Phil is performing a heel puncture. He is inspecting the infant’s heel for an appropriate puncture site. Phil gently, yet firmly, holds the infants heel, while imagining a V-shaped boundary line, with the center point at the back of the heel. Phil chooses his puncture site on the left side of the heel, on the outside of the V-shaped boundary line. What (if anything) has Phil done wrong?
  1. Phil should have chosen a site inside the V-shaped boundary.
  2. Phil should have inverted the V-shaped boundary line.
  3. Phil should have used a circle-shaped boundary line.
  4. Phil did not do anything wrong.
Explanation
Answer: D - Using a V-shaped boundary, starting at the back of the heel, helps the phlebotomist to choose a puncture site that is less likely to contain bone, tendon, or nerve tissue underneath the skin. In the central portion of the heel (the inside portion of the V-shaped boundary) bone tissue is very close to the surface of the skin, and could easily be injured by a lancet. Choosing a puncture site outside of the V-shaped boundary keeps the puncture site options contained to a safer area (the sides of the heels).
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