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Capillary Puncture Steps

The first four capillary puncture steps are very similar to the venipuncture steps for collection. Each test request should be reviewed before the test is started. The phlebotomist should approach the patient and identify herself before preparing the patient for the capillary puncture. The phlebotomist should also verify the patients dietary restrictions and determine if the patient has a sensitivity to latex. The phlebotomist should sanitize her hands and put on gloves before beginning the test.

The next steps differ from the venipuncture steps.

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Step 5: Position Patient

For finger punctures, the patient's arm should be supported on a firm surface. The hand should be extended and the palm should be facing up. A young child can sit on a parent or guardian's lap and be restrained with one arm while the adult's other arm is used to hold the child's arm steady. An infant may have the heel punctured. An infant should always be lying face up with the foot lower than the torso. This position will help with the collection process by having gravity assist with blood flow.

Step 6: Select the Puncture Site

The best site for a puncture or incision is ont that is warm, pink or normal in color and free of scars, cuts, bruises, or rashes. A puncture site should not be swollen, infected or cyanotic. Obtaining a blood specimen from an infected or swollen site could negatively affect test results. The fingers and hand are typically used for capillary punctures on adults. The heels are used for capillary punctures of infants.

There are specific guidelines that should be followed when obtaining blood from a capillary puncture site.

-Do not collect blood from fingers on the same side as a mastectomy unless you have consulted with the physician first.

-Do not puncture an infant or child's finger if they are under the age of 1 year.

-Do not puncture the tip or side of the finger.

-Do not puncture the index finger because it is more sensitive and can be harder to puncture.

-Do not puncture the fifth or little finger because the bone may become injured.

-Do not puncture the thumb.

-Do not puncture parallel to the lines of the fingerprint.