The effect of two different lancets and heel warming on duration of crying and procedure time during blood sampling: A randomized controlled study

Balcı, Serap; Dur, Şadiye; Özdemir, Şule; Kavuncuoğlu, Sultan

doi:10.1016/j.jnn.2021.06.003

Cited by 3 publications

(22 citation statements)

References 29 publications

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“…The 3 warming items used were (1) a disposable glove containing water (glove), (2) a Flexxum 15 × 19 cm gel pack (gel pack), and (3) a cotton blanket normally used to swaddle infants (blanket). To warm these items at a controlled temperature, to ensure reproducibility of the study and as a safety measure to avoid burns of the heel, we used an incubator set at 39°C (Memmert IF75m, 74 L, fan 80°C) 9,17. A preliminary pilot study showed that the items needed storage in the incubator for minimum 1 hour to gain maximum warmth and show consistency in temperatures.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, reducing the number of painful procedures as well as the pain experienced during the necessary procedures must be considered as an important task for healthcare professionals 1–3. To reduce or relieve the infant's pain during heel stick procedure, various methods are recommended, such as sucrose analgesia, lactation, skin-to-skin care, vibration, swaddling, and warming the infant's heel before the procedure 3,7–10…”

Section: Background and Significancementioning

confidence: 99%

“…Infant's heel warming aims to minimize the risk of difficult blood sampling by increasing the capillary blood flow 11. A better blood flow at the incision site is presumed to decrease the duration of the sampling procedure and reduce the pain and discomfort for the infant 7,9. The sampling duration is therefore an important procedure quality estimate.…”

Section: Background and Significancementioning

confidence: 99%

“…[1][2][3] To reduce or relieve the infant's pain during heel stick procedure, various methods are recommended, such as sucrose analgesia, lactation, skin-to-skin care, vibration, swaddling, and warming the infant's heel before the procedure. 3,[7][8][9][10] Infant's heel warming aims to minimize the risk of difficult blood sampling by increasing the capillary blood flow. 11 A better blood flow at the incision site is presumed to decrease the duration of the sampling procedure and reduce the pain and discomfort for the infant.…”

Section: Background and Significancementioning

confidence: 99%

“…11 A better blood flow at the incision site is presumed to decrease the duration of the sampling procedure and reduce the pain and discomfort for the infant. 7 , 9 The sampling duration is therefore an important procedure quality estimate. Furthermore, a high blood flow is presumed to lower the need to exert pressure on the incision site, such as by squeezing, thereby minimizing the risk of hemolysis.…”

Section: Background and Significancementioning

confidence: 99%

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Warming Prior to Heel Stick

Toennesen,

Kierkegaard,

Kofoed

et al. 2023

Advances in Neonatal Care

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Background: Capillary blood sampling (heel stick) in infants is commonly performed in neonatal care units. Before the procedure, warming the infant's heel is often a customary practice, but no consensus exists on the most effective heel-warming method. Purpose: To compare the effects of routinely used warming methods (glove, gel pack, or blanket) applied prior to heel stick on blood sample quality and infant's comfort. Methods: This prospective, double-blind, randomized controlled trial conducted in the neonatal intensive care unit included infants (postmenstrual age of ≥28 + 0 weeks and ≤43 + 6 weeks) who were computer-randomized to 1 of 3 warming methods. The primary outcome was blood flow velocity at sampling. Secondary outcomes were hemolysis index, infant COMFORTneo score, and frequency of postprocedure skin injuries. In addition, irrespective of the warming method used, the correlation between heel skin temperature and postprocedure heel skin injury was analyzed. Results: A total of 176 heel warmings were successfully randomized, and 173 were analyzed. Despite a significant difference in obtained heel skin temperature after warming between the 3 warming methods (P = .001), no difference in blood flow velocity (P = .91), hemolysis index (P = .99), or COMFORTneo score (P = .76) was found. Baseline skin temperatures above 37.0°C were associated with higher incidences of skin injury, and skin temperatures after warming were significantly higher in skin-injured heels (P = .038). Implications for Practice and Research: All 3 warming methods had similar effects on blood sample quality and infant's comfort. However, excessive warming of the heel should be avoided to prevent skin injuries.

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Section: Methodsmentioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

See 3 more Smart Citations

Warming Prior to Heel Stick

Toennesen,

Kierkegaard,

Kofoed

et al. 2023

Advances in Neonatal Care

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Effects of automatic heel lancet on invasiveness in neonates: A systematic review and meta‐analysis

Shiroshita,

Yonezawa,

Ota

et al. 2024

Acta Paediatrica

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AimWe conducted a meta‐analysis comparing the invasiveness of automatic lancet devices, which can collect adequate amount of blood at shallow puncture depths, with conventional manual lance devices (lancet or needle) to statistically identify less invasive instruments for neonatal heel lance.MethodsWe searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and Ichushi databases for studies comparing the invasiveness between automatic lancet and manual lancet or needle in term and preterm neonates in neonatal intensive care unit.ResultsThis review included 9 out of 449 searched articles, with 673 neonates. Automatic lancet had significantly lower pain scores (standardised mean difference: −2.0, 95% confidence interval: −3.3 to −0.7), heart rate (mean difference: −8.0, 95% confidence interval: −13.8 to −2.1), cry duration (mean difference: −21.5, 95% confidence interval: −32.5 to −10.4), number of punctures (mean difference: −0.6, 95% confidence interval: −1.1 to −0.2), and duration of procedures (mean difference: −37.7, 95% confidence interval: −75.2 to −0.2) than manual lancet or needle. Furthermore, peripheral oxygen saturation was significantly higher in automatic lancet than in manual lancet or needle (mean difference: 4.5, 95% confidence interval: 0.5–8.5).ConclusionAutomatic heel lancet devices were less invasive than manual heel lance devices (lancet or needle).

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Effect of Heel Warming with a Thermofor at Two Different Temperatures Before Heel Stick Sampling in Healthy Term Neonates on Total Crying and Procedure Durations: A Randomized Controlled Trial

PAZARCIKCI,

AYDINLI

2023

Acibadem Univ Saglik Bilim Derg

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Purpose: The purpose of this research is to determine the effect of heel warming with a thermofor at two different temperatures before heel stick sampling in healthy term neonates on total crying and procedure durations. Methods: This study was a randomized controlled trial. The sample for the research comprised 120 healthy term neonates with heel stick sampling performed by the same nurse. Neonates were randomized into control (n = 40), heel warming with a thermofor containing warm water (n = 40) and heel warming with a thermofor containing hot water (n = 40) three groups. In the study, to determine the efficacy of the heel warming intervention, neonates were recorded for six minutes before heel stick sampling and five minutes after heel puncture with a video camera. Results: In the study, both the total procedure duration and total crying duration were statistically significantly shorter in the group with heel warming with hot water compared to the control group (KW = 6.088, p = 0.016; KW = 7.611, p = 0.006, respectively). However, in the group with heel warming with warm water, there was no significant difference in terms of total crying and procedure durations compared to both the control group and the group with heel warming using hot water (p> 0.05). Conclusion: Before heel stick sampling in healthy term neonates, warming the heel with a thermofor containing hot water is effective in shortening the total crying and procedure durations.

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The effect of two different lancets and heel warming on duration of crying and procedure time during blood sampling: A randomized controlled study

Cited by 3 publications

References 29 publications

Warming Prior to Heel Stick

Warming Prior to Heel Stick

Effects of automatic heel lancet on invasiveness in neonates: A systematic review and meta‐analysis

Effect of Heel Warming with a Thermofor at Two Different Temperatures Before Heel Stick Sampling in Healthy Term Neonates on Total Crying and Procedure Durations: A Randomized Controlled Trial

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