumerate the preferred sites for skin puncture:
ā¢ Lateral plantar heel surface ā newborns and infants
ā¢ Palmar surface of the non dominant fingers (3rd and 4th fingers) ā most common
ā¢ Plantar surface of the big toe
ā¢ Earlobes ā least used site
SITES TO AVOID
ā¢ Inflamed and pallor areas
ā¢ Cold and cyanotic areas
ā¢ Congested and edematous areas
ā¢ Scarred and heavily calloused areas
Advantages of Skin Puncture
ā¢ It is accessible to the operator
ā¢ Easy to manipulate
ā¢ Ideal for peripheral blood smears.
Disadvantages of Skin Puncture
ā¢ Less amount of blood can be obtained
ā¢ Additional and repeated test cannot be done
ā¢ Blood obtained has tendencies to hemolyze easily.
Lancets
- __________ are sterile, disposable, sharp instruments used for capillary puncture.
- Their blades or points must permanently retract to prevent sharp injuries.
70% isopropyl alcohol
- CLSI recommends using __________to clean surface of the skin before puncturing with a lancet or other sharp device.
Gauze or cotton balls
- _____________ are used to wipe away the first blood drop to eliminate alcohol residue and excess tissue fluid.
first blood drop
- Gauze or cotton balls are used to wipe away the _______ to eliminate alcohol residue and excess tissue fluid.
Bandages
- _______ are used to cover the site after collection.
MICROCOLLECTION CONTAINERS
Also known as microtubes
MICROCOLLECTION CONTAINERS
Special small plastic tubes used to collect tiny amounts of blood obtained from capillary punctures
MICROCOLLECTION CONTAINERS
Often referred to as bullets because of their size and shape
MICROHEMATOCRIT TUBES
Disposable, narrow-bore plastic or plastic-clad glass capillary tubes that fill by capillary action and typically hold 50-75 uL of blood.
MICROHEMATOCRIT TUBES
Also known as capillary tubes
MICROHEMATOCRIT TUBES
Used primarily for manual hematocrit (PCV) determinations
Packed Cell Volume
PCV
MICROHEMATOCRIT TUBES
Coated with ammonium heparin or plain
red or green
Heparin tubes have _______ band on one end
blue
Nonadditive tubes have _____ band
WARMING DEVICES
ā¢ Warming the sites increases blood flow up to seven times and is especially important when performing heel sticks.
ā¢ Water temperature must not exceed 42ĀŗC or it could scald the patient
42ĀŗC
Water temperature must not exceed ______ or it could scald the patient
SEALANTS
- are claylike substances used to seal one end of microhematocrit tubes
4-6mm
The clay plug should be _____ long
1st: clay sealant
2nd: paraffin wax
- when sealing the microhematocrit tubes what are the two things you are going to use?
PROCEDURE FOR SKIN PUNCTURE
ā¢ Identify the patient properly
ā¢ Choose an appropriate site for collection
ā¢ Clean the site with 70% alcohol
ā¢ Hold finger between your index finger and thumb
ā¢ Puncture the finger using a quick, smooth motion
ā¢ Wipe away the first drop of blood
ā¢ Collect blood sample
ā¢ Apply pressure to puncture site
ā¢ Label specimen in sight of patient
INDICATIONS FOR CAPILLARY PUNCTURE
ā¢ Can be done if small amount of blood is required.
ā¢ There are no accessible veins
ā¢ Available veins are fragile or must be saved for other procedures such as chemotherapy
ā¢ Blood is to be obtained for POCT procedures such as glucose monitoring
ā¢ Capillary blood is the preferred specimen for some tests such as newborn screening
RED BAND
Capillary blood obtained through skin puncture transferred to an anticoagulated capillary tube (HEPARIN) ā with ______.
BLUE BAND
EDTA-anticoagulated blood transferred to a non-anticoagulated capillary tube ā with ______
2/3 TO Ā¾ FULL
āŖ NOTE: CAPILLARY TUBES MUST BE _____.
air bubbles and spaces
In collecting the sample by microhematocrit tubes avoid ________.
clay sealant ; paraffin
Sealed first with a ______ then ______.
Label the specimen properly with:
ā¢ patientās full name
ā¢ age
ā¢ date of birth
ā¢ time and date of collection
ā¢ initials of the phlebotomist
ORDER OF DRAW (MICROTAINER)
ā¢ Blood Gases (CBGs)
ā¢ Slides & Smears
ā¢ EDTA tubes
ā¢ Other additive microtainer
ā¢ Serum microtainer
Clinical and Laboratory Standards Institute
CLSI
Heparin
_______ is a natural anticoagulant found in the body
capillary action
capillary tubes are fill by __________ and typically hold 50-75 uL of blood.
50-75 uL
- the capillary tube can typically hold ______ of blood