Performing Heel Sticks in neonate and infants may be used for:


	•	Capillary blood gas (CBG)


	•	Collection of labs requiring < 1 cc in which other sources for collection may be limited.

Note: If collecting Potassium specimens via heelstick or fingerstick, the blood must be free-flowing.

Hemolysis can occur and skew the value of K+ (false high value).

Pre-procedure


	•	Refer to guidelines cited on lab page.


	•	Use lancet and microcontainer, capillary, or hematocrit tubes as correct.


	•	Prewarm the infant's heel**


	•	About 3-5 minutes at 42 C.

** Rationale: Increases the flow of blood for collection.

SAFETY:


	•	Avoid thermal injury because the infant's skin is thin.

•

Select the correct site.


	•	Regions are shown in darker purple.


	•	Any other area can cause injury to the underlying bone.


	•	Do not use a previous puncture site.

Procedure:


	•	Hold the baby's foot firmly.


	•	Clean the site with an alcohol sponge. Dry the cleaned area with a dry cotton sponge.


	•	Using a sterile blood lancet, puncture the side of the heel in the appropriate area.


	•	Wipe away the first drop of blood with a piece of clean, dry cotton pad.


	•	Use gentle pressure to produce a rounded drop of blood.


	•	Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid or hemolysis of cells may occur.


	•	A very thin smear of petroleum jelly will reduce the surface tension and cause the blood to form a drop.


	•	Fill the capillary tube(s) or micro container(s) as needed.

(Sample brand of microcontainer used in hematology collection.)

Note top of tube helps direct flow into the container. This is removed once volume is collected and replaced with the attached purple top.

Post-Procedure


	•	When finished, elevate the heel, place a 2 x 2 pad on the puncture site, and hold it in place until the bleeding has stopped.


	•	Dispose of the lancet in the appropriate sharps container.


	•	Remove gloves and wash your hands.

ldp