There are four common sites phlebotomists use for blood draws: median antecubital, cephalic, basilic and dorsal hand. While each vein is viable for a blood draw, it is important to understand each draw site’s potential risks. Show MEDIAN ANTECUBITAL VEIN The median antecubital vein is the most common for blood draws. It is in the inner arm, anterior of the elbow joint. This vein is associated with minimal pain and is the most prominent when anchored. CEPHALIC VEIN Located on the lateral portion of the arm, the cephalic vein is the second most common draw site choice. The cephalic vein is a safe alternative to the median antecubital vein when necessary. BASILIC VEIN Similar to the top two choices, the basilic vein is on the medial side of the arm. Drawing blood from this area does pose a greater likelihood of the vein rolling or collapsing because it is difficult to anchor. This vein is also closer to the artery and nerve which makes it more challenging to draw from. DORSAL HAND VEINS Dorsal hand veins are often the last resort for phlebotomists, but they can be successful. These veins are found above the hand, near the wrist, and by the thumb.
On this page: PersonnelBlood spot collection can be performed by trained personnel such as hospital nursery staff, laboratory staff, or out-of-hospital birth providers. TimingTiming of blood spot collection is important for accurately interpreting test results. Tests for some of the disorders on the newborn screening panel have different cutoff values based on the infant’s age (in hours) at the time of blood spot collection. As a result, blood spots drawn too early or too late may increase the chance of false positive or false negative results. Blood spots are best collected between 24 and 48 hours of age. Blood spots collected before 24 hours of age cannot be fully interpreted, which means some test results will be marked “unsatisfactory” on the newborn screening report. An unsatisfactory result will require another blood spot collection. Blood spots collected after 48 hours may not allow enough time for results to be interpreted before serious symptoms occur in newborns affected by certain disorders on the newborn screening panel. However, special circumstances may arise that require blood spot collection at earlier or later times. Infant should be at least 24 hours old in elapsed time, not just in "clock" time. This distinction is important on the days surrounding the switch to Daylights Saving Time. Accurate collection and recording of time is especially important with blood draws done right at 24 hours in order to avoid collecting blood before 24 hours of age. If you are collecting before 24 hours of age, please reference our Newborn Screening <24 Hour Discharge Guideline. It provides guidance about how to complete newborn screening for infants discharged to home before 24 hours of age. Blood Spot CollectionThe Minnesota Newborn Screening Program uses blood collection standards developed specifically for newborn screening programs by the Clinical and Laboratory Standards Institute. The primary goal of these standards is to ensure the quality of blood spots collected from newborns. Poor quality specimens interfere with the screening process, potentially delaying the detection and treatment of an affected infant. If our staff receive a specimen of poor quality, we will request a repeat specimen from the birth provider. Proper specimen collection technique as outlined by the Clinical and Laboratory Standards Institute include the following steps:
Delivery Address: Newborn Screening Program 601 Robert St. N St. Paul, MN 55155
Mailing Address: Newborn Screening Program P.O. Box 64899 St. Paul, MN 55164
Newborns Requiring TransferWithin Minnesota, birth hospitals are legally responsible for arranging to have newborn screening administered to every infant in its care. This can be accomplished by screening the newborn in the birth facility or by having a protocol in place with a receiving hospital to screen the infant. The birth hospital should screen an infant before transport in the following situations:
How to Collect Blood Spot Specimens from Newborns VideoThe following video was produced by PerkinElmer Genetics with input from the Minnesota Newborn Screening Program. This less than 5 minute video covers how to properly collect blood spot specimens for newborn screening.
How to Collect Blood Spot Specimens from Newborns Video Text Putting Babies First VideoThe following video answers many frequently asked questions about blood spot collection, including the optimal timing of collection, drying of blood spots, and methods of collection. The video was produced in partnership by the Iowa State Hygienic Laboratory and Baby's First Test. Note: This video is based on Iowa’s newborn screening protocol. Although the video states that a repeat newborn screen should be collected eight weeks after an infant’s last transfusion, we recommend that a repeat specimen be collected 90 days after the last transfusion. Please feel free to contact us with any questions. Putting Babies First Video Text |