Lancet for Newborn Heel-Stick Glucometer
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I was wondering what size lancet everyone is using at their facility for newborn glucose from a heel-poke?
We use Nova meters, and I stumbled upon a policy that says they are not to use the finger-stick lancet, and must always use a tenderfoot for heel poke. We are a children's hospital, so we get some seriously tiny babies. We do a ton of capillary blood draws, so I can see using a tenderfoot for a blood draw, but seems excessive for just a glucometer test.
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For Newborn, we use Unistik 3 Comfort Gauge 28G; depth 1.8. We have NOVA meter and does not take much but 1.2 ul of blood.
After the stick, if the baby has good blood flow and you do not squeeze the heel too much, then it should be a good sample. I watched the Nursery staff do heelstick glucose and they almost always get plenty of blood for testing using this lancet.
The only time they use Tenderfoot lancets are for collecting bilirubin sample.
We even use this size lancet for tender skin old patients.
Right now for heel sticks for NOVA we are using a medipurpose yellow lancet, 1.0 depth, 21 gauge. One of my NICUs complains fairly often that they can't get a sample. Oddly though, I don't hear that from the NICU on the other campus.
They call the lab and demand a larger lancet but we won't send them one because we only carry the tenderfoot lancets which are a much larger lancet and any time these accidentally get out on the floors, they start to use them routinely because of course they get an easy sample.
Could I get them one that's deeper than what I use? Is there a standard somewhere to follow for repetitive pokes like Q1 hour glucoses on a heel?
Hi Danyel,
I was searching for this info as well and found this from WHO:
Finger: Under 6 months - Do Not Use, 6 months to 8 yrs - 1.5mm depth ,>8 yrs - 2.4mm depth Heel: Preemie - 0.85 mm depth, Newborn - no more than 2.4 mm depth
Then I looked at all of the different lancets we have in our system to compare guage and depth. For Preemie we use the white tenderfoot for heel sticks (1.75mm g and 0.85mm depth), For newborns we use the blue tenderfoot for heel sticks (2.5mm g and 1.00mm depth) or the purple lancet (30g and 1.6mm depth).