Which of the following needle gauge ranges should a phlebotomist select when performing a venipuncture for blood donation?

Choice A Reason:
Explaining the procedure to both the parent and the child is crucial. It helps in preparing the child psychologically and ensures that the parent is informed and can provide support during the process. Clear communication can reduce anxiety and make the child more cooperative. It is also a part of informed consent, where the parent understands what the procedure entails and why it is necessary¹².

Choice B Reason:
Choosing not to tell the child when the needle insertion is coming might seem like a way to avoid causing them anticipatory anxiety. However, this approach can lead to mistrust. Children need to be prepared for what to expect, and surprising them can be more traumatic in the long run. It is better to be honest and use age-appropriate language to describe the sensation as a 'quick pinch' or 'poke'¹².

Choice C Reason:
Obtaining a heel stick is a common method for blood collection in infants, particularly newborns, as their veins are not as developed. However, for preschoolers, venipuncture is usually the preferred method because they have more developed veins, and it allows for a larger volume of blood to be collected if needed³.

Choice D Reason:
Obtaining a thumb stick is not a standard practice for blood collection in preschoolers. The thumb has bones and tendons close to the surface, which can increase the risk of injury. The preferred sites are the antecubital fossa of the arm or the back of the hand where the veins are more accessible and there is less risk of hitting bone³.

Choice A Reason:
Taking the specimen temperature before 4 minutes is the correct procedure according to the Department of Transportation (DOT) guidelines. The DOT Rule 49 CFR Part 40 Section 40.65 states that the temperature of the specimen must be checked no later than four minutes after the employee has given the specimen. The acceptable temperature range is 32–38 °C/90–100 °F, which helps to verify the validity of the specimen.

Choice B Reason:
Taking the specimen temperature at 5 minutes is not within the DOT guidelines. The temperature must be taken before 4 minutes have passed to ensure the specimen's integrity and to comply with the regulatory requirements.

Choice C Reason:
At 15 minutes, the temperature check would be too late. The DOT guidelines specify that the temperature should be checked no later than four minutes after collection to ensure the specimen has not been tampered with and is within the acceptable temperature range.

Choice D Reason:
After 30 minutes, the temperature of the urine specimen would not reflect the body temperature at the time of collection, which is necessary for the validity of the test. This delay could allow for the temperature to fall outside of the acceptable range, potentially invalidating the specimen.