Basic Principles of Phlebotomy Part VI:

Capillary Draws

CLS 424 Phlebotomy

Student Lab Rotation

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Skin Puncture:

• Method of choice for infants, children under 1 year

• Adults– Scarred – Fragile veins– Hardened veins– Home glucose monitoring (POCT)– Patients with IV

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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

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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

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Skin Puncture Equipment:

4. Bandage/tape

5. Sharps container

6. Warming device– Commercial warmer– Warm wet washcloth

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Skin Puncture Equipment:

7. Lancet – Always use

standardized equipment

– NEVER use a surgical blade

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Skin Puncture Equipment:8. Micro-specimen

containers– Capillary tubes– Microtainers– Capillary blood gas

tubes– Micropipet diluting

system

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Skin Puncture Equipment:

9. Glass slides:

used to prepare

blood smears

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Skin Puncture Procedure:1. Wash hands

2. Approaching the patient

3. Patient identification

4. Latex allergy?

5. Bedside manner

6. Site selection7. Cleanse site: DO NOT use providone- idodine

8. Perform puncture: Wipe away first drop of blood

9. Label the specimen

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Skin Puncture Site Selection:

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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

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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

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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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