Heel stick on side of foot/medial ankle

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    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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  3. 4 Comments so far...

  4. 1
    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.
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    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.
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    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. 0
    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.


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