Bloodspecimencollection 2
Bloodspecimencollection 2
Bloodspecimencollection 2
Skin puncture (fingerstick) blood is a mixture of blood from arterioles, venules and capillaries and contains interstitial and intracellular fluids. Skin
puncture samples may be obtained to determine blood chemistry, hematology and/or blood gas values in neonates and young children when
venous or arterial access is severely limited. These specimens are commonly used in patients with severe burns, extreme obesity, thrombotic
tendencies, some malignancies using venous access for therapeutic purposes, geriatric or others with inaccessible or fragile superficial veins. If a
patient is dehydrated or has poor peripheral circulation, it may be impossible to obtain a representative blood sample from a skin puncture.
Site selection
Capillary punctures are to be performed on the fleshy pad of the fingertips in patients 12 months of age and older. Sides of the fingers should
be avoided due to the following: 1) less tissue between skin and bone makes it more likely to injure periosteum, which makes a procedure
more painful and may increase the rate of possible complications; 2) side of the finger incisions may be associated with injury to distal neuron-
vascular bundle, increasing the likelihood of more prolonged bleeding and sensation disturbance at the finger-tip.
Third or fourth finger preferred.
For infants up to 12 months, only medial or lateral plantar surface of the heel should be used. Avoid back curvature of the heel, which is the
side of Achilles tendon attachment.
If arterialized capillary blood is needed (as for arterial blood gas analysis), pre-warmed ear lobe is the preferred site of collection.