Phlebotomy and Heel Stick Procedures

Heel stick phlebotomy has become the best means for drawing blood from newborns in order to screen for disease and other disorders within the first 24 hours of life. The procedure involves a small prick on the infant's heel which generates a thin flow of blood which is then gathered for the lab to analyze. These tests are vital to ensure that no infection or other illness has been contracted while the newborn is at the hospital and to ensure that mom and dad are leaving with a healthy baby.

Patient Identification

• Before any phlebotomy procedure may be conducted, the phlebotomist must identify the patient by verifying name tag identifiers for the newborn. It is important that the patient have her name tags correctly completed by the attending registered nurse so the phlebotomist can correctly administer the procedure to the patient that is supposed to receive it. Avoid "yes" or "no" responses when questioning nurses as to the identity of a given patient as this may lead to confusion.

Patient Preparation

• Hands should be washed prior and immediately after finishing all phlebotomy procedures. Gloves should be worn at all times during the procedure and should not be altered in any fashion. The patient's heel should be swabbed down with warm moist heat for three to five minutes before being wiped with alcohol. Gloves should be changed at this time in preparation for the lancing procedure.

Specimen Gathering

• Grasp the patient's heel in a firm, yet gentle, grip with a forefinger at the arch of the foot and thumb directly on the ankle. The phlebotomist must then open the sterile blood lancet packet without touching the tip in order to maintain a sterile environment for the infant. Once successfully completed, the puncture is made in one continuous motion less than 20 mm deep at the top of the infant's heel. Blood flow should be collected with a capillary specimen collection tube.

Specimen Labeling

• Blood samples should be clearly labeled with the patient's name, date of birth, account number, date of sampling, time of sampling, location the sample was drawn and the initials of the phlebotomist that gathered the sample. Once the procedure has been completed, the phlebotomist should stop any blood flow using sterile gauze.