Babies' veins are smaller and they tend to squirm much more than adults and even older children during any type of medical procedure. For this reason, the phlebotomy techniques used on youngsters and adults are often inadequate for babies. Understanding how these techniques differ can put new parents at ease when they must take their babies to get blood work.
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The recommended location for collecting blood from a newborn baby or infant is the heel, according to a phlebotomy tutorial on the University of Utah's website. More specifically, blood should be drawn from the two bottom, side corners of the heel. Prewarming the infant's heel to about 42 degrees Celcuis can make drawing blood easier because it increases circulation. A sterile blood lancet should be used to create a puncture. Often, newborns don't bleed immediately, so gentle pressure should be used on the puncture site to produce blood droplets.
If tapping into a vein to collect blood, it's recommended that the dorsal vein on the hand be used, according to Bonnie K. Davis in "Phlebotomy: A Customer Service Approach." That's because this technique decreases hemolysis, or the destruction of red blood cells. It also decreases the risk of dilution due to the presence of interstitial fluids, and the number of punctures required, which in turn decreases a baby's agitation. This procedure is almost identical to any other type of venepuncture, but a smaller needle and butterfly wingset is used, and greater care must be placed on inserting the needle slowly so that the needle does not pierce through the vein.
Some babies don't mind having blood drawn, but these are likely the exception rather than the rule. This means that phlebotomists need to understand how to deal with babies who may be agitated and flailing around. If restraining the child becomes necessary, they should ask a parent or guardian present to help do so. If parents are unable to restrain the child or seem distressed by the process, other medical personnel can be enlisted to help hold the patient still. Tokens and praise for bravery can make the experience less traumatic, notes the University of North Carolina Health Care Systems.
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