capillary puncture

• capillary puncture is also known as skin puncture
• Type of equipment for capillary collection

  1. lancet/incision devices
  2. Laser lancet
  3. Microcollection containers
  4. Microhematocrit tubes and sealants (50-75 microliters of blood sample)
  5. Microscope slidesWarming devices
  6. Capillary blood gas equipment (CBG)
• Composition of capillary blood specimen

  1.  capillary blood specimen
  2. Arterial blood- bright red blood appearance 
  3. Venous blood- -deoxygenated
  4. Interstitial fluid
  5. Intracellular fluid
• Indication of performing capillary puncture on adults, children, and infants

  • Veins are fragile and not accessible because of scars, burns, etc.
  • Veins are reserved for another procedure such as chemotherapy 
  • Clotting tendencies
• Preferred method for infants and young children because of the following reasons:

  • Health risks such as anemia, and cardiac arrest
  • Requires only a small volume of blood
  • Venipuncture could damage veins and tissues surrounding the site
• Order of draw

  • Specific sequence with which blood must be drawn and collected to avoid cross contamination of additives
• CLSI Standards, Order of Draw

  • Blood gas specimens
  • EDTA specimens
  • Other additive specimens
  • Serum specimens
• Step 1: receive, review and accession test request
• Step 6: position patient

  • Nondominant hand extended and palm up 
  • Young child: held in the lap by a parent or guardian with one arm and holds the child’s arm steady with the other
  • Infant (heel puncture): supine (lying face up) foot lower than the torso to allow gravity assist blood flow
• Step 7: Select the puncture site

  • Site should be pink, normal in color, and warm
  • Free from scars, cuts, bruises, rashes, cyanosis, edema, or infection
• • Palmar surface of the distal, end segment of the middle finger or ring finger of the non-dominant hand
• • Incision site should be less than 2.00mm deep
  • To avoid bone damage
  • Plantar surface of the heel, or on the median or lateral edge
• Step 8: warm site if applicable

  • Warming
  • Increases the blood circulation in the area for up to 7x
  • Using a warm washcloth or towel, warm the site for 3 to 5 minutes
• Step 9: gather supplies and equipment

  • Select collection devices and place them within easy reach
• Step 10: clean and air-dry site

  • Clean and sanitized using antiseptic or 70% isopropyl alcohol