Notes on Heel Stick Procedure and Newborn Screening

Heel Stick Procedure

• Purpose: To obtain a blood sample from a newborn for lab tests.
• Steps:
  • Warm the newborn's heel to increase blood circulation.
  • Cleanse the puncture site with an alcohol swab and allow it to dry completely.
  • Use a spring-activated lancet on the medial or lateral portion of the plantar surface of the heel. Avoid the central heel area to prevent injury to the bone.
  • Apply pressure to the puncture site with dry gauze after the blood draw to stop bleeding.
  • Apply a bandage to the puncture site.

Lab Tests at Birth

• Newborn Genetic Screening: Typically performed within 24-48 hours of birth.
  • These screening tests are state-mandated, meaning they are required by law in each state, although the specific tests may vary.
  • Common screening tests include:
    • Phenylketonuria (PKU)
    • Congenital hypothyroidism
    • Galactosemia
    • Sickle cell disease

Phenylketonuria (PKU)

• Definition: PKU is a genetic defect in protein metabolism.
• Pathophysiology: The body cannot properly break down phenylalanine, an amino acid found in protein. This leads to a buildup of phenylalanine in the blood, which can cause intellectual disabilities if left untreated.
• Intervention: If the PKU screening test is positive (typically defined as > 20 mg/dL), the child will require a special formula and a lifelong low-protein diet to manage the condition.
• Mnemonic: With PKU, Protein can Kill U, highlighting the need to restrict protein intake.