Phlebotomy heel puncture

First step in heel puncture

Review test request (scenario)

Patient identification

Use two identifiers

Before starting procedure

Explain procedure and obtain parent consent

Verify before collection

Collection requirements, sensitivities, potential problems

Before touching patient

Prepare equipment and supplies

Infection control step

Hand hygiene and gloves

Infant positioning

Face up with foot lower than torso

Heel puncture site

Medial or lateral plantar surface

Sites to avoid

Bruised, swollen, or previous puncture sites

Warming the heel

3–5 minutes

Cleaning the site

Alcohol pad with friction, air dry

Holding the heel

Nondominant hand encircling heel

Holding the lancet

Dominant hand with thumb and index finger

Lancet placement

Flat against the skin

Maximum puncture depth

2 mm

After puncture action

Dispose lancet in sharps container

Encouraging blood flow

Lower heel and apply gentle pressure

First drop of blood

Wipe away

Collecting blood

Scoop into collection tube

Filling tubes

Follow order of draw

Post-collection care

Gauze, elevate heel, apply pressure

Specimen handling

Label and prepare for transport

Final site check

Ensure bleeding stopped (no bandage)

Used materials

Discard properly

End interaction

Thank patient and parent/guardian

After glove removal

Perform hand hygiene

After procedure requirement

Document procedure

Communication and safety

Use proper communication and standard precautions