The following video will show you how to prepare for and perform home blood spot
monitoring to monitor your child's metabolic condition. Your metabolic team
will let you know what time of day and how often you should perform the blood
collection procedure.The supplies you will need are a filter paper card with a
patient sticker on the back. This patient sticker will have your
child's name and a bar code on it.This sticker will be provided by the clinic.
A lancet. Optional supplies include an alcohol swab, cotton balls or tissue.
Helpful tips. Make sure you are in a comfortable calm environment when
performing the procedure. It is recommended that you maintain a routine
for how and when you do the dried blood spot monitoring. Allow your child some
control over their environment. This can help to reduce anxiety associated with
the procedure. Use distractions such as a favorite television show, music or
bubbles. This can also help to reduce any worries your child may have. If possible,
have two adults present when performing the procedure on a younger child. One to
hold and distract the child and the other to perform the procedure. It may be
helpful for younger children to be seated on a caregivers lap or in a
highchair. Reward your child when the procedure is complete. This could include
giving them stickers, a favorite snack or television or game time.
Preparing to do the test. Make sure your child's hand is warm. If it feels cold to
the touch, you can run warm water over it or wrap the hand in a warm washcloth.
Have your child do jumping jacks, windmill their arms or clap their hands,
or do the finger poke after a bath or shower if this is a good time for you.
Have your child wash their hands with soap and warm water for at least 20
seconds. Choose the finger you are going to use.
For older children, allow them to decide. For babies up to one year of age, you may
use the heel.If you are using an alcohol swab, swab the area you are about to poke
and allow that area to dry. However, if your child's hands have been washed,
using an alcohol swab is not necessary. Performing the test. Remove the small end
of the lancet. Place the small end against the finger
where you want to draw the blood. Try to use the side of the finger, and not the
middle, as it will hurt less. Apply pressure on the lancet in order to
release the needle inside. The needle will come out and then retract.You will
hear a click if it worked. Make sure the finger is pointing towards
the floor and not being held up in the air.
Squeeze the finger until a large drop of blood forms.Touch the filter paper to
the drop of blood. The blood will be absorbed into the paper and spread out.
Only one full circle is required to perform the testing. If the circle is not
filled put another drop of blood beside the initial drop so that the drops run
together. Do not put additional drops of blood on
top of the ones you already have. Check the back of the filter paper card
to make sure it is as saturated as the front. Once the circle is filled, apply
pressure to your child's finger to stop the bleeding. If your child requires a
bandage, one can be applied, however, do not put a bandage on babies or children
who put their hands in their mouths as bandages are a choking hazard.
Remember, only one saturated circle is required.
The following is an example of an acceptable card. This is what a good
sample should look like the entire circle is filled and the back is as
saturated as the front.This is an example of a card that would not be
accepted by the lab.As you can see, on the front of this card
there are many small dots. This means there was not a large enough drop of
blood on the finger before it was applied to the filter paper. On the back
of the card, you can see the blood has not saturated through.The lab needs to
be able to take a punch of the paper that is fully saturated in blood.
There cannot be any white showing. What happens to the sample? For the lab to
process the sample, they need to be able to take a punch out of the card.
This punch needs to be fully saturated with blood.They will occasionally need
to take more than one punch if there are concerns with the results or with a
sample. When you are ready to submit the sample, make sure the time and date you
did the blood collection procedure is documented on the front of the filter
paper card. Allow the card to fully dry. Then once it's dry, place it in a small
plastic baggie or in plastic wrap before putting it into an envelope. Make sure
you put your return address on this envelope.
You will mail the card to The Hospital for Sick Children, Department of
Pediatric Laboratory Medicine, Rapid Response Lab, room 3642, 170 Elizabeth Street,
Toronto, Ontario, M5G 1E8, IF you have any questions or need
further tips, please contact your metabolic clinic nurse.
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