WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy

6 Paediatric and neonatal blood sampling.....................................................................................35
6.1 Background information on paediatric and neonatal blood sampling....................................... 35
6.1.1 Choice of procedure and site ......................................................................................... 35
6.2 Practical guidance on paediatric and neonatal blood sampling................................................. 35
6.2.1 Patient identification ..................................................................................................... 35
6.2.2 Venepuncture................................................................................................................. 36
6.2.3 Finger and heel-prick ..................................................................................................... 37
6.3 Illustrations for paediatric and neonatal blood sampling........................................................... 37
7 Capillary sampling......................................................................................................................41
7.1 Background information on capillary sampling.......................................................................... 41
7.1.1 Choice of site ................................................................................................................. 41
7.1.2 Selecting the length of lancet......................................................................................... 42
7.1.3 Order of draw................................................................................................................. 42
7.1.4 Complications................................................................................................................. 42
7.2 Practical guidance on capillary sampling.................................................................................... 43
7.2.1 Selection of site and lancet............................................................................................. 43
7.2.2 Procedure for capillary sampling.................................................................................... 43
7.3 Illustrations for capillary sampling............................................................................................. 45
PART III IMPLEMENTATION, EVALUATION AND MONITORING..........................................................47
8 Implementing best phlebotomy practices...................................................................................49
8.1 Setting policies and standard operating procedures.................................................................. 49
8.2 Procurement.............................................................................................................................. 49
8.2.1 Blood-sampling equipment............................................................................................ 50
8.2.2 Protection....................................................................................................................... 50
8.3 Phlebotomy training................................................................................................................... 51
8.4 Safe waste and sharps disposal.................................................................................................. 51
8.5 Prevention and management of incidents and adverse events................................................. 52
8.5.1 Patient related................................................................................................................ 52
8.5.2 Health-worker related.................................................................................................... 53
8.5.3 Risk assessment and risk reduction strategies................................................................ 54
9 Monitoring and evaluation.........................................................................................................55
PART IV REFERENCES......................................................................................................................57
PART V ANNEXES............................................................................................................................63
Annex A: Methods and evidence base...........................................................................................65
Annex B: Infection prevention and control, safety equipment and best practice............................69
Annex C:
Devices available for drawing blood................................................................................71
Annex D: Managing occupational exposure to hepatitis B, hepatitis C and HIV...............................73
Annex E: Training course content for phlebotomists .....................................................................77
Annex F:
Explaining the procedure to a patient.............................................................................79
Annex G: Disassembly of needle from syringe or other devices......................................................81
Annex H: Blood spillage ................................................................................................................83
Annex I:
Annex J:
Modified Allen test.........................................................................................................85
Cochrane review.............................................................................................................87
Annex references...........................................................................................................................103
Glossary ........................................................................................................................................105
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<strong>WHO</strong> guidelines on drawing blood: best practices in phlebotomy