5 Capillary and Special Collections
Learn how to collect and handle capillary specimens, blood cultures, donor blood, and other specialized samples while following their specific site, timing, container, and transport requirements.
Fundamentals for special collections
Special collections require the same fundamentals as routine phlebotomy: correct patient identification, hand hygiene, appropriate personal protective equipment, accurate labeling, and prompt handling. They may also have specific requirements for collection site, timing, sterility, or transport.
Follow the test order, collection-device instructions, and facility procedure whenever they differ from a general example.
is obtained by skin puncture and contains blood from small vessels along with some interstitial fluid. It is useful when only a small volume is needed, including for selected point-of-care tests, neonatal testing, and certain hematology measurements. Venipuncture may be preferable when a larger volume or multiple tests are required.
Select and prepare the site
Adults and older children: Use the side of the fingertip, commonly the middle or ring finger. Avoid sites that are cold, swollen, scarred, infected, or poorly perfused. Follow local restrictions for patients with conditions that may affect circulation or healing.
Infants: Use the medial or lateral plantar surface of the heel. Avoid the back and center of the heel. Choose a puncture depth appropriate to the patient and device to reduce the risk of injury.
Warm a cold site gently if permitted by procedure. Clean the site and allow it to dry.
Use a single-use lancet and puncture once with a deliberate motion. Wipe away the first drop when the procedure or test instructions call for it. Collect subsequent drops without forceful squeezing, since excessive pressure can introduce tissue fluid and contribute to hemolysis or inaccurate results. Apply pressure afterward and confirm bleeding has stopped; dispose of the lancet immediately in a sharps container.
Collection order and containers
The usual capillary order of draw is hematology first, chemistry second, and blood-bank specimens last. This differs from the standard venipuncture order. Use the correct microcollection container, fill it as required, and mix additive tubes gently according to the manufacturer's directions.
For example, when collecting capillary hematology and chemistry specimens, collect hematology first and chemistry second; do not use venipuncture tube order for this skin puncture.
help detect microorganisms in the bloodstream. Contamination from skin organisms can cause misleading results, while insufficient blood volume can reduce the chance of detecting infection. Collect cultures before antimicrobial therapy when feasible, but do not delay urgent care. The order, culture system, and facility protocol determine the number of sets, bottle type, and required volume.
Collection practices
Verify the patient using the required identifiers and gather the correct culture bottles and supplies.
Prefer peripheral venipuncture unless the clinical question or facility protocol calls for a line draw. If cultures are drawn from a line to investigate a catheter-related infection, paired peripheral and line specimens may be required.
Disinfect the skin with the approved antiseptic and allow it to dry fully. Disinfect bottle septa as directed. Do not touch the prepared site; if it must be touched, follow the facility's sterile-site procedure.
Collect the ordered volume and bottle set. Record the collection time and site, and label each bottle with the required patient and specimen information.
Transport cultures promptly according to laboratory instructions. Do not refrigerate them unless the laboratory specifically directs it.
For a suspected bloodstream infection, an order may call for multiple sets from separate peripheral venipunctures. Collecting only one set or underfilling bottles may limit interpretation or organism recovery.
is a separate, regulated process performed by trained staff at an authorized blood collection facility. Its goal is to collect a blood component safely for transfusion or further processing, rather than to perform diagnostic phlebotomy. The collection establishment assesses donor eligibility before donation under applicable requirements and its procedures.
A typical whole-blood visit includes registration, a confidential health-history review, and a brief health check that may include vital signs and hemoglobin measurement. If the donor is eligible, staff collect blood using a sterile, single-use collection set, monitor the donor during recovery, and offer refreshments.
Donation volume, timing, eligibility criteria, and post-donation instructions are governed by the blood center's current procedures. Phlebotomy staff should not independently determine eligibility or promise that a donor qualifies.
Other specialized specimens
Specialized specimens may depend more on patient instruction, timing, or container choice than on venipuncture technique. Before collection, confirm the requested specimen type, container, labeling, storage, and delivery requirements with the laboratory.
Urine and respiratory specimens
For , the patient cleans the area as instructed, begins urinating into the toilet, and then collects the midstream portion in the designated container without touching its inside. This helps reduce contamination from skin or genital organisms.
For , instruct the patient to produce material from a deep cough, not saliva, and collect it in the specified sterile, leakproof container. If the specimen is collected to evaluate tuberculosis, follow the facility's airborne-infection precautions and designated collection location.
and timed specimens
Use only the swab and transport medium specified for the test. Collect from the ordered anatomical site, avoid contaminating the swab, and place it in the transport system as directed. Test-specific instructions matter because acceptable swab types and transport conditions vary.
For , confirm the exact required collection time against the medication dose, procedure, or test order. Document the actual collection time; do not estimate or relabel a specimen to match the requested time.
Specialized blood spots
For and other specialized blood spots, follow the current collection card, patient-age and timing requirements, drying instructions, and shipment procedure. Incomplete or contaminated spots may require recollection.