Three venepuncture techniques in babies: a comparative study

Abstract

Modifying hyodermic needles for blood sampling in babies is common. However, such techniques mean that medical devices are not always used as manufacturers intend and potential and actual risks associated with their use occur. A number of new devices have recently been designed to overcome safety issues. However, whether new devices are any more effective than existing modified methods is unknown. Through a randomoised controlled trial, this study attempted to compare the safety and efficacy of three blood sampling techniques in babies: (i) the 'broken' needle, (ii) the 'modified' buttrefly' and (iii) a new 'single winged' needle designed specifically for venepuncture in babies and young children. Eligibility criteria for inclusion to the study comprised: babies twelve months of age and under, weighing over 1500 grams, requiring at least three routine blood samples to monitor their condition, six hours apart. Informed, written parental consent was also required. The sample was drawn from a neonatal intensive care unit and achildren's unit in a large teaching hospital. Ethical approval for the study was gained form the local research ethics committee. Babies recruited into the study were randomised according to the order in which the three blood sampling techniques were used. Data were collected in terms of: (1) whether the blood sample had been obtained after one, two or more than two attempts; (2) whether there was clotting in the sample and (3) whether there was bruising and the extent of the bruising measured at the largest diamter of the bruise. Fourteen babies completed the study reulting in the trail being severely underpowered. Recruitment to the study was disappointing and was, in part, attributed to a number of adverse incidents that had occurred in clinical and research practices involving babies and children, that had gained much media attention, both before and during the study period