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11/13/24, 7\:25 PM Guide | Neonatal CBG (heel prick)

Neonatal CBG (heel prick)

Table of contents

Background

A capillary blood sample is a less invasive method of collecting blood samples than venepuncture and can preserve venous
access. A capillary blood gas involves collecting a small volume blood sample, which can be analysed using a blood gas
machine providing information on acid-base status, ventilation and electrolytes).
Capillary samples can also be sent for other tests (e.g. U&E, glucose). However, venepuncture may be a better option if
multiple tests are required.

Gather equipment

Collect all equipment needed for the procedure and place it within reach on a tray or trolley, ensuring that all the items are
clearly visible\:
Clean procedure tray
Non-sterile gloves
Apron
Lancet
Capillary tube and silicone plugs
Sharps container
Alcohol swab (2% chlorhexidine gluconate in 70% isopropyl)
Soft yellow para
Gauze
Sterile plaster
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Gather equipment

Choosing a lancet device

Choose a lancet device to perform a capillary blood gas. Always follow local guidelines, as local equipment may vary.
Infants \< 2000g\: yellow Neoheel™ lancet
Infants >2000g\: blue Neoheel™ lancet

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Don PPE if appropriate.
Introduce yourself to the parent/carer, including your name and role.
Con
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i n v o l v e s a s m a l l p r i c k i n t o t h e h e e l . T h e p r o c e d u r e w i l l o n l y t a k e a f e w m i n u t e s .
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“ T o d a y , I n e e d t o t a k e a b l o o d s a m p l e , w h i c h
Gain consent from the parent/carer to proceed with capillary blood gas sampling.
Check if the patient has any allergies (e.g. latex).
Adequately expose the patient’s foot for the procedure.
Position the patient comfortably, with skin-to-skin or parental contact.
To reduce discomfort, administer appropriate pain relief, such as expressed breast milk, non-nutritive sucking or sucrose.

Choosing a site

Choose a site to perform a capillary blood gas on\:
Select a site that is warm and has good perfusion on the lateral aspect of the heel
Avoid the posterior curve of the heel and any sites that have been previously bruised or have di
bandages/lines etc.
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Pre-existing medical conditions may prevent particular limbs from being used (e.g. arterio-venous
stroke a

Perform the capillary blood gas

1. Clean the chosen site with an alcohol swab (if preterm, clean with a saline wipe) and allow it to dry.
2. Hold the patient’s heel in a circle between thumb and index
3. Place the lancet device
4. Wipe away the
5. Apply a thin layer of soft para
6. Squeeze the heel gently but
7. Place the capillary tube close to the puncture site/droplet of blood in a slightly downward position to allow easier blood
into the tube.
If blood is not
If the blood appears to have dried, try to clean the site and apply pressure again.
8. Collect the blood and
If air bubbles exist, invert the tube downward to bring the blood forward and remove the bubbles, then continue collecting
the sample.
9. Cap the tube with the silicone plugs.
10. Apply pressure to the puncture site with gauze until the bleeding stops, then apply plaster.
A correctly

To complete the procedure…

Explain to the parent/carer that the procedure is now complete and that they should seek review if the puncture site
becomes in
Thank the parent/carer for their time.
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Dispose of sharps, PPE appropriately and wash your hands.
Immediately take the tube to a blood gas machine with the patient's details to process.
Source\: geekymedics.com
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