SKIN PUNCTURE/ CAPILLARY PUNCTURE

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45 Terms

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SKIN PUNCTURE/ CAPILLARY PUNCTURE

A fingerstick to obtain blood for routine laboratory analysis and usually preferred for children.

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Dermal Puncture

SKIN PUNCTURE/ CAPILLARY PUNCTURE are also known as __________.

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1.75mm

Length of the lancet: _______.

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<2.0mm ; <2.5 mm

The depth of the incision should be ______ for children and ________ for adults.

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across the fingerprints or perpendicular

The cut should be oriented _________ to generate a large drop of blood using single deliberate motion.

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Lateral plantar heel surface

- the preferred site for newborns and infants

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Palmar surface of the non dominant fingers (3rd and 4th fingers)

- the most common site for adults

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Earlobes

- the least used site

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Enumerate the preferred sites for skin puncture:

• Lateral plantar heel surface – newborns and infants
• Palmar surface of the non dominant fingers (3rd and 4th fingers) – most common
• Plantar surface of the big toe
• Earlobes – least used site

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SITES TO AVOID

• Inflamed and pallor areas
• Cold and cyanotic areas
• Congested and edematous areas
• Scarred and heavily calloused areas

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Advantages of Skin Puncture

• It is accessible to the operator
• Easy to manipulate
• Ideal for peripheral blood smears.

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Disadvantages of Skin Puncture

• Less amount of blood can be obtained
• Additional and repeated test cannot be done
• Blood obtained has tendencies to hemolyze easily.

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Lancets

- __________ are sterile, disposable, sharp instruments used for capillary puncture.
- Their blades or points must permanently retract to prevent sharp injuries.

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70% isopropyl alcohol

- CLSI recommends using __________to clean surface of the skin before puncturing with a lancet or other sharp device.

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Gauze or cotton balls

- _____________ are used to wipe away the first blood drop to eliminate alcohol residue and excess tissue fluid.

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first blood drop

- Gauze or cotton balls are used to wipe away the _______ to eliminate alcohol residue and excess tissue fluid.

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Bandages

- _______ are used to cover the site after collection.

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MICROCOLLECTION CONTAINERS

Also known as microtubes

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MICROCOLLECTION CONTAINERS

Special small plastic tubes used to collect tiny amounts of blood obtained from capillary punctures

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MICROCOLLECTION CONTAINERS

Often referred to as bullets because of their size and shape

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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.

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MICROHEMATOCRIT TUBES

Also known as capillary tubes

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MICROHEMATOCRIT TUBES

Used primarily for manual hematocrit (PCV) determinations

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Packed Cell Volume

PCV

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MICROHEMATOCRIT TUBES

Coated with ammonium heparin or plain

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red or green

Heparin tubes have _______ band on one end

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blue

Nonadditive tubes have _____ band

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WARMING DEVICES

• Warming the sites increases blood flow up to seven times and is especially important when performing heel sticks.
• Water temperature must not exceed 42ĀŗC or it could scald the patient

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42ĀŗC

Water temperature must not exceed ______ or it could scald the patient

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SEALANTS

- are claylike substances used to seal one end of microhematocrit tubes

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4-6mm

The clay plug should be _____ long

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1st: clay sealant
2nd: paraffin wax

- when sealing the microhematocrit tubes what are the two things you are going to use?

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PROCEDURE FOR SKIN PUNCTURE

• Identify the patient properly
• Choose an appropriate site for collection
• Clean the site with 70% alcohol
• Hold finger between your index finger and thumb
• Puncture the finger using a quick, smooth motion
• Wipe away the first drop of blood
• Collect blood sample
• Apply pressure to puncture site
• Label specimen in sight of patient

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INDICATIONS FOR CAPILLARY PUNCTURE

• Can be done if small amount of blood is required.
• There are no accessible veins
• Available veins are fragile or must be saved for other procedures such as chemotherapy
• Blood is to be obtained for POCT procedures such as glucose monitoring
• Capillary blood is the preferred specimen for some tests such as newborn screening

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RED BAND

Capillary blood obtained through skin puncture transferred to an anticoagulated capillary tube (HEPARIN) – with ______.

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BLUE BAND

EDTA-anticoagulated blood transferred to a non-anticoagulated capillary tube – with ______

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2/3 TO ¾ FULL

ā–Ŗ NOTE: CAPILLARY TUBES MUST BE _____.

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air bubbles and spaces

In collecting the sample by microhematocrit tubes avoid ________.

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clay sealant ; paraffin

Sealed first with a ______ then ______.

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Label the specimen properly with:

• patient’s full name
• age
• date of birth
• time and date of collection
• initials of the phlebotomist

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ORDER OF DRAW (MICROTAINER)

• Blood Gases (CBGs)
• Slides & Smears
• EDTA tubes
• Other additive microtainer
• Serum microtainer

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Clinical and Laboratory Standards Institute

CLSI

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Heparin

_______ is a natural anticoagulant found in the body

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capillary action

capillary tubes are fill by __________ and typically hold 50-75 uL of blood.

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50-75 uL

- the capillary tube can typically hold ______ of blood