15 - 01 D EPARTM ENT O F H E ALTH Issue: Raised by: Capillary Blood Lancing Device - Review Various; Diabetes Educators (PHC - CAHS / TEHS); Child Health Nurses (PHC - CAHS / TEHS). Background: Pressure activated capillary blood lancing devices (lancets) are used routinely in remote health centres to collect capillary blood samples for clinical tests including haemoglobin (Hb), blood glucose (BGL) and INR measurements. Lancet design varies in the size and shape of the lance needle, and the depth of the puncture, all of which influence the sample size. Current lancet models used in PHC Remote are defined by their flow rates - Hi, Medium or Lo. The Hi-flow lancet being utilised for testing that requires a larger sample (Hb / INR) was found to cause excessive trauma and bleeding, particularly in children. Discussion: A trial of the medium-flow and hi-flow lancets was conducted in Central Australia. Remote Health Centres were provided with a supply of medium flow lancets and were requested to trial their use in all situations of use, including INR, Hemocue and BGL in all age groups. All responses were conclusive that the medium-flow lancet proved as efficient with less morbidity in comparison with the hi-flow lancet. It is therefore proposed that it be replaced by the medium-flow device for Hb and INR testing, particularly in children. The Lo-flow lancet is adequate and remains available, for BGL testing. Consultation: NT Diabetes Educators; Various NT remote Health Centres; NT Top End Product Review Committee References: Product literature. Outcome: Medium-flow lancets are to be utilised for obtaining capillary routine samples when testing Hb and INR in PHC Remote Health Centres. Lancets are available from NT Regional Hospital Stores as follows: Lancet Description Medium Blood Flow Contact-activated Lancet 21g / 1.8mm depth Recommended Use Hb (HemoCue) INR (iSTAT/CoaguChek) Single-use, disposable Low Blood Flow (single drop) Contact-activated Lancet 30g / 1.5mm depth Single-use, disposable BGL (Glucometer) Ordering CA LANCE 004 Top End LANCE 004 CA LANCE 008 Top End LANCE 006
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