HemoCue Training and Education Program. Capillary Sampling. Hemoglobin. USPRO1 Rev 1 3/03. Training and Education Program 2003 HemoCue, Inc.

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1 HemoCue Training and Education Program Capillary Sampling Hemoglobin 1

2 The Circulation Blood leaves the heart through the aorta and travels through a system of muscular arteries. These branch off into smaller vessels, the arterioles. 2

3 The Circulation The arterioles, which are microscopic in size, carry the blood to the tissues. The ends of the arterioles form the venules, which carry blood away from the tissue and back to the heart. 3

4 The Circulation The arteries have a thick wall made up of connective tissue fibers and up to 2-3 layers of muscle cells. As the vessels become smaller, the muscles cells are a single layer. Eventually the muscle cells are spaced at wider intervals. 4

5 Some capillaries are encircled by a ring of muscle cells that act as a valve to regulate the blood flow. The number of red blood cells, hematocrit and the hemoglobin concentration can vary greatly depending upon where the sample is taken. The Circulation 5

6 The Circulation Therefore, in order to obtain a good representative drop of blood, it is necessary to follow proper capillary sampling technique, thus eliminating or lessening some potential sources of error. 6

7 Have all supplies ready. Make sure that the microcuvettes have not expired or been opened for more than 3 months. If opening a new vial of microcuvettes, write the date opened on the vial. 7

8 Have the analyzer turned on and the cuvette holder in the outer position. The screen should say READY with three flashing dashes. Take a microcuvette out of the vial. To protect the remaining cuvettes from humidity, tightly recap the vial! 8

9 Capillary Sampling The patient should be seated. Make sure that the hand is warm. Make sure that the hand is relaxed. It is best to use the middle or ring finger. Fingers that have tight rings on them should not be used for testing, unless the rings are removed. 9

10 Clean the fingertip with alcohol. Wipe off the alcohol with a clean, dry lint-free wipe, i.e., gauze, or allow to air dry completely. (Do not use cotton balls). 10

11 Prior to performing the puncture, prime the fingertip by applying pressure at the upper joint with your thumb, using a rolling motion towards the tip of the finger. Do not milk the finger, i.e. sliding your thumb from the palm of the hand towards the puncture site!! 11

12 Apply pressure with your thumb at the upper joint and position your index finger on the side of the patient s finger, in a position that will allow you to gently squeeze. Position the lancet device so that the puncture will be made across the whorls (lines) of the fingerprint, not along the lines. Press the lancet firmly against the finger prior to activating the lancet. This will aid in obtaining a good sample. 12

13 Capillary Sampling After the puncture has been made, apply gentle pressure as needed to extrude a large drop of blood by gently opening the puncture site. Release the pressure on the finger and wipe off the drop with a dry lint-free wipe. Wipe away an additional one or two good sized drops of blood as before, alternating applying and releasing pressure on the finger as needed. 13

14 Holding the microcuvette at the wing end, insert the tip of the cuvette into a large drop of blood. 14

15 Hold the cuvette in place until the entire teardrop shaped cavity is filled with blood. If the cuvettte is not completely filled, discard and use a new cuvette. Do not add blood to a partially filled cuvette! 15

16 Check the cuvette for the presence of air bubbles in the optical eye. If present, discard and fill a second cuvette after wiping off an additional drop of blood. Wipe off the excess sample from the outer surfaces of the cuvette with a lint free wipe, as if wiping butter from a knife. Be careful not to touch the open end of the cuvette with the wipe. (This may cause blood to be removed, which could produce an erroneous result.) 16

17 Capillary Sampling The filled cuvette must be inserted into the analyzer for measurement within 10 minutes of filling. Lay the cuvette into the cuvette holder with the wing end facing outward and the cuvette positioned to match the indentation in the holder. Gently slide the cuvette holder into the analyzer. ( Slamming the cuvette holder into the analyzer could result in blood being deposited in the optronic unit). 17

18 The result will be displayed on the screen within one minute. Depending on the version of the analyzer, the result will remain on the screen for five minutes or until the cuvette holder is pulled out for removal of the cuvette. 18

19 Dispose of the lancet, cuvette and other biohazardous material as required according to policy. When testing is completed for the day, turn off the analyzer, remove the cuvette holder and clean with alcohol or a mild soap solution. Dry the cuvette holder completely before reinserting into the analyzer. 19