Pre-analytical Challenges Encountered with Capillary Blood Collection and Testing

(based on 692 customer ratings)

Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM
Reviewer: Kevin McNeil, MBA-HCA, MLS(ASCP)CM

It is very important that the healthcare providers collecting and testing capillary samples are properly trained and adhere to the policies and procedures in order to reduce errors and ensure quality results. Test results are only as good as the sample used for testing. This course is meant to help with such challenges and will point out where care needs to be taken at the different steps along the way in order to avoid pre-analytical errors.

Continuing Education Credits


  • Describe the composition of capillary blood, how it differs from venous blood, and how tests results may or may not differ from venous blood tests.
  • Outline the reasons for performing capillary blood tests, including the advantages and disadvantages.
  • Describe the proper puncture sites for heel and finger capillary blood collection.
  • Identify errors that should be avoided during capillary blood collection.
  • Identify errors that should be avoided during transport and storage of capillary specimens.

Course Outline

  • Introduction
      • Introduction to Capillary Blood Collection and Testing
      • Composition of Capillary Blood
      • Testing Situations When Capillary Blood Collection is Appropriate
      • Common Tests Performed on Capillary Blood
      • Testing Situations When Capillary Blood Collection is Not Appropriate
      • What is capillary blood composed of?
      • When is capillary blood collection appropriate?
  • Types of equipment needed specifically for capillary blood collection
      • Special Devices for Capillary Blood Collection
      • Capillary Blood Gas Equipment
      • If a patient's dermal collection site is cyanotic (bluish in color due to reduced blood circulation), how should the phlebotomist proceed?
      • During the capillary blood gas collection process, what is the purpose of the metal "flea?"
  • Common steps for finger and heel capillary collection
      • Typical Sites for Capillary Blood Collection
      • Supplies and Equipment
      • Identification of Patient
      • Diet Restrictions
      • Effect of Stress on Capillary Blood Collections and Test Results
      • Positioning the Patient
      • Site Selection
      • Site Cleansing
      • Site Puncture
      • Filling and Mixing Collection Tubes
      • Order of Draw
      • In which order should the following capillary specimens be collected according to Clinical and Laboratory Standards Institute (CLSI)?
      • When performing a heel puncture on an infant, how deep should the puncture be?
  • Specimen handling
      • Labeling Capillary Blood Specimens
      • Specimen Transport
      • Effects of Clotting on the Capillary Blood Sample
      • Effects of Temperature on the Capillary Blood Sample
      • Effects of Hemolysis on the Capillary Blood Sample
      • Effects of Light on Specimens
      • Specimen Storage
      • Which of the following scenarios is NOT a concern for a phlebotomist when collecting a bilirubin specimen from a neonate?
      • Which of the following analytes will be falsely increased and which will be falsely decreased due to hemolysis?
  • References
      • References

Additional Information

Level of Instruction: Beginning 
Intended Audience: This course is intended for phlebotomists, phlebotomy supervisors, patient care coordinators, medical laboratory technicians, medical technologists, laboratory supervisors, managers, and directors. This course is also appropriate for medical laboratory science students and pathology residents.
Author Information: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and a MBA from the University of Georgia.
Reviewer Information: Kevin McNeil, MBA-HCA, MLS(ASCP)CM received a Masters in Business Administration in Healthcare Administration in 2011 from South University in Atlanta, Georgia and his BS degree in Medical Laboratory Science from the Medical College of Georgia. He is currently a Senior Systems Analyst at Gwinnett Medical Center in Lawrenceville, Georgia. Kevin had been employed with Gwinnett since 2006, working as a generalist and previously as a Phlebotomy Supervisor. 

Just one user? Visit for individual subscriptions.
This course is part of:
069 Blood collection tubes sizes.gif
fingerprint parallel
092 Lancets.gif
wipe away 1st drop heel_200
109 Patient identification continued.gif
Pneumatic tube system
tubes_biohazard bag