DERMAL PUNCTURE Flashcards
also referred to as skin puncture, capillary puncture
dermal puncture
considered the method of choice for collecting blood from infants and children younger than 2 years
dermal puncture
pertains to the rupture of RBC membrane that can affect a series of tests.
Hemolysis
dermal puncture is usually accomplished by a quick firm stab using a lancet or pricker at a depth of _____ (as per CLSI guidelines)
2-3 mm
The blood collected in dermal puncture is called what?
capillary blood
Capillary blood is composed of a mixture of _____ and ____ blood (arterial portion is higher 🡪) plus intracellular and interstitial fluids.
venous and arterial blood
Sterile, disposable, sharp instruments used for capillary blood collection
OSHA recommends that all dermal puncture devices must have the ability to retract and lock after use to prevent reuse and accidental puncture.
Lancets
To prevent contact with bone, the depth of the puncture is critical. CLSI recommends that the incision depth should not exceed ________ in a device used to perform heelsticks (infants).
2.0 mm
Depth of capillary bed from skin:
infants: 🡪
0.35 to 1.6 mm
Depth of capillary bed from skin:
adults 🡪
3 mm
Frequently referred to as the microhematocrit tubes
Small tubes used to collect approximately
50 to 75 µL of blood for the primary purpose of performing a microhematocrit test.
Capillary Tubes
How many microliters of blood does capillary tube collect for microhematocrit
50 to 75 µL
Hematocrit Tube with No anticoagulant
Blue microhematocrit tubes
Hematocrit Tube Coated with heparin
Red microhematocrit tubes
✍ Small collection tubes often referred to as “bullets”
✍ made up of plastic; (present no danger from broken glass)
✍ provide larger collection volumes (up to approximately 600 uL of blood.
✍ They are color coded; with minimum and maximum fill levels
Microcollection tubes
Microcollection tubes are also called what?
bullets
600 uL of blood
how many microliters of blood can microcollection tubes collect?
✍CLSI recommends 70% alcohol
✍Gauze / cotton is used to wipe away the first drop of blood:
✍ to eliminate alcohol residue
✍to eliminate excess tissue fluid
✍It is also used to hold site after collection
Alcohol pads / gauze / bandages
how many percentage of alcohol is recommended by CLSI
70% Warming devices
Warming devices
✍Increases blood flow seven times
✍Can be a towel or a diaper dampened with warm water (must not exceed 42oC for it might scald the patient)
✍One can also use a commercial heel warmer (a
packet containing sodium thiosulfate and glycerin which when mixed together by gentle squeezing will generate heat)
a warming device must not exceed what temperature
42 degree celcius
Clay-like substances used in sealing microhematocrit tubes
sealant
DERMAL PUNCTURE PROCEDURES
Review Test Request, Greet the patient and explain the procedure, Identify and Prepare Patient, Verify Diet and Medication Restrictions, Position the patient, Prepare equipments needed, Sanitize hands and Put on Gloves, Site Selection, Warm the Site if necessary, Disinfect and Air Dry The Site of Puncture
Common sites of puncture
✍ Lateral plantar heel surface (babies)
✍ Palmar surface of the fingers
✍ Plantar surface of the big toe
✍ Earlobe (less painful)
best site of dermal punctures
Lateral plantar heel surface
previously recommended skin puncture site for arterial blood (this site is not anymore recommended at present)
Earlobe
The fleshy area are located near the center of the third
and fourth fingers of the ______ side of the nondominant hand are site of choice for finger puncture.
palmar
why is the thumb avoided in dermal puncture
heavily callused
why is the index avoided in dermal puncture
increased nerve ending
why is the fifth finger avoided in dermal puncture
decreased amount of tissue
What disinfectant is not used in dermal puncture
povidone-iodine
Two lab procedures that will require Povidone Iodine:
Blood Culture Collection, Blood Donation
First Tube to be filled:
EDTA (lavender-topped tube)
Used in hematology; mostly affected by clotting that is why it should be prioritized
EDTA (lavender-topped tube)
Second Tube
Other additive specimens (green or blue)
Last Tube
Serum specimens (red/yellow-topped tube)
is a very light-sensitive chemical and is rapidly destroyed when exposed to light.
Bilirubin
✍ Is a public health program that involves testing of the newborn babies for genetic, metabolic, hormonal, and functional disorders that can cause physical disabilities, mental retardation, or even death, if not detected or treated early.
Newborn Screening
Newborn is embodied in what republic act
Republic Act 9288
Newborn Screening is also known as what?
Newborn Screening Act of 2004
