1. Basic Principles of Phlebotomy Part VI: Capillary Draws CLS 424 Phlebotomy Student Lab Rotation

2. 2 Skin Puncture: Method of choice for infants, children under 1 year Adults –Scarred –Fragile veins –Hardened veins –Home glucose monitoring (POCT) –Patients with IV

3. 3 Capillary Blood Mixture of arterial, venous, capillary blood and fluid from surrounding tissues Fluid from surrounding tissues may interfere and/or contaminate the specimen Warming skin puncture site increases arterial blood flow to the area Reference ranges often differ from venous

4. 4 Skin Puncture Equipment: 1.PPE 2.Cleaning agent –Alcohol pads: routine –Soap and water: alcohol testing, allergies –DO NOT use providone iodine 3.Cotton balls, gauze

5. 5 Skin Puncture Equipment: 4.Bandage/tape 5.Sharps container 6.Warming device –Commercial warmer –Warm wet washcloth

6. 6 Skin Puncture Equipment: 7.Lancet –Always use standardized equipment –NEVER use a surgical blade

7. 7 Skin Puncture Equipment: 8.Micro-specimen containers –Capillary tubes –Microtainers –Capillary blood gas tubes –Micropipet diluting system

8. 8 Skin Puncture Equipment: 9.Glass slides: used to prepare blood smears

9. 9 Skin Puncture Procedure: 1.Wash hands 2.Approaching the patient 3.Patient identification 4.Latex allergy? 5.Bedside manner 6.Site selection 7.Cleanse site: DO NOT use providone- idodine 8.Perform puncture: Wipe away first drop of blood 9.Label the specimen

10. 10 Skin Puncture Site Selection:

11. 11 Skin Puncture Procedure: Hold finger between your index finger and thumb Puncture the finger using a quick, smooth motion Wipe away the first drop of blood

12. 12 Skin Puncture Procedure: Collect sample –DO NOT touch collecting device to skin surface –DO NOT scrape collecting device across skin surface –DO NOT scoop blood into collecting device

13. 13 Skin Puncture Procedure: Order of draw is critical: platelets accumulate at puncture site causing clot formation –Blood smear –EDTA –Heparin –Serum Apply pressure to puncture site Label specimen in sight of patient (indelible marker)

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