A variety of disposable skin puncture devices are available that will ensure a safe procedure when used properly. Most devices have a spring loaded feature for the blade or the lancet. Once activated, the lancet will automatically puncture the skin using a quick motion. The lancet will immediately retract back into the housing of the device. This design eliminates the possibility of accidental needlestick injury to the phlebotomist.
All devices are single use only and must be disposed of in an approved sharps container immediately after activation. An example of an approved sharps container is shown below.
It is very important for the phlebotomist to use the puncture device that is designed specifically for the procedure that will be performed. Lancets are manufactured to ensure incisions to a safe depth and length. A special lancet designed for use on babies less than 5 pounds is available and should always be used when performing a heelstick on a premature infant. A lancet designed for puncture of a finger should not be used for the puncture of a heel. A heel incision device is set to a maximum penetration depth of 2.0 mm (some facilities may require even shallower penetration for premature infants). Fingerstick devices may exceed this maximum depth of penetration that is allowed for an infant heel puncture.
The upper image on the right illustrates a lancet style that is typically used for fingersticks. The lower image on the right is one style of puncture device that is used for heelsticks.