Stating that collecting blood samples in newborns, especially in premature babies, can be a difficult and sometimes restrictive procedure depending on the conditions, Prof. Dr. Nilgün Tekkeşin said, “Heel stick is a minimally invasive and easily accessible way to obtain capillary blood samples for various laboratory tests, such as newborn screenings and glucose level measurements.”
Noting that the heel stick procedure is generally used until the baby is 12 months old, Prof. Dr. Nilgün Tekkeşin said, “Heel blood samples are most easily obtained when the baby is in a supine position.”
Prof. Dr. Nilgün Tekkeşin from the Department of Medical Biochemistry (English) at Üsküdar Üniversitesi Faculty of Medicine, provided important information about the “heel stick” technique, one of the most commonly used methods for collecting blood samples from newborns and premature babies.
Collecting blood samples in newborns is difficult
Stating that collecting blood samples in newborns, especially in premature babies, can be a difficult and sometimes restrictive procedure depending on the conditions, Prof. Dr. Nilgün Tekkeşin said, “The size of veins and volume status in these patients can pose a challenge for venous access even for the most skilled healthcare professional. Capillary blood sampling is the most commonly used method for taking blood samples from babies. In some cases, the heel stick technique is also used for capillary blood samples.”
Heel stick, an easily accessible method for tests…
Stating that this technique is useful for small blood samples or repeated small-volume blood samples, Prof. Dr. Nilgün Tekkeşin said, “Heel stick is a minimally invasive and easily accessible way to obtain capillary blood samples for various laboratory tests, such as newborn screenings and glucose level measurements. However, thanks to advanced laboratory techniques requiring smaller sample volumes and advanced automated heel stick devices that minimize trauma and pain, heel stick has become a viable method for obtaining blood for many routine blood tests.”
Venous blood collection is not suitable for all babies
Explaining that there is some evidence that venous blood collection in newborns may result in less pain than heel stick, but this procedure may not be suitable for premature babies or babies requiring multiple and frequent blood sampling, Prof. Dr. Nilgün Tekkeşin stated, “The development of newer, more effective, and less painful lancing devices could increase the relative benefit of heel stick.”
Heel stick is generally used until 12 months of age
Also noting that the heel stick method is ideal for premature babies, newborns, and infants, Prof. Dr. Nilgün Tekkeşin said, “Heel stick is generally used until 12 months of age. Heel blood sampling is functional whenever capillary blood is an acceptable source. Such situations include: the required sample is relatively small, another acceptable blood source (e.g., central venous catheter, umbilical cord catheter, arterial line) is not currently available, and samples taken from the heel can be used for general biochemistry and liver function tests, complete blood count, newborn screening, bedside glucose monitoring, and blood gas analysis.”
Local anesthesia can affect blood sample quality
Prof. Dr. Nilgün Tekkeşin also stated that standard local or systemic pharmacological anesthesia is not required for the heel stick technique, and continued:
“On the contrary, local anesthetics can affect the quality of the blood sample. However, oral sucrose, ambient light adjustment, noise reduction, and swaddling can be recommended to comfort the baby. A heel stick device of appropriate size for the baby's weight should be preferred, thus controlling the incision size and minimizing trauma. Heel blood samples are most easily obtained when the baby is in a supine position. Proper site selection is important to minimize pain and prevent contact with the calcaneus bone.”
