Blood Collection:
Finger and Hand

PRC-PALM- SPC-5.51-pro1-prs4: FINGER STICK AND HAND COLLECTION PROCESS

Finger stick Collection:

Proper hand hygiene which includes proper hand washing/antiseptic hand-rub and proper use of gloves with every finger stick is to be followed. Wash hands using foam antiseptic hand-rub or antiseptic soap and water. Wear gloves, a lab coat and other personal protective equipment as necessary. If obtaining blood from a small child or infant, have the child or infant sit on an adult’s lap with the adult holding the child’s elbow.

Do puncture:

• The finger of a child greater than 1 year of age or an adult
• Use: 3rd and 4th fingers of the non-dominant hand

 
Do not puncture:

• Tip, center or side of finger
• 2nd index finger-thicker, callused skin
• 5th finger-less soft tissue overlying the bone
• Avoid cold, cyanotic, swollen, scarred or covered in rash fingers

Note:  The best locations for finger sticks are the 3rd and 4th fingers of the non-dominant hand. Do not use the tip of the finger or the center of the finger. Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface. The 2nd (index) finger tends to have thicker, callused skin. The fifth finger tends to have less soft tissue overlying the bone. Avoid puncturing a finger that is cold or cyanotic, swollen, scarred, or covered with a rash.

• Puncture position should be 3rd and 4th fingers of non-dominant hand
• Across the lines of the fingerprint, not along the lines of the fingerprint
• Why?
  • If cut made across the fingerprint and area has been wiped dry, the blood should well up into a large rounded drop. (Correct)
  • If cut has been made along the lines of the fingerprint, the blood will steam down the finger (Incorrect)

B. Lance the selected area of the child’s finger and wipe off the first drop of blood, which tends to contain excess tissue fluid. (Follow manufacturer’s guidelines).

C. Using a microtainer, allow one drop of blood at a time to fall from the puncture into the center of the opening of the tube and shake gently to move the drop to the bottom of the tube. The tube must be filled at least halfway and then capped.

D. The order of draw is important because of the tendency of platelets to accumulate at the site of the wound. Specimens should be obtained as follows:

1.  CBC (microtainer)
2.  Chemistry (microtainer)

E. Provided the child is over 1 year old, a bandage/coban can be applied to the puncture site when blood collection is complete.

F. Dispose of the lancet in a sharp container.

G. Label tubes. Place tech code, time, and date on requisition form, if applicable.  Remove gloves and wash hands.

Hand Collections:

Special circumstances require blood to be collected from a hand. Using a straight needle or butterfly is acceptable.