Dermal puncture sites by age, heel stick depth limits, microcollection order, newborn screening, and pediatric and geriatric approach.
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- What is the preferred puncture site for a heel stick on an infant?
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The medial or lateral plantar surface of the heel.- Up to approximately what age is heel stick the recommended dermal puncture method?
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About 12 months old, or until the infant is walking.- Which fingers are preferred for a finger stick?
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The middle or ring finger.- Where on the finger should a finger stick puncture be made?
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The palmar surface of the distal segment, slightly off-center from the pad.- Why is the little (pinky) finger avoided for a finger stick?
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Its tissue is too thin, risking injury to the bone.- Why are the thumb and index finger avoided for a finger stick?
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They tend to be calloused, and the thumb carries a pulse, risking arterial puncture.- A heel stick puncture should not exceed ____ in depth.
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2.0 mm- Why must a heel stick avoid the posterior curvature (back) of the heel?
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The calcaneus (heel bone) lies close to the surface there, risking osteomyelitis.- What type of device should always be used for a dermal puncture?
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A sterile, single-use, retractable lancet with a fixed, controlled puncture depth.- Why is a manual, non-retractable blade not used for dermal punctures today?
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It cannot control puncture depth, increasing the risk of excessive depth and bone injury.- In which direction should a finger or heel puncture be made relative to the skin's ridge lines?
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Across (perpendicular to) the ridges, not parallel to them.- Why is the puncture site often warmed before a dermal puncture?
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Warming dilates blood vessels and increases blood flow, making collection easier.- What temperature and duration are typical for a heel warmer?
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About 42 degrees C for approximately 3 to 5 minutes.- Why should the first drop of blood from a dermal puncture be wiped away?
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It may be contaminated with tissue fluid or residual alcohol, which can affect results.- Why should a phlebotomist avoid excessive squeezing, or milking, during a dermal puncture?
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It can cause hemolysis and dilute the sample with tissue fluid.
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