No More Heelsticks?

Specialties NICU

Published

A group of our nurses are in the process of being trained on a new way to draw blood, then they will train us. It's drawing blood from a capillary bed on the forearm (I think), or somewhere on the arm. Like I said, we haven't been trained yet, but we will be here in the near future.

Just wondering if anyone else is doing this? What do you think of it? Better than heelsticks or not?

TiffyRN, BSN, PhD

2,315 Posts

Specializes in Nurse Scientist-Research.

I'm very interested in hearing about this. My first thought is scarring? Not as big a deal to have scars on your heels as all over your arms, in my opinion. Certainly not all babies get this, but some of our chronics have scars right on the sides of their heels from heelsticks. One of our nurses who had a micro (now a healthy 5yo) says the scars are still visible on his heels.

Specializes in NICU.

Correction ..... it's from a venous pool, not a capillary bed.

There are a certain number of people in the training group that have been checked off and they are teaching the rest of the people in the training group. Then eventually they all will train us. I'm interested to hear more about it too. They've been talking and researching about this for a while now.

Mimi2RN, ASN, RN

1,142 Posts

Specializes in NICU.

I don't like heelsticks, but I can't imagine getting venous blood for everything, including a drop for blood sugar testing. Let us know how this works!

Mags4711, RN

266 Posts

Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

I agree that heelsticks are ridiculously barbaric. We have an attending who had twins while she was a fellow with us and mentioned that her kids walked on their tiptoes for quite a while when they first started walking. The scars are still there in a 2 yr old 25 weeker I primary nursed.

I find it fascinating that you cannot find a lot of research on what the repeated heelsticks do to their feet later in life. I've looked and looked. I found one reference to a 10 month old who had a calcification from a heelstick they believed was from a short stay in the NICU. The article referenced calcium deposits and scarring but no footnotes pointed me to any other articles. There's not a lot of data positive nor negative. There is tons of data about pain related to heelsticks, though. Makes me go, hmmmmm...:rolleyes:

prmenrs, RN

4,565 Posts

Specializes in NICU, Infection Control.

My son still has a few scars from his NICU stay 23 years ago.

I think parents can help overcome the painful memories by providing positive tactile stimulation to the places that got stuck. A gentle massage on those heels while rocking and holding the baby--that sort of thing.

A lot of kids walk on their tiptoes @ first. They all had @ least one heelstick for their NB screening. Not all were NICU citizens for a long time. Not sure it's a cause and effect relationship.

All that aside, the thought of doing w/o heelsticks would warm the cockles of my heart! What a great thing!! I hope it happens--SOON!

Specializes in NICU.

I don't know what the criteria for the venous pool stick would be .... I can't imagine we'd be doing it for blood sugar testing (not with other labs, but just for a sugar). But even if we just had to do heelsticks ONLY for blood sugar testing, that wouldn't be as bad.

It just gets so bad when they heelstick these kids every couple of days for labs, then you go to get a blood sugar and can't even find a clean spot on the heel and it just looks so painful :(

I'll post more info once they start training us, I'm interested to learn more.

prmenrs, RN

4,565 Posts

Specializes in NICU, Infection Control.

Have they given you anything to read? A reference article--something?

Mags4711, RN

266 Posts

Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.
...It just gets so bad when they heelstick these kids every couple of days for labs, then you go to get a blood sugar and can't even find a clean spot on the heel and it just looks so painful :(

I'll post more info once they start training us, I'm interested to learn more.

Every couple of days? We should be so lucky! Our kiddos get poked (unless they have Umbi lines or a broviac) easily a couple of times a day if they are vented, and at least once a day if they are on TPN. Gotta get those daily TPN labs, ya know...(typed with a very healthy dose of sarcasm) And we can't forget those Gent and Vanco levels...

I am very excited to learn more when you have the info to pass along!:roll

Specializes in NICU.
Have they given you anything to read? A reference article--something?

No, not yet. And I can't see to find anything on the net about it. Next time I work I'll ask if they have an article available to read.

Specializes in NICU.
Every couple of days? We should be so lucky! Our kiddos get poked (unless they have Umbi lines or a broviac) easily a couple of times a day if they are vented, and at least once a day if they are on TPN. Gotta get those daily TPN labs, ya know...(typed with a very healthy dose of sarcasm) And we can't forget those Gent and Vanco levels...

I am very excited to learn more when you have the info to pass along!:roll

One our neos hates heelsticks and really tries to limit the number of labs we do. If they're on TPN they do get daily sugar checks. But we don't do daily lytes or other labs usually, just every few days. Even if they're vented they try to just do CBGs a few times a week unless the kid is sympomatic of they're going to extubate.

Mags4711, RN

266 Posts

Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.
One our neos hates heelsticks and really tries to limit the number of labs we do. If they're on TPN they do get daily sugar checks. But we don't do daily lytes or other labs usually, just every few days. Even if they're vented they try to just do CBGs a few times a week unless the kid is sympomatic of they're going to extubate.

How wonderful! That would be a dream for me :)

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