LAB MANUAL - CAPILLARY BLOOD COLLECTION

Question 1

Implies puncturing the ________ layer of the skin to access the capillary beds that run through the subcutaneous layer of the skin.

Answer 1

dermal

Question 2

Capillary Blood Collection: Preferred method of blood specimen collection for _____ and _______

Answer 2

newborns and infants

Question 3

CLSI

Answer 3

Clinical Laboratory Standards Institute

Question 4

for infants less than one year of age

Answer 4

Heel stick

Question 5

children older than one-year

Answer 5

Fingerstick

Question 6

CAPILLARY BLOOD MAY ALSO BE USED FOR ADULTS UNDER CERTAIN CIRCUMSTANCES INCLUDING:

Answer 6

Patients with fragile, superficial, or difficult to access veins.

Patients requiring only one blood test for which a capillary specimen is appropriate.

Point-of-care testing where only a few drops of blood are needed.

Patients where multiple unsuccessful venipunctures have already been performed, especially if the test(s) requested requires only a small volume of blood.

Patients with burns or scarring in venous blood collection sites.

Extremely obese patients
Patients requiring frequent blood tests.

Patients receiving IV therapy in both arms or hands
Patients at risk for serious complications associated with venipuncture, venous thrombosis, or deep venous puncture.

Patients whose veins are “reserved” for intravenous therapy or chemotherapy.

Question 7

CAPILLARY BLOOD COLLECTION IS INAPPROPRIATE FOR:

Answer 7

Severely dehydrated patients

Patients with poor circulation

Coagulation studies requiring plasma specimens.

Tests that require large volumes of blood (such as Erythrocyte Sedimentation Rate and blood cultures).

Question 8

THE FOLLOWING TESTS ARE COMMONLY PERFORMED USING CAPILLARY BLOOD:

Answer 8

Point-of-Care testing (POCT, i.e. blood glucose monitoring)

Complete blood count, hemoglobin, and hematocrit

Peripheral Blood Smear (manual slide for white blood cell differential)

Neonatal Blood Gases

Neonatal Bilirubin

Neonatal Screening (filter paper or bloodspot testing)

Electrolytes.

Question 9

For the order of draw in Capillary Blood Collection, CLSI recommended to collect_________ first, as the blood becomes an increasingly more like venous blood if the collection is delayed.

Answer 9

blood gases

Question 10

If collection of blood for a CBC is
delayed, there is an increased likelihood of erroneous cell counts due to ____________.

Answer 10

platelet clumping

Question 11

To minimize effects of platelet clumping, the following order is recommended:

Answer 11

1. Blood Gases
2. EDTA tubes
3. Other additive tubes
4. Serum tubes

Question 12

EQUIPMENT FOR CAPILLARY SPECIMEN COLLECTION

Answer 12

PUNCTURE DEVICES
INCISION DEVICES
LASER LANCETS
MICROHEMATOCRIT CONTAINERS
MICROHEMATOCRIT TUBES AND SEALANTS

Question 13

Used to puncture the skin by inserting either a needle or blade vertically into the tissue.

Answer 13

PUNCTURE DEVICES

Question 14

Preferably for sites that are repeatedly punctured.

Answer 14

PUNCTURE DEVICES

Question 15

slice through capillary beds

Answer 15

INCISION DEVICES

Question 16

Create less painful than puncture devices and require fewer repeat incisions and shorter collection times.

Answer 16

INCISION DEVICES

Question 17

Recommended for infant heel sticks.

Answer 17

INCISION DEVICES

Question 18

skin puncture should be:
_________, _________, ________ with a _________ to reduce the possibility of accidental needlestick injuries and reuse.

Answer 18

sterile, disposable, single-use device with a permanently retractable blade or needle

Question 19

use a safety type of laser (in compliance with laser and medical device safety standards) that generates high energy when the laser comes in contact with the skin

Answer 19

Laser lancet

Question 20

A small hole is created in a very short time (Less than 1/10000 second) with very little pain.

Answer 20

Laser lancets

Question 21

Some are fitted with narrow plastic capillary tubes to facilitate specimen collection.

Answer 21

MICROHEMATOCRIT CONTAINERS

Question 22

Have color-coded caps or stoppers that correspond to ETS blood collection tubes, and markings for minimum and maximum fill levels
measured in microliters.

Answer 22

MICROHEMATOCRIT CONTAINERS

Question 23

Are narrow-bore plastic or plastic-clad glass capillary tubes that fill by capillary action.

Answer 23

MICROHEMATOCRIT TUBES

Question 24

MICROHEMATOCRIT TUBES can hold up to ___ - ___ of blood

Answer 24

50 to 70 uL

Question 25

The tiny tubes are used for manual hematocrit
or packed cell volume determinations

Answer 25

Microhematocrit Tubes

Question 26

The walls of red-banded tubes are coated with __________

Answer 26

ammonium heparin

Question 27

Are used in collecting hematocrit tubes directly from a capillary puncture.

Answer 27

red-banded tubes

Question 28

Plain, uncoated
Used when blood collected from a lavender top tube.

Answer 28

Blue-banded

Question 29

What should be taken into
consideration when selecting the skin

Answer 29

patient’s age
accessibility of the puncture site blood volume required

Question 30

Select a site that is

Answer 30

warm
pink

free of any calluses
burns
cuts
scar
bruises
rashes

Question 31

The site should NOT be

Answer 31

cyanotic (bluish from lack of oxygen)
edematous (swollen)
or infected.

Question 32

Avoid skin areas that have evidence of

Answer 32

previous punctures

Question 33

Recommended site for capillary collection on adults and children over one year of age.

Answer 33

Palmar surface of the distal (end) segment or the THIRD (middle) or FOURTH (ring) finger of the nondominant hand.

Question 34

The puncture should be made slightly off center from the central, fleshy portion of
the fingertip and if using a blade-type puncture device, __________ to the fingerprint whorls.

Answer 34

perpendicular

Question 35

Puncturing _______________________ may cause the blood to flow the pattern of the fingerprint, redirecting the flow and making it more difficult to collect.

Answer 35

along or parallel to the whorls

Question 36

The ___________ is often calloused and potentially more sensitive to pain due to additional nerve endings.

Answer 36

index finger

Question 37

The _______ also may be calloused and has a pulse, indicating arterial presence, and, therefore, should be avoided.

Answer 37

thumb

Question 38

The distance between the skin surface and the bone in the_________ also makes it unsuitable for puncture.

Answer 38

fifth finger

Question 39

The _____ and _____ of the finger should be avoided as the tissue is about half as thick as the central portion of the fingertip.

Answer 39

side and tip

Question 40

The recommended site for heel punctures is the

Answer 40

lateral (outside) or medial (inside) plantar surface of the heel

Question 41

In small or premature infants, the heel bone (calcaneus) may be no more than _____ beneath the skin surface and no more than half this distance at the posterior curvature of the heel.

Answer 41

2.0 mm

Question 42

When using incision devices, puncturing the heel at a ________ to the length of the foot is recommended.

Answer 42

90° angle

Question 43

FOR INFANTS, PUNCTURES MUST NOT BE PERFORMED ON:

Answer 43

The posterior curvature of the heel.
The central area of an infant’s foot (area of the arch).
The fingers of a newborn or infant less than one year old
Earlobes