Pre-Examination Challenges Encountered with Capillary Blood Collection and Testing

Alexandru Casapu, MBA, MLS(ASCP)CMPBTCM
Reviewer: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM and Kevin McNeil, MBA-HCA, MLS(ASCP)CM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General: 1 hour(s)

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It is very important that the healthcare providers collecting and testing capillary samples are properly trained and adhere to the policies and procedures in order to reduce errors and ensure quality results. Test results are only as good as the sample used for testing. This course is meant to help with such challenges and will point out where care needs to be taken at the different steps along the way in order to avoid pre-analytical errors.

Objectives

  • Describe the composition of capillary blood, how it differs from venous blood, and how tests results may or may not differ from venous blood tests.
  • Outline the reasons for performing capillary blood tests, including their advantages and disadvantages.
  • Describe the proper puncture sites for heel and finger capillary blood collection.
  • Identify errors that should be avoided during capillary blood collection.
  • Identify errors that should be avoided during transport and storage of capillary specimens.

Course Outline

  • Introduction
    • Introduction to Capillary Blood Collection and Testing
    • Composition of Capillary Blood
    • Testing Situations When Capillary Blood Collection is Appropriate
    • Common Tests Performed on Capillary Blood
    • Testing Situations When Capillary Blood Collection is Not Appropriate
    • What is capillary blood composed of?
    • When is capillary blood collection not appropriate?
  • Types of equipment needed specifically for capillary blood collection
    • Special Devices for Capillary Blood Collection
    • Capillary Blood Gas Equipment
    • If a patient's dermal collection site is cyanotic, how should the phlebotomist proceed?
    • During the capillary blood gas collection process, what is the purpose of the metal "flea"?
  • Common steps for finger and heel capillary collection
    • Typical Sites for Capillary Blood Collection
    • Supplies and Equipment
    • Identification of Patient
    • Diet Restrictions
    • Effect of Stress on Capillary Blood Collections and Test Results
    • Positioning the Patient
    • Site Selection
    • Site Cleansing
    • Site Puncture
    • Filling and Mixing Collection Tubes
    • Order of Draw
    • Match the following site cleansing error with its consequence for capillary blood collection:
    • When performing a heel puncture on an infant, how deep should the puncture be?
    • Match the capillary specimens with the order in which they should be collected according to the Clinical and Laboratory Standards Institute (CLSI).
  • Specimen handling
    • Labeling Capillary Blood Specimens
    • Specimen Transport
    • Effects of Clotting on the Capillary Blood Sample
    • Effects of Temperature on the Capillary Blood Sample
    • Effects of Hemolysis on the Capillary Blood Sample
    • Effects of Light on Specimens
    • Specimen Storage
    • Which of the following scenarios is not a concern for a phlebotomist when collecting a bilirubin specimen from a neonate?
    • Choose whether the analyte will be falsely increased or decreased due to hemolysis.
  • References
    • References

Additional Information

Level of Instruction: Basic
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Alexandru Casapu, MBA, MLS(ASCP)CMPBTCM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.
The author has no conflict of interest to disclose.
Reviewer Information:
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab by Vastian. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Kevin McNeil, MBA-HCA, MLS(ASCP)CM received his Master of Business Administration in Healthcare Administration in 2011 from South University in Atlanta, Georgia, and his BS in Medical Laboratory Science from the Medical College of Georgia. He is currently a Senior Systems Analyst at Gwinnett Medical Center in Lawrenceville, Georgia. Kevin had been employed with Gwinnett since 2006, working as a generalist and previously as a Phlebotomy Supervisor.