Heelstick Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Heelstick and links to relevant pages within the course.
Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.
| Discussion Hemolysis can easily be caused by improper phlebotomy techniques. Hemolysis occurs when RBCs are broken up and hemoglobin is released into the plasma, causing it to become pink rather than its natural straw color. Hemolysis can occur by using too small a needle, pulling a syringe plunger too rapidly, expelling blood vigorously into a tube, or shaking a tube of blood too hard. Hemolysis can cause falsely increased potassium, magnesium, iron, and ammonia levels, and other aberrant lab results.In this case, Marcie did not properly wipe the site with gauze after cleaning it with alcohol, and alcohol contacting the blood could have caused RBCs to break up or hemolyze. Marcie also squeezed the baby’s foot too hard, causing hemolysis.Relevant topics:Site selection and preparation, Heelstick: Puncture, Hemolysis, Causes of hemolysis | View Page |
| Blood collection tubes: sizes Adult tubes generally hold from 3 to 10 ml of blood.
Pediatric tubes usually hold from 2 to 4 ml.Tubes for fingersticks or heelsticks generally hold one half ml or less.
| View Page |
| Heelstick - Neonatal Blood collection Microlances (such as the Tenderfoot™ (ITC) or the QuikHeel™ (BD), shown here, are used to puncture the heel & collect capillary blood.These devices control the depth of incision, since going too deep into an infant’s heel could injure the heel bone, and cause osteomyelitis (bone infection). | View Page |
| Heelstick - Apply sterile gauze After collection is completed, apply pressure to the puncture site with a sterile gauze pad until bleeding has stopped.Do not apply an adhesive bandage to an infant’s foot since it may injure its delicate skin. | View Page |
| Heelstick - Pediatric collection procedures: Introduction Veins of small children and infants are too small for venipuncture;Safety Lancets are used to puncture the skin and collect capillary blood.Butterfly needles may be used to collect venous blood in older children.
| View Page |
| Heelstick - Site selection and preparation Firmly grasp the infants foot. Do not use a tourniquet. The heel may be warmed with a cloth to help increase blood flow. Wipe the collection site with an alcohol prep pad, and allow the alcohol to dry. Wipe the site with sterile cotton or gauze, to be sure all the alcohol has been removed. | View Page |
| Heelstick - Puncture Puncture the left or right side (outskirt) of the heel, not the bottom of the foot.Wipe away the first drop of blood since it may contain excess tissue fluid or alcohol which could alter test results. | View Page |
| Heelstick - specimen collection Collect the blood into the appropriate tube.Do not: Squeeze the infant’s foot too tightly and wipe with alcohol during the collection.These actions could result in hemolysis (breakdown of the red blood cells), invalidating the test results. | View Page |