NHA Certified Phlebotomy Technician (CPT)Patient PreparationMedium
A phlebotomy technician is preparing to collect a blood sample for a bilirubin test from a newborn. Which of the following is the MOST important patient preparation consideration for this specific test?
- AWarming the heel prior to the skin puncture.
- BProtecting the specimen from light immediately after collection.
- CEnsuring the infant is calm and not crying.
- DVerifying the infant's feeding schedule.
Show answer & explanationAnswer & explanation
Correct answer: A. Warming the heel prior to the skin puncture.
For heel stick collections, especially in newborns, warming the heel significantly increases blood flow to the capillaries, making collection easier and reducing the need for repeat punctures. This is crucial for a successful and less traumatic collection.
Why the other options are wrong
- B. Protecting the specimen from light is a post-collection handling step for bilirubin, not a patient preparation step.
- C. While a calm infant is always preferred, warming the heel is a direct physiological intervention to improve blood flow for collection.
- D. Verifying feeding schedule is generally important for newborns but not the MOST important preparation specifically for a bilirubin heel stick.
Newborn Heel Warmth
Before performing a heel stick on a newborn, applying a warm compress to the heel for 3-5 minutes is crucial to increase blood flow, making capillary collection easier and reducing the risk of hemolysis and repeat punctures.
- Warming dilates capillaries.
- Increased blood flow aids collection.
- Reduces trauma and risk of hemolysis.
- Standard practice for newborn heel sticks.
Memory trick: Warm the heel, make the blood flow swell.