Question

What steps will you take to perform a dermal puncture?

Answer 1

A dermal (skin) puncture may be required when a venipuncture cannot be performed or may be the option of choice for some point-of-care test procedures. A dermal puncture may be a fingerstick or, in the case of small infants, may be a heelstick. Dermal puncture (capillary blood) is an alternavtive to venipuncture to obtain the blood sample. The dermal puncture is preferred of the venipuncture is inappropriate or impossible.

Patient safety for these collections involves proper identification prior to specimen collection, care in preparing the collection site, proper technique during collection, and treatment of the puncture wound following collection. The technique that is used for collection of the specimen must also prevent the introduction of errors that could cause the specimen to be rejected and require recollection.

Dermal Puncture Steps

1. obtain and examine requisition
2. greet patient and explain procedure
3. identify patient by two identifiers ( name, dob)
4. compare patient information with requisition ( if patient, compare with armband)
5. sanitize hands and put on gloves
6. position patient
7. select appropriate puncture site
8. warm site if applicable
9. cleanse site with alcohol and allow to air dry
10. assemble rest of equipment needed
11. smoothly perform puncture
12. dispose of sharp in sharps container
13. wipe away first drop of blood
14. fill tubes in correct order of draw
15. apply pressure to puncture with gauze
16. seal tube and invert tube to mix (8-10 times)
17. label tube
18. examine puncture site for stoppage of bleeding and apply bandage
19. dispose of other used supplies as needed
20. thank patient
21. remove gloves and sanitize hands