Newborn Screening Blood Sample Collection Procedure
1. Complete the required information on the specimen collection form, using a ballpoint pen. To prevent specimen contamination do not touch the filter paper circle area.
2. Gloves must be worn for specimen collection per OSHA guidelines. Filter paper must not come in contact with gloved hands, formulas, antiseptic solutions, lotions, or other materials at any stage of the collection process. These materials may be absorbed into the filter paper and adversely affect the specimen and diagnosis.
3. Select the puncture site on the heel. The shaded areas on the following diagram indicate the preferred puncture sites. The least hazardous sites for heel puncture are medial to a line drawn posteriorly from the middle of the big toe to the heel or lateral to a line drawn posteriorly from between the fourth and fifth toes to the heel.
4. Warming the skin-puncture site may increase blood flow to the site. A chemical heel-warmer pack or a warm, moist towel at a temperature no higher than 42° C may be used on the site for 3 minutes. Keep foot in dependent position to increase blood flow.
5. Cleanse site with 70% isopropyl alcohol and allow to air dry. Vigorous rubbing during this step may stimulate blood flow to the area.
6. Puncture the skin with one continuous motion using a sterile lancet with < 2.5 mm tip. Longer tips may cause excessive tissue damage.
7. Wipe away first drop of blood with dry, sterile gauze and discard, since it may be contaminated by disinfectant or tissue fluid.
8. Allow the second drop to form by spontaneous free flow of blood.
9. Touch the filter paper form to the drop of blood, as close to the center of the circle as possible. While observing from the opposite side, allow the blood spot to enlarge until the circle is reasonably filled (2/3 filled).
10. Check that written information on collection form is accurate and complete. Do not forget to fill in "date and time of collection."
11. Dry specimen for 3 hours and send to VU lab (central receiving) in a plastic specimen bag. Do not fold form.12. Complete a State Newborn Screen Report Form, review, have peer review with signature, have medical receptionist scan this form into StarPanel, and file in the patient chart.
13. For first specimens, give the parents the lavender-colored pamphlet (English) "Your Baby and Newborn Screening" or peach-colored pamphlet (Spanish) "Su Bebé y Exámenes en el Recién Nacido". Inform parents that the State Screen was done.