Table of Contents IntroductionPreparation partPatient partPreparationProcedureTo complete Introduction Wash hands, Introduce self, Patients name & DOB, Explain procedure and obtain consent form parents (or child if appropriate) Paediatric capillary blood gas equipment Preparation part Wash hands Clean trayGather equipment around tray (think through what you need in order) Equipment list GlovesVaseline (if available)Alcohol 70%/chlorhexidine 2% skin cleansing wipeSterile lancet/puncture systemCapillary sample collection tube (with bungs and magnet rod)Cotton gauze swabsTape Wash handsOpen packets and place equipment neatly in tray in plastic parts of packetsReturn to patient (with tray and sharps bin) Patient part Preparation Wash hands and apply glovesIdentify appropriate site:Lateral or medial plantar heel (in young infant)Medial or lateral border of finger pulp (in older child)Apply Vaseline to area if available (to prevent blood globule dispersing in skin ridges)Warm the areaIf using the foot, hold the ankle dorsiflexed with one handSterilise area – wipe in spiral motion working outwards and wait 30 seconds for it to dry Procedure Puncture skin with lancet/puncture system (then drop into sharps bin)Wipe off the first drop of blood with cotton gauzeOnce a blood globule has built up, holding the sample collection tube horizontally, press the end gently onto the globule of blood until the blood enters the tubeThen move the collection tube away until the next globule has accumulated, then press the end onto the globule againRepeat this until the tube is filledTips:If blood if not forming freely, gently massage the area to encourage blood flow and gently squeeze the lower leg/ankle or digit (but let the capillaries refill intermittently)Intermittently dab the area with cotton gauze swab to prevent coagulation of any blood left near the puncture siteThere must not be any air bubbles in the tube or the gas machine will not be able to analyse it – keep the tube horizontal at all times to avoid thisOnce tube is fullInsert magnet rod into one end and place a bung on each end, then mix by inverting it slowly and label it with a patient ID stickerPlace gauze over the puncture site and tape down or apply plaster To complete Thank patient and cover themTake sample to blood gas analyser immediatelyRemove bungsPlace adaptor onto one end to allow insertion into blood gas analyserEnter patient information and await printed resultsBin waste and gloves, clean tray and wash handsDocument procedure and results in patients notes