CAP Pro Course - Phlebotomy - Challenges of Phlebotomy: Pediatric Blood Collection, Alternate Sites, and Difficult Draws (2025 & 2026)

Author: Carol Becker, MS, MLS(ASCP)CM
Reviewer: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM

Continuing Education Credits

Objectives

  • Review established venipuncture practices and recognize approved techniques and tools used to safely provide quality phlebotomy care for adult patients.
  • Identify adult patient conditions and circumstances that may require alternative blood collection techniques.
  • Describe the proper dermal puncture procedure used as an alternative technique in the collection of blood specimens in adult patients and those pediatric patients greater than one year of age.
  • Explain the special considerations, techniques, and potential complications that can be encountered during neonatal and pediatric blood collection.

Course Outline

  • Review established venipuncture practices and recognize approved techniques and tools used to safely provide quality phlebotomy care for adult patients.
      • Fundamental Phlebotomy Practices
      • Patient Approach and Preparation for Venipuncture
      • Patient Identification
      • Preanalytical Considerations
      • Quick Steps to Adult Venipuncture
      • Potential Patient Complications
      • Venipuncture Safety Practices and Special Considerations for Handling Specimens Associated with COVID-19
      • A patient has arrived at the outpatient center for a blood draw. This patient appears anxious and fearful of the collection procedure. What is the bes...
      • A phlebotomist assigned to the floor today is performing an identification process on a male inpatient who does not have an identification bracelet or...
      • A partially-filled blood collection tube, received in the laboratory for testing, is considered a poor specimen quality variable for which of the foll...
  • Identify adult patient conditions and circumstances that may require alternative blood collection techniques.
      • Special Situations Impacting Adult Blood Collection
      • Alternative Blood Collection Sites
      • Use of Syringes and Winged Collection Devices
      • Steps to Hand Vein Blood Collection
      • Geriatric Blood Collection
      • When performing a hand venipuncture to obtain blood, the phlebotomist should insert the needle into the hand vein at what angle?
      • The following scenario unfolded when a phlebotomist reported to a patient's room for a stat blood collection:The phlebotomist realized immediately tha...
      • Mr. Steele, a retiree, presents at the local medical center outpatient unit for a venipuncture. Katie is the phlebotomist who calls him to her draw st...
      • Hand veins can be difficult to access for the which of the following reasons?
  • Describe the proper dermal puncture procedure used as an alternative technique in the collection of blood specimens in adult patients and those pediatric patients greater than one year of age.
      • Dermal Puncture Technique
      • Challenges to Using Dermal Puncture Technique
      • The Fingerstick
      • The Fingerstick Procedure
      • The Order of Draw for Capillary Blood Collection
      • Which of the following images represent the correct area for performing a fingerstick blood collection?
      • Which two fingers are acceptable for use to obtain a capillary blood sample?
      • A phlebotomist is called to the pediatric floor to perform a fingerstick on a 3-year-old child for the following tests:Chemistry: Basic metabolic prof...
  • Explain the special considerations, techniques, and potential complications that can be encountered during neonatal and pediatric blood collection.
      • Pediatric Blood Collection Challenges
      • Pediatric Venipuncture
      • Special Considerations for Pediatric Heelsticks
      • The Pediatric Heelstick Procedure
      • The new phlebotomist on staff is sent to the nursery to obtain blood on a newborn for bilirubin testing. She has identified her patient and is gatheri...
      • An appropriate site for an infant heelstick would be which of the following?
      • The CLSI recommends that a heel puncture device should NOT puncture or penetrate deeper than which of the following measurements?
  • References
      • References

Additional Information

Level of Instruction: Basic
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, phlebotomists, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Carol Becker, MS, MLS(ASCP)CM is a retired Program Director for the Clinical Laboratory Science program and Histology program at OSF St. Francis Medical Center located in Peoria, Illinois. Carol received her Master's degree at the University of St. Francis in Joliet, Illinois, and her Bachelor's degree in Medical Laboratory Science from the University of Illinois in Champaign, IL.
Reviewer 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 the Clinical Laboratory Technology Program at Georgia Piedmont Technical College. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.

This course is part of the CAP Competency Assessment Hub.

See other included Pro courses

See other included instrument checklists