By the way: make sure to avoid pricking thumbs and index fingers as they are most commonly used to touch and feel. And while you're at it, know that it won't hurt to have your fingers checked out by a doctor on a regular basis.
But what is an appropriate site? Finger - Usually the third or fourth finger is preferred in adults and children. The thumb has a pulse and is likely to bleed excessively. The index finger can be calloused or sensitive and the little finger does not have enough tissue to prevent hitting the bone with the lancet.
The best finger to get blood from is your ring finger. When performing a finger-prick test, use the side of your ring finger. It is where circulation is at its peak, and you are more likely to collect a complete sample from this one finger.
When performing a fingerstick, the phlebotomist should puncture either side of the fleshy pad of the middle or ring finger, but not the extreme side of the finger. The exact center of the fleshy pad or the tip of either finger should also be avoided.
Choose any of the middle three fingers because palmar fascia of middle three fingers is limited to hand only(whereas that of thumb and little finger is continuous with that of arm), if infection occurs following puncture it will be limited to the hand only.
The middle or ring finger is preferred as having the greatest depth of tissue beneath the skin and hence offering the least chances of injury. The thumb or index finger may be more likely to be calloused or scarred, as well as being much more sensitive, making the procedure more painful.
The following rules apply when capillary blood sampling is performed from a finger: The puncture must be on the palm-up surface of the distal segment (fingertip) of the middle or ring finger (Figure 3, a).
It does not matter which finger is used for glucose measurements. External pressure may lead to unreliable readings.
Once your hands are warm and dry, use the lancet on the side of your “favorite” finger. This may be mostly mental, but when it's early morning and my hands are cold, using a tried-and-true finger (left little finger, for me) really helps.
Recommended finger: the World Health Organisation recommends the middle or ring fingers are used for blood glucose tests (second and third fingers). You may want to avoid using your little finger due to the skin being thin.
A significant finding of the study was glucose readings were significantly higher in the right arm compared to the left arm. Volunteers were alerted to having low blood glucose 30 percent of the time on the left arm, in comparison to 22 percent of the time on the right arm.
Change up the location of your finger prick. If you put your hands together, palms touching, you will be able to see the areas of your fingers with fewer nerve-endings. Pricking the sides of your fingers can be less painful because there are fewer nerves there.
Wipe away the first drop of blood because it may be contaminated with tissue fluid or debris (sloughing skin). Avoid squeezing the finger or heel too tightly because this dilutes the specimen with tissue fluid (plasma) and increases the probability of haemolysis (60).
Traces of blood can remain in the end cap and may cause cross infection. This procedure may potentially transmit disease, particularly the virus infections hepatitis B, hepatitis C and HIV from contaminated equipment, gloves, hands or surfaces.
Although blood from the fingertip most accurately reflects changes in venous glucose levels, numerous nerve endings there may make testing painful and repeated sticks can lead to local tissue damage.
Try adjusting your lancet. Some lancet devices are adjustable, so you can choose how deeply they prick. Use the shallowest setting possible, as deeper pricks will hurt more. Choose a different blood glucose meter.
Officially, all lancets are single use.
Wipe away the first droplet of blood with a cotton ball or gauze as indicated. Rationale: The first drop of blood may be contaminated with the alcohol used for disinfection, which may provide an inaccurate result.
After pricking your finger with the lancet, you should need to apply only slight pressure to release blood flow. If you need to apply a lot of pressure to produce a sample, that finger may not be the best testing site for you. Squeezing or milking the finger can contaminate the sample and lead to inaccurate results.
Finger prick blood glucose readings and sensor glucose readings won't always match and in fact are likely to be different. That's because sensor glucose readings come from the interstitial fluid (ISF), a thin layer of fluid that surrounds the cells of the tissues below your skin, not from your blood.
Sites that should be avoided include areas with extensive scarring, healed burns, inflamed sites, edematous sites, previous puncture sites, earlobes and thumbs. Such terms as “needs to,” “must,” “require” and “should” are used to explain how medical professionals should perform capillary blood collection procedures.
Capillary collection should not be performed on adult patients if adequate veins are available and patient is willing to allow their use. Also, capillary collection should be avoided if patient is dehydrated, has edema, or presents with poor circulation to the extremities.
IF BLOOD STOPS FLOWING INTO THE TUBE:
The vein may have collapsed; resecure the tourniquet to increase venous filling.
The finger prick can cause blood contamination of surfaces in contact with the lanced finger, especially door handles, risking infectious disease transmission, particularly if another person touching the contaminated door handle also has a punctured fingertip.
The best place to prick the fingertip is on the side because it has the best blood supply, yet allows for the least painful fingerstick. Any finger may be used for a fingerstick. Firmly insert a new ACCU-CHEK Softclix lancet in the lancet holder until it snaps into place.