The toxicology section of the lab provides blood lead testing for the identification of childhood lead poisoning and occupational lead exposure. Below is an abbreviated procedure for the collection of blood lead specimens by finger stick. Specimen collectors should be thoroughly familiar with the comprehensive procedure before collecting patient specimens.
Fingerstick Specimen from a Child
It is recommended to use the MicroVette® Capillary Blood Collection System by Sarstedt, Inc., a manufacturer and distributor of single use clinical and laboratory disposables, or the Vacuette® MiniCollect® Capillary Collection System by Greiner Bio-One.
These microcollection systems are simple to use as they automatically fill up due to normal venous pressure. They are designed for a single venous blood collection using one-handed control while the other hand of the phlebotomist holds the child's finger. All Greiner Bio-One blood collection tubes utilize a proprietary plastic formulation, special closure system and advanced ergonomic design to improve safety and integrity at every step.
*MicroVette is registered trademarks of Sarsted.
**Vacuette and MiniCollect are registered trademarks of Greiner Bio-One.
Procedure Safety and Precautions
When collecting a blood lead specimen careful setup and precautions must be taken throughout the procedure to prevent environmental contamination of the specimen. It is important that the patient's (child's) hand is sufficiently cleansed because contamination most often occurs due to insufficient cleansing.
Contamination can also be caused by the lancet or the end of the blood collection apparatus which may have been in direct contact with a contaminated surface. Also it is best to wear powder-free gloves during collection procedures and as always appropriate blood borne pathogen guidelines must be strictly adhered to.
And Don't Laugh! Sing...
Laughing when a child is afraid is very insensitive, if not humiliating. Then again, sometimes, people have awkward ways of dealing with painful situations and when a parent sees their child in pain you never know how they may react. It is okay for a phlebotomist to remind the parent to remain calm and encourage them to reassure the child throgh touch, and voice.
Kudos to the parents and the phlebotomist in this video.
ATTENTION: Please realize that this video (published from YouTube) is NOT HERE TO TEACH you phlebotomy techniques, but merely to show you different scenarios of the phlebotomist's daily routine. The video may contain techniques, or procedures that do not conform to proper, and safe venipuncture protocol. Viewer discretion is strongly advised.
Collection Procedure and Some Words of Wisdom!
Be aware of safety measures and precautions
Open and arrange equipment so that all collection materials are within easy reach
Label all collection tubes with the child's name. Avoid allowing the capillary tip to contact environmental surfaces.
Wash, rinse, and dry the child's hand. Following washing, the finger to be punctured must not be allowed to touch any surface, including the other fingers.
Scrub the finger (usually the middle or ring finger) with an alcohol pad.
Blot the sampling area once with a dry gauze pad.
Puncture the finger's pad slightly to the side using a sterile lancet.
Absorb the first drop of blood with the corner of a gauze pad and allow a second well rounded drop to form.
Touch the capillary tip of the MultiVette® to the second blood drop, minimizing direct contact with the skin surface. The Multivette should be horizontal or angled downward slightly for proper blood flow. Blood will be drawn into the tip.
If necessary, gently massage the base of the finger to improve blood flow. Do not 'milk' the finger as this may dilute the blood with tissue fluids.
Fill the capillary tip until blood is flush with the purple cap of the MultiVette®. This will provide approximately 100 mL of blood. Unscrew the capillary assembly and remove. Blood will be drawn from the tip into the Multivette tube.
Screw the cap onto the Multivette®, and shake vigorously to mix. You should be able to hear the mixing doughnut while shaking.
Place the labeled tube and absorbent material into a Ziploc bag.
Place the specimens and completed test request forms in mailing containers. For convenience, several labeled MultiVette® tubes may be placed in one Ziploc® bag for mailing.
Mail specimens promptly to the hematology/toxicology reference lab. If mailing will be delayed, refrigerate the specimens if possible.