Originally posted by Zzub
In a newborn, you can't take blood from the viens, apparently. I did ask at the time. It was a horrible experience, the boy was screaming and the
nurse had to press quite hard to get blood.
It didn't look like a blood sample was being taken. I meant to bring it up at the time.
They do the heel, cause it is the best place to do it in. Yes it is a little painful but better than trying to stick their arms. Plus they need it for
PKU and other nasty critters.
"infants be screened for the following seven diseases:
congenital hypothyroidism, phenylketonuria (PKU), galactosemia,
hemoglobinopathies, congenital adrenal hyperplasia (CAH), medium chain acyl-
CoA dehydrogenase (MCAD) deficiency, and biotinidase deficiency."
MY SO who is a CCRN (Critical Care RN) hates it when they do several heel sticks on the same baby.
And she does what is called cluster sticks ---see example---
"Only a single drop of blood is needed for this (okay, two drops- always wipe away the first drop and get your reading on the second), and doing a
heelstick, IMO, is unnecessary/excessive unless you're also obtaining other blood samples at the same time (ie, for AM labs or for a blood gas, which
brings me to another point- CLUSTER YOUR STICKS! Coordinate your care with the respiratory team so that you can minimize the number of times the baby
gets stuck whenever possible!). The lancets used for heelsticks (like the Tenderfoot lancets- the white/pink or blue/pink ones?) have longer blades
that go a bit deeper; they're meant for larger blood samples. When getting a glucose sample only, you can use a smaller lancet (like the tiny pink
lancets or the white ones with the blue push button- I've seen both and have no idea who makes them, but hopefully you'll know what I'm talking
about). Also, you can get a glucose from the big toe or thumb, or, if you have to, any of the fingers or toes (and alternate your sites so that the
puncture areas have a chance to heal). If your unit is doing heelsticks for just blood glucose, I would highly suggest that you talk to your
supervisor about this in a non-confrontational, professional way and find out why. If people are doing this regularly, perhaps this is a practice that
should be changed- maybe you can get an inservice from someone to teach everyone on the unit the proper way to draw blood? Someone from phlebotomy? An
NNP? A nurse who has done her research? Don't be afraid to question! Advocate for the babies! No one can ever fault you for looking out for the best
interest of the babies, even if you are incorrect"
They use their head for IV's (in lil tiny preemies) cause it is also easy to do, and the baby will have less of a chance to pull it out. It's scary
for a parent to walk in and see this, but my SO does a good job of explaining why it is needed and it is for the comfort of the baby also.