No More Heelsticks?

Specialties NICU

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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?

There are many monitors out there that adults can use using blood from their forearm. They came out about 5 years ago. I think the technology is improving so much that less blood is required and the sticks can be less invasive and done in less painful areas.

Can I use this opportunity to get on a soapbox about heel sticks?

Please make sure that you "stack" the "sticks" horizontally and in the V area. And use the smallest lancet possible. If you have a term kid on q hour sugar checks, use a preemie lancet.And if you have micro preemie lancets, use them on on the 3 pounder that just needs a sugar check. You only need a small drop, no need for the big guns.

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Specializes in NICU.
Please make sure that you "stack" the "sticks" horizontally and in the V area. And use the smallest lancet possible. If you have a term kid on q hour sugar checks, use a preemie lancet.And if you have micro preemie lancets, use them on on the 3 pounder that just needs a sugar check. You only need a small drop, no need for the big guns.

I totally agree! I can't stand it when I see someone using a tenderfoot or one of those big slicers just for a sugar check! That's what the little pokers are for, they barely poke and they give you just a tiny little drop of blood, which is just what you need for a sugar check, nothing more.

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

I also agree and we do use a preemie lancet for our sugar checks, but the sugar checks aren't the issue for me. It's the daily labs (or more) and the frequent gases when kids are vented (of course not when they are stable, but then it is at least once a day! grrrr). I do try to stack them, but I once found one in the middle of the top of my baby's heel pad. I went off on that one :smiley_ab , took a pic and posted it all over the unit on what NOT to do!

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Just wanted say that i did my first heel stick for PKU metabolic screen a coupld of weeks ago (student nurse), and almost cried. The poor baby was asleep and even though we gave him some sweeties he was shocked by the pain to say the least.

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Specializes in NICU.

I saw one of the venous pool sticks last night at work! Very interesting. She just used a butterfly and did it kinda like a venipuncture, except deeper, on the inside of the forearm. She did the stick so we could get a blood culture and a blood gas.

The only thing that I wonder about is how they know they're not hitting an artery? The blood was pretty red. Hmmmm

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did she look for a vein and do labs off of a venous stick? I am not really understanding what you are talking about.

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Specializes in NICU.
did she look for a vein and do labs off of a venous stick? I am not really understanding what you are talking about.

No, she didn't look for a vein and do a normal venous stick. Like I said I haven't been trained in it yet, so I'm just going off what I saw last night. I didn't have time to ask a lot of questions when we were getting blood because we were all in a hurry, as this kiddo was sick.

She said once you learn your landmarks, then you know where to stick the butterfly needle and it's pretty easy. So no, it wasn't like a normal venipuncture where you find the vein and go in. I guess there's some sort of "venous pool" there in that area, and that's what you stick.

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Is it a really deep stick?

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I gotta say I'm having a hard time wrapping my brain around this too. It's not at all what I thought.

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I just can't help but keep thinking of what the scars will look like down the road. How many times would the average preemie have the forearm accessed in this manner? My almost 13 year old still has very visible heel stick marks on her heels, and a noticible scar on her hand from all the IV sticks. Those scars grow with the kiddos (her PDA scar is now a whopping 9 inches...when they did the surgery [she was 680 gms.] it was closer to 2 inches). So will the scars resemble the "track lines" of a "user" when they are teenagers?? I know since this technique is new, all those answers are likely not known. I can tell you without a shadow of a doubt, my daughter is VERY happy the scars are on her feet and not her arms. Teenage girls are already so self-conscious. If they were on her arms, I could see her wanting to wear long sleeve shirts to hide them. It would trouble me more as a parent to see body image issues related to scarring.

Just my 0.02...

~J

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Specializes in NICU, PICU, educator.

I'm not getting it either and I can't find any info on it. What were the ABG results...were they venous or arterial?

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Specializes in NICU.

Maybe I should have not posted anything about this until I had more information, I'm sorry. I was just curious to see if other hospitals were doing this.

I don't think they would do something to harm these babies, I know they did a lot of research and discussing about it for a long time now, and now they are training the core training group. I'll get more information as we're all trained.

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