A safety lancet for neonatal blood spot tests: a design that facilitates pain-free, atraumatic samples
Safety lancets are used to collect capillary blood samples to test if neonates have rare but serious congenital conditions, such as sickle cell disease, cystic fibrosis, congenital hypothyroidism and inherited metabolic diseases. Blood samples are taken from the heel, but the procedure can cause the neonate pain or discomfort, as well as a risk of local trauma to the nerves and blood vessels, bleeding, infection and scarring. This article explores the need for blood sampling in neonates, discusses the procedure and outlines the types of lancets available. It describes the Neoheel Safety Lancet (Smiths Medical), whose features are designed to avoid pain and trauma during the procedure. Three case studies are included to describe its use in clinical practice.
In neonates, blood samples obtained from an artery or vein are regarded as the ‘gold standard’ for laboratory specimens as they are perceived to reflect the body's true values. However, sampling from arteries and veins is not always feasible and the risks associated with indwelling catheters, such as thrombosis and infection, limit the duration for which they can be left in situ (Bruck, 1991). Furthermore, in hospitalised sick neonates, repeated venous sampling can limit the number of intravenous sites available for the administration of total parenteral nutrition or medications. Capillary blood sampling, therefore, remains the preferred method of obtaining small amounts of blood for laboratory analysis. Compared with venepuncture or arterial puncture, this procedure is easier and safer. Furthermore, the results of most laboratory tests of these samples have been found to be comparable to those from blood drawn from arterial catheters (Yang et al, 2002).
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