Question 1

What is the preferred site for dermal puncture in adults and children older than 1 year?

Accepted Answer

The plantar surface of the heel is not used; instead, the fleshy pad of the distal (third or fourth) finger, specifically the middle or ring finger, is the preferred site.

Question 2

Which fingers are AVOIDED during dermal puncture and why?

Accepted Answer

The index finger (thumb side) is avoided because it is more sensitive and calloused, and the pinky finger is avoided because it has less tissue depth, increasing the risk of bone injury.

Question 3

Where exactly on the finger should the lancet puncture be made during a dermal puncture?

Accepted Answer

The puncture should be made on the fleshy pad of the fingertip, slightly to the side of center, perpendicular to the fingerprint lines to maximize blood flow.

Question 4

What is the preferred dermal puncture site for infants younger than 1 year?

Accepted Answer

The medial or lateral plantar surface of the heel is the preferred site for infants younger than 1 year (neonates and infants).

Question 5

Which areas of the infant heel must be AVOIDED during a heel stick and why?

Accepted Answer

The posterior curvature of the heel and the arch of the foot must be avoided to prevent damage to the calcaneus (heel bone) and nerves/arteries in those areas.

Dermal Puncture – Phlebotomy Certification (NHA)

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