Neonatal Chemistry


Kansas Neonatal Blood Spot Collection,
Forms, and Shipping Guidelines

Cute Baby

Collection of a blood spot for the Newborn Screening Laboratory


  1. Complete ALL information on the collection form. With a ballpoint pen, print All information requested on the form.  Press hard.  Include current address information. Do not contaminate filter paper circles by allowing the circles to come in contact with spillage or by touching before or after blood collection. Keep “SUBMITTER COPY” if applicable.
     

  2.  

    Neontal Screening Form


     
  3. See diagram for puncture site. Avoid previous puncture sites or curvature of the heel.

  4.  

    Safe Puncture Area

    Shaded area is safe area for puncture site.

    Baby sleeping in a blanket.
  5. Place infant's limb in a position to increase venous pressure.
     
  6. Warm site with soft cloth, moistened with warm water up to 41°C, for three to five minutes.
     
  7. Cleanse site with alcohol prep. Allow area to AIR DRY.
     
  8. Puncture heel (refer to diagram). Make puncture using sterile lancet with tip no longer than 2.5 mm or use heel-stick device. Wipe away first blood drop with sterile gauze pad. Allow another LARGE blood drop to form.
     
  9. Gently apply filter paper to large drop of blood BUT NOT the heel. Allow blood to soak through and completely fill preprinted circle. Apply blood to one side of filter paper only. (Either side may be chosen for the procedure.) DO NOT Layer, or apply blood more than once for the same collection circle. DO NOT touch heel to filter paper.


  10.  

    Applying Blood to Filter Paper


     
  11. Fill remaining circles in the same manner as step 7 (allow a new large blood drop to form for each circle). If blood flow is diminished puncture a new sample site and repeat steps 5 through 7. Care of skin puncture site should be consistent with your institution's procedures.
     
  12. Allow blood spots to thoroughly air dry for at least 3 hours in a horizontal position away from heat and sunlight preferably on a rack. Avoid touching or smearing blood spots. Never superimpose one filter paper on another before thoroughly drying.
     
  13. Replace the white paper overlay over filter paper after blood spots have dried. Do not tear off or dispose of the paper overlay. Mail the specimen within 24 hours of collection.
     
  14. Please refer to http://www.marchofdimes.com/files/Neonatal.pdf for more information.
    Please refer to visual below for unsatisfactory blood spot codes.

What Is A Good Blood Spot?


Satisfactory Blood Spots

Satisfactory Blood Spots

Good Blood Spots. Entire circle filled with even saturation.




Unsatisfactory Blood Spots

Low Quantity Blood Spots - Back

Back

Low Quantity Blood Spots - Front

Front

Quantity not sufficient. Spots are too small and do not completely saturate the filter paper




Uneven Saturation of Blood Spots

Rough and wrinkled spots, uneven saturation, and possible heel pressing the filter paper.




Uneven Saturation of Blood Spots

Blood applied in multiple small spots.




Uneven Saturation of Blood Spots

Uneven saturation.



Guidelines for the Shipment of Dried Bloodspot Specimens to
the Kansas Health & Environmental Laboratories


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  • Allow blood spots to thoroughly air dry for at least 3 hours in a horizontal position, away from heat and sunlight.  Avoid touching or smearing the blood spots.  Do not allow the blood spots to come into contact with anything while drying.
  • After the blood spots are dry, cover the filter paper with the paper overlay attached to the collection kit (filter paper and forms).  This is required by the US Postal Service.  Never superimpose one filter paper on another.
  • The collection kit needs to have the biohazard symbol attached in order to meet US Postal Regulations.  This symbol is printed on the paper overlay of the KHEL forms.
  • The dried blood spots must NOT be packaged in airtight, leak-proof plastic bags. The lack of air can cause heat to buildup and the accumulation of moisture that can damage the blood spot test substances.  Also, chemicals in the plastic could contaminate the blood spot causing incorrect analytical test results.
  • The collection kit can be enclosed in a quality-bond paper envelope and securely sealed.  The US Postal Service refers to the outer envelope as a secondary container.  This envelope must have sufficient strength to withstand ordinary postal processing. 
  • DO NOT batch specimens unless it spans a 24 hour period and is coordinated with courier pickups or mail service.
  • DO NOT put specimens in an outside drop box.
  • Mail specimens to:
    • KDHE / KHEL
      NEONATAL CHEMISTRY
      6810 SE Dwight Street
      Topeka, KS 66620