Newborn Blood Screening Protocol

[nurse2teach]

General guidelines recommend heelsticks for newborn blood screening. What are the guidelines/protocols used in your institutions regarding drawing specimens for newborn screening via central lines?

[neonatal_nurse]

We use heelsticks as well. But if the baby is still in the NICU and still completing several treatments, we delay the newborn screening until the baby is well enough to for it.

[texas2007, BSN, RN]

If we have a line available to draw the lab from, we will use that. If a kid has a line, they probably have some lab to draw along with the screening as well like a blood gas or chemistry panel for instance. We do not delay our screenings for any reason.

[nurse2teach]

what process do you use? eg:

wasting 2- 2.5ml of blood,

nothing else can be in that line like heparin, antibiotics, etc.

process of placing sample on filter paper (ie- no needle)

Or are there any other guidelines that are used? and do you have any invalid specimens related to this process that you know of?

what do you do with your micropreemies?

[prmenrs, RN]

Check w/the state agency coordinating the testing as to whether you can use a line draw--the reference test results are based on heelstick blood, not the same as a venous/arterial draw b/o the extra-cellular fluid that comes w/a heelstick.

I sure hope that made sense.

[NICU_babyRN, BSN, RN]

Illinois, two hospitals:

One NBS at 24hrs of life OR prior to first blood transfusion.

If blood is given, a 2nd NBS is drawn 48hrs after completion of blood product transfusion.

A 2nd NBS is drawn once the baby is on "full feeds" of formula or BM and off all IV fluids.

A THIRD is drawn at time of discharge.

If infant is transferred from another hospital, NBS upon admission unless not yet 24hrs old.

If baby has UAC, may draw from UAC (draw up in 3ml syringe and "drop" on paper.

If no UAC then heel stick.

[soprano3]

initial blood screen at 2 days of age via heelstick (unless micropreemie, then we use a UAC or Art. line)

[Tina1639]

We do our Newborn Screens at birth and at 48 hours of life via heelstick or arterial line draw. We don't draw out of any existing venous line, only arterial and waste 2cc. If I do a heelstick I will draw it up in a syringe off the heel to make sure my circles are filled properly instead of letting it drop right on to the paper from the heel (that way I reduce my sheet getting messed up by a kicking baby!) We also repeat the Screen when the baby has reached full feeds or if any abnormal results come back from a previous Screen.