NHA Certified Phlebotomy Technician (CPT)Collection RoutineMedium
A phlebotomy technician is performing a heel stick on an infant for a newborn screening. Which of the following areas of the heel is the safest and most appropriate for the puncture?
- AThe central arch of the foot.
- BThe medial or lateral aspects of the plantar surface.
- CDirectly under the heel bone.
- DThe posterior curvature of the heel.
Show answer & explanationAnswer & explanation
Correct answer: B. The medial or lateral aspects of the plantar surface.
The medial or lateral aspects of the plantar (bottom) surface of the heel are the recommended sites for infant heel sticks. These areas are furthest from critical structures like nerves, arteries, and bone, reducing the risk of osteomyelitis or nerve damage.
Why the other options are wrong
- A. The central arch contains nerves and tendons and is not a safe puncture site.
- C. Puncturing directly under the heel bone (calcaneus) can lead to osteomyelitis (bone infection) in infants.
- D. The posterior curvature (back of the heel) is too close to major nerves and arteries, and the heel bone, increasing injury risk.
Infant Heel Stick Site
The specific, safe area on an infant's heel designated for dermal puncture to collect capillary blood, avoiding critical anatomical structures.
- Medial or lateral aspects of the plantar surface.
- Avoids the center, posterior curvature, and arch of the foot.
- Crucial for preventing osteomyelitis and nerve damage.
- Puncture depth should not exceed 2.0 mm.
Memory trick: HEEL Safely: Hot (warm), Edge, Avoid Center, Lancet Size.