Heel Stick Capillary Blood sampling

Heel stick is a minimally invasive and easily accessible way of obtaining capillary blood samples for various laboratory tests, especially newborn screens and glucose levels.

Indications
For the collection of blood in neonates and infants.

Contraindications
Edematous skin puncture site
Children older than 1 year of age.

Materials need for the procedure

• Sterile gauze
• Alcohol wipe
• Heel warmer
• Automatic lancet device
• Appropriate containers for blood sample
• Adhesive bandage
• Sterile gloves

Procedure

1. Warm the infant’s heal for approximately 5 minutes. With gloved hands , cleanse the area with alcohol wipe. Hold the foot firmly with the leg in a tucked – flexed position

2. Grasp infant’s heel in a moderately firm grip, with the fore finger at the arch of the foot and the thumb below the puncture site at the ankle.

3. Puncture the heel on the most medial or lateral portions of the planter surface of the heel ( medial to a line posteriorly from the mid great toe to the heel, or lateral to a line drawn posteriorly between the fourth and fifth toe to the heel ).

4. Wipe away the first drop of blood with sterile gauze. If the blood is not free flowing, use gentle massage to produce a rounded drop of blood. Gentle pressure should be eased and reapplied as drops of blood flow into containers.

5. After blood has been collected , elevate infant’s foot above the rest of the body and press sterile gauze against the puncture site until bleeding stops. Cover the site with an adhesive bandage.

Complications

• Infection or abscess of the heel
• Necrotizing osteochondritis