Capillary (Skin) Puncture: Sites, Depths and Order of Draw
Infants: medial or lateral plantar heel, no deeper than 2.0 mm. Older children and adults: side of the middle or ring fingertip. Capillary order: blood gas, EDTA, other additives, serum last.
Sites by age
| patient | site | never use |
|---|---|---|
| Infants from birth to about 6 months, including premature newborns | Heel: medial or lateral plantar surface. Medial limit: a line back from the middle of the big toe; lateral limit: a line back from between the 4th and 5th toes | Posterior curvature of the heel, the central heel pad, swollen or previously punctured sites |
| Over 6 months or over 10 kg, and adults | Fingertip of the middle or ring finger, palm side, off-centre on the side of the pad, across the fingerprint lines | Thumb and index finger (sensitive, calluses), little finger (too little tissue), swollen or previously punctured sites, the hand with an IV infusion, the side of a mastectomy |
| Earlobe | Occasionally for mass screening, research or sports medicine |
Age rule from WHO 2010 (Table 7.1); the Croatian capillary recommendations use the finger only over 6 months or over 10 kg. Follow your laboratory's rule.
Preview only. The full sheet also covers: Maximum puncture depth; Technique; Capillary order of draw.
Sources
- Lenicek Krleza J, Dorotic A, Grzunov A, Maradin M. Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochem Med 2015;25(3):335-358 (PMC4622200) · Biochemia Medica via PubMed Central
- WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy (2010); official WHO IRIS PDF, also published as NCBI Bookshelf NBK138650 · World Health Organization
- CLSI GP42 Collection of Capillary Blood Specimens, 7th ed. (2020): free product summary (scope, changes from GP42-A6); the standard itself is paywalled and was not read · Clinical and Laboratory Standards Institute
Free Routine Blood Collections practice questions
- Question 1Under CLIA, a laboratory's written labeling procedure must call for the patient's name or a unique identifier and, when appropriate, which other item?
- Question 2Croatian national recommendations allow tubes to be labeled after the draw only if the patient is still seated in front of the phlebotomist. Why?
- Question 3According to MedlinePlus, emergency services should be called when a seizure lasts longer than how long?