Materials used in capillary puncture
Sterile dry cotton
Sterile wet cotton
Lancet or penlet
Capillary tube of capillette or an appropriate collection vessel
Steps in Capillary Puncture
The practitioner prepares materials and place them within reach.
They then identify the patient properly by asking his/her name.
A suitable site is selected, usually the ring finger of the left hand for adults and the big heel or big toe for infants.
The site of puncture is sterilized from the center going outwards in a circular manner.
With a smooth and deliberate manner, the site is punctured
The first blood is wiped and the specimen is collected making use of the capillary tubes or other appropriate container.
The wound is pressed for 3-5 minutes and a sterile dry cotton and a micropore or plaster are applied.
Additional Tips on Capillary Puncture
Practitioners should smile and introduce themselves before asking the name of the patient.
They should give a brief description of the test to be done.
Children 5 years old and below would most likely would need a restraining blanket or device.
Older children will usually understand if the doctor explains why they need to perform the procedure.
The practitioner needs to make them an active participant by making them understand that they need their cooperation for the success of the blood collection.
The other pads of the fingers and the earlobes are other alternative capillary puncture sites. Determine which is best for your patient by examining the site.
Practitioners should say thank you after the procedure.
Precautions on Capillary Puncture
The practitioner should not state the patient's name but let the patient state it. The patient may not hear correctly and still say yes or no.
He may state it, or have him spell it out, or best if he can write it down; and then patient identification can be done properly.
The practitioner's material should not be near the patient, especially if the patient is a child. Children can pull the material.
The practitioner should not underestimate children. They can become stronger when intimidated and afraid. They should be restrained properly.
The practitioner should not puncture sites which have hematoma or bruises.
The practitioner should wipe the first drop of blood, as it contains mainly tissue juices and may yield inaccurate results.
If the test is bleeding time (BT) or clotting time (CT) then the practitioner should not wipe the first drop of blood. There is protocol with these two tests.
The practitioner should make sure that all materials are sterile and dry to prevent infecting the patient and contaminating the blood samples.