A comparative study of heel-stick devices for infant blood collection

Am J Dis Child. 1993 Mar;147(3):346-8. doi: 10.1001/archpedi.1993.02160270108032.


Objective: To evaluate two heel-stick devices by comparing the volume of blood collected, blood sampling time, amount of hemolysis, pain inflicted during the procedure, and extent of bruising.

Design: Randomized trial.

Setting: Primary care center in a tertiary-level perinatal hospital.

Participants: Forty healthy, full-term newborns with a postnatal age of greater than 24 hours. Newborns were fed no more than 1 1/2 hours before blood sample collection and fulfilled the requirement for routine phenylketonuria and thyroid screening.

Interventions: Newborns were allocated to a single stab with either an automated incision or a lancet puncture device.

Measurements/main results: The total volume of blood and blood sampling time were significantly better with the automated incision device (P < .001). Hemolysis was also reduced with the automated incision device (P < .03). Plasma hemoglobin levels were below 1.0 g/L in all samples obtained with the automated incision device and in 71% of samples obtained with the lancet device. There were no differences in the extent of bruising or in pain symptoms manifested by mean increases in heart rate and percentage of time crying during the procedure.

Conclusions: The larger volume of blood obtained within a shorter period for blood collection and reduced hemolysis with the automated incision device make it a preferred instrument for neonatal blood collection.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Blood Specimen Collection / adverse effects
  • Blood Specimen Collection / instrumentation*
  • Blood Specimen Collection / standards
  • Crying
  • Ecchymosis / epidemiology*
  • Ecchymosis / etiology
  • Female
  • Heart Rate
  • Heel / blood supply
  • Heel / injuries*
  • Hemoglobins / analysis
  • Hemolysis
  • Humans
  • Infant, Newborn
  • Male
  • Pain / diagnosis
  • Pain / epidemiology*
  • Pain / etiology
  • Quality Control


  • Hemoglobins