Heel stick on side of foot/medial ankle

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  1. This is a discussion on Heel stick on side of foot/medial ankle in Pediatric Nursing, part of Nursing Specialties ... Hey there! Wouldn't you believe it, another question about heel sticks! :) Last night I had a...

    by Sep 27, '12
    Hey there! Wouldn't you believe it, another question about heel sticks!

    Last night I had a kiddo that I needed a blood sugar sample from. She had a right club foot and that was the foot I was using for the test, so her foot curved outward, making it harder to differentiate between the foot and the medial ankle. I cleaned the area and the mom counted to 3, so I placed the lancet on the medial periphery of the foot pad and clicked the lancet. Blood came, but it looked like it nicked higher up than I had planned. When I put the band-aid on, it looked like the lancet had punctured a little bit above the foot pad and more like the side of the foot. The baby stopped bleeding and all was well, but I keep reading stuff about osteomyelitis and it's scaring me half to death! I know that's mostly if you stick right in the middle of the heel, but still?!

    Please help put my mind at ease...
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    by beautifulbyHisblood Sep 27, '12 2:55 pm
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  3. 4 Comments so far...

  4. Sep 27, '12 by
    I would not recommend doing a heel stick on a foot with a significant deformity, for the reasons you describe.

    Was the other heel not accessible? How old was the child? Perhaps a finger stick would have been an option?
    Jory likes this.
  5. Sep 27, '12 by
    In the future, I would use the foot without the deformity, a toe or an finger. Any of the above are acceptable for a glucose. I don't think I've ever done a heel stick just for glucose... finger or toe will give you a sufficient sample.
  6. Sep 27, '12 by
    I too, would not use the heel with the deformity, but would use the other foot.

    I have never seen a nurse use a finger on an infant for glucose, but the big toe..sometimes.

    I started using lancets made for premies if I had only a glucose to take...they made a smaller prick...I figured this out the hard way when I had to use the lancet on myself...was ridiculously painful.
    nola1202 likes this.
  7. Oct 26, '12 by
    Excellent advice from all the other posts, just wanted to address your anxiety. Thankfully, 99.9% of our less than stellar interventions have no adverse effects. You are learning and that's what's important. I notice with the square lancets for heel sticks, the actual stick is a little higher than I anticipated it would be. I've learned to correct for that with experience. I also lol about getting stuck with a lancet...me too! youch!
    Rest easy, and keep asking questions, reading and learning from experience.