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Comparison of capillary blood sampling using an automated incision device with and without warming the heel
Marianne Janes1, Janet Pinelli, Shannon Landry
1The Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada, and School of Nursing, McMaster University, Hamilton, ON, Canada.
Insights
Heel warming before heelstick procedures in infants does not increase blood volume collected. This practice may be an unnecessary use of nursing time and hospital resources for neonatal capillary blood sampling.
Area of Science:
- Neonatal care
- Pediatric phlebotomy
- Clinical trial methodology
Background:
- Capillary blood sampling (CBS) is essential for neonatal monitoring.
- Optimizing blood collection volume and procedure efficiency is crucial in infant care.
- The efficacy of pre-procedural heel warming for CBS in neonates is not well-established.
Purpose of the Study:
- To evaluate the impact of pre-procedural heel warming on blood volume obtained via heelstick in preterm and term infants.
- To compare the efficiency and infant distress levels between warmed and non-warmed heelstick procedures.
Main Methods:
- A randomized controlled trial was conducted with 100 preterm and term infants.
- Infants were randomized into two groups: heel warming (Control, n=50) and no warming (Experimental, n=50).
- Key outcomes included blood volume, collection time, crying duration, and repeat procedures.
Main Results:
- No significant difference in blood volume was observed between the warming and non-warming groups.
- Collection time, crying duration, and the need for repeat procedures were similar across both groups.
- The use of manual squeezing was more frequent in the control group (warming) compared to the experimental group (no warming).
Conclusions:
- Pre-procedural heel warming appears to be an unnecessary technique for capillary blood sampling in preterm and term infants.
- Implementing heel warming may lead to increased nursing time and hospital financial costs without demonstrable clinical benefits.
- Current evidence suggests that non-warmed heelstick procedures are equally effective and potentially more efficient.
Objective:
To determine if heel warming prior to heelstick increases the volume of blood collected compared to no warming.
Study Design:
Randomized controlled trial involving 100 preterm and term infants requiring capillary blood sampling (CBS), randomized to receive warming (Control) (n=50) or nonwarming (Experimental) (n=50).
Results:
This sample of infants showed no benefit of warming the heel prior to CBS. Volume of blood, collection time, crying time, and repeat procedures were not different between groups. More infants in the Control group received squeezing during the procedure compared to the Experimental group.
Conclusion:
Heel warming prior to CBS may be an unnecessary technique in preterm and term infants that expends nursing time and hospital financial cost.