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Health Professionals Guide to Newborn Screening: How to collect a specimen

Health Professionals Guide to Newborn Screening

How to Collect a Blood Specimen

Instructions for Specimen Collection:
Note: Closely follow the collection instructions on the back of the blood collection card. (Reference: Blood Collection on Filter Paper for Neonatal Screening Program - Fourth Addition; NCCLS Document LA4-A4)

  • To prevent specimen contamination, do not touch any of the filter paper circles before or after collection.
  • Select puncture site and cleanse with 70% isopropanol.
  • Use a sterile, disposable lancet with 2.0 mm or less, point to perform a swift, clean puncture.
  • Keep heel in horizontal position (Heel Down) at or below heart level.
  • Wipe away first blood drop.
  • Allow a second LARGE blood drop to form and apply to surface of filter paper circle. If not completely filled, add a second LARGE drop immediately. FILL all required circles. FILL from only one side of the filter paper. Circles must be completely filled when observed from both sides of the filter paper. See below. NOTE: Heparinized capillaries can be used to apply blood to the filter paper.
  • Dry specimen at room temperature 3-4 hours in HORIZONTAL position.
  • Forward specimen to State Lab within 24 hours.
  • IMPROPERLY COLLECTED SPECIMENS WILL BE REJECTED.
  • If problems occur during collection, repeat collection using another card.  The original card can be returned for replacement.

Tips for Specimen Collection:

  • Complete each item on the newborn screening collection form.
    • NOTE: If hearing screening  results are not available before the blood screening is completed,  pull the “blue” sheet from the blood collection card. When the hearing results are available, complete the “blue” sheet and mail to WSLH.
  • Warm heel with a warm towel and hold heel at or below the heart.
  • Sampling after a feeding promotes better blood flow.
  • Fill one circle at a time.
  • If capillaries are used to transfer blood from heel to paper:
    • a. Capillaries must be heparinized (Do not use EDTA).
    • b. Mix capillaries well before applying blood to filter paper.
    • c. Apply blood to filter paper immediately after filling.
    • d. Do not touch capillary to filter paper.
  • When appropriate umbilical lines (arterial or venus) can be used as a blood collection site. Be sure there is appropriate draw back (~ 0.5 mL) before blood collection. It is recommended that the last specimen (at discharge) be taken from the baby’s heel.

 

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