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a method that uses a lancet to
make a small incision into the capillary bed of the skin to obtain a small
volume of blood specimen.

Capillary puncture

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This is at ype of lancet that produces a small hole
in the skin by vaporizing water in the skin. This eliminates the
risk of sharp injury because cauterizing the skin is not necessary.

Laserlancet-

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These are sterile, sharp instruments
that are intended for one-time use only. They are designed foruse
in making cuts in the skin for finger or heel puncture.

Lancet/Incision devices

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Also known as microtube, this
container is a small plastic tube used to hold blood specimen
collected in the capillary puncture.

Microcollection container -

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There are 2 types that are used in capillary puncture: ______ and _______

finger puncture lancet and heel puncture lancet.

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these arenarrow bore
tubes that are made of either plastic or glass. They are typically
used for hematocrit determinations.

Microhematocrit tubes and sealants

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It has markings on the
side that show the minimum and maximum fill levels and,
occasionally, comes with a narrow capillary tube.

Microcollection container -

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They can hold 50 to 75 uL
and filled by capillary action. One end is sealed with sealants
made of clay orplastic.

Microhematocrit tubes and sealants

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these are used for blood films for
hematology determinations.

Microscope slides

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Microhematocrit tubes and sealants

can hold ______
and filled by capillary action. One end is sealed with sealants
made of clay orplastic.

50 to 75 uL

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-these are used to increase the blood flow
seven-fold by warming the puncture site.

Warming devices

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this is a special
equipment used for collecting capillary blood gas (CBG)
specimen, which contains CBG collection tubes, stirrers, magnet,
and plastic caps.

Capillary blood gas (CBG) equipment

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The capillary blood specimen is a mixture of different blood and
fluids which include the following:

arterial blood, venous blood, capillary
blood, interstitial fluid, and intracellular fluid.

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_______- is the bright
red blood found in the pulmonary vein, left chamber of the heart, and
the arteries.

Arterial blood

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the blood that travels from the peripheral veins passing through
the venous system then through the right chamber of the heart.

Venous
blood

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preferred specimen for infants, young children, elderly patients, and
patients with severe burns.

Capillary blood

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This
is dark red in color because it is deoxygenated.

Venous
blood

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It is the oxygenated blood in the circulatory system.

Arterial blood

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___ is the
preferred specimen for infants, young children, elderly patients, and
patients with severe burns.

Capillary blood

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__________ is found inside the cells. It facilitates the movement of
fluid in the membrane and blocks the entrance of unwanted materials.

Intracellular fluid

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Capillary blood It is extracted from the ___ and _____
found in the capillary bed. _____ fills the spaces around the
cells, filtered from the blood capillaries, and drained away as lymph.

venules and arterioles ; Interstitial fluid

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the cpillary refererence values may vary from the ____

venousvalues

The concentration of the ____ is higher while the ____ , ___ and ___ concentrations are lower

the conc. of the glucose in the blood is higher conc. lower total protein (TP) Calcium (Ca4+) Potassium (K+)

Capillary specimen could be a good alternative to venipuncture for adults and older children under the following circumstances:

(1) veins are fragile and not accessible because of scars and burns; (2) veins are reserved for another procedure such as chemotherapy; (3) clotting tendencies; (4) extreme fear of needles; and 5) veins will be used for glucose monitoring or oral glucose tolerance test (OGTT).

This is also the preferred method for infants and young children because of the following reasons:

(1) health risks such as anemia and cardiac arrest; (2) requires only a small volume of blood; (3) venipuncture could damage veins and tissues surrounding the site; (4) puncturing could result in hemorrhage, thrombosis, gangrene, and infection; risk of injury because of the restraint needed in venipuncture; and (5) capillary blood is the preferred specimen.

Capillary puncture should not be used for ___

ESR, blood cultures, and studies that need plasma specimen or have large volume specimen requirement.

refers to the specific sequence with which blood must be drawn and collected in tubes to avoid cross-contamination of additives between the tubes.

ORDER OF DRAW

The order of draw should be capillary

capillary blood gas specimens (CBGs), EDTA specimens, other additive specimens, and serum specimens.

Step 1: Review and checkaccession testrequest.

Step2: Approach, identify, and prepare the patient.

Step 3: Verify diet restrictions and latex sensitivity.

Step 4: Sanitize hands and put on gloves.

Step 5: Position the patient.

the patient's arm should be placed on a firm surface. His/Her arms should be extended, and his/her palms are facing up. If the patient is a young child, he/she should be placed on the lap of his/her guardian. The infant heel puncture should be performed with the baby in a supine position and his/her foot not lower than his/her torso.

Step 6: Select the puncture or incision site. As a general criterion, the skin of the incision site should be __________. The selected area should be free from _______

pink, normal in color, and warm ; scars, cuts, bruises, rashes, cyanosis, edema, or infection.

Step 7: Warm the site, if necessary. Warming the incision site increases the ____ in the area for up to _____ , the site should be warmed for ________

blood circulation ; seven times. With a warm washcloth or towel ; 3 to 5 minutes.

Step 6: Select the puncture or incision site. If the patient is an adult or an older child, the________ should be used. The center or the fleshy portion of the finger should be used.

palmar surface of the distal, end segment of the middle finger or ring finger of the non-dominant hand

Step 6: Select the puncture or incision site. For infants, the incision site should be less than __ To avoid _____ the incision recommended site should be on the ___________

2.0mm deep. ; bone damage, ; plantar surface of the heel, or on the median or lateral edge.

Step 10: Puncture the site and discard the lancet. he/she should hold the foot gently but firmly and proceed to ________ The thumb should be placed at the _______, and the rest of the fingers around the _______. Then the lancet is positioned in the _______

encircling the heel using the index finger near the arch. ; bottom, ; top portion of the foot ; medial or lateral plantar of the heel.

Step 8: Clean and air-dry the site.

The incision site should be cleaned and sanitized using antiseptic or 70% isopropyl alcohol.

Step 12: Fill and mix tubes or containers in the order of draw. The phlebotomist should prioritize the ______ specimens to avoid clumping and clotting. The anticoagulant containers should be followed by serum specimens. Do not forget to collect drops of blood into the collection tube/device.

collection of slides, platelet counts, and other hematology

A small drop of blood is placed near the ______ Another slide is used to spread the blood in a _____ over the slide. It is then air-_______

frosted end of the glass side. ; thin film ; dried and stained.

Step 7: Warm the site, if necessary. Warming is usually done when the specimen is for __________ .It is also recommended for ____-

pH or blood gas specimen collection. ; heel sticks.

Step 9: Prepare the equipment.

The phlebotomist must wear gloves before arranging the sterilized collection devices and placing them in an area that is easy to reach. Packages should be opened in front of the patient.

Step 10: Puncture the site and discard the lancet. the phlebotomist should hold the finger _____ finger of the ________-. He/She should then place the _____ against the central fleshy part of the incision site.

between the thumb and index finger of the non- dominant hand. ; lancet flat

_________ is a blood test that is used to check abnormalities in the blood cells.

Routine blood film/smear preparation

Step 11: The first blood drop should be wiped away because it may be contaminated with

excess tissue fluid.

Step 15: Check the site and apply

BANDAGE

Step 14: Label specimen and observe

special handling instructions.

Thick blood smear preparation is used to determine if the patient has ________- which is diagnosed by its presence inthe peripheral blood smear. The procedure starts by placing a large drop of blood in the ________The blood drop is spread until it is about the size of a dime, using a cover slip or another slide. This should be air-dried for at least ________ staining.

malaria, ; center of the slide. ; 2 hours before

Step 16: Dispose of used and

contaminated materials.

Step 13: Placegauze and apply pressure. _____

Keeptheincisionsiteelevated.

Step 18: Transport specimen to

the lab

Step 17: Thank patient,

remove gloves, and sanitize hands.

__________ by ______is recommended for infants and small children. The blood samples are collected on the ________

Capillary blood gas specimen ; heel puncture ; same site as routine capillary puncture specimens.

_________ collection is used to help determine any liver disorder in infants. This is collected with a heel stick.

Neonatal bilirubin

Specimen Required:

Supplies: Amber-frosted tube, 5 mL (T192) Collection Container/Tube: Preferred: 2 Serum gel microtainers Acceptable: 2 Red-top microtainers