finger prick blood draws: are all lancets created equal?

Fingerstick blood draws are generally quicker to draw and more patient-friendly than blood draws from veins. But, are there considerations in lancet choice and finger prick preparations that could impact patient comfort?

Lancet Types

Standard - A standard exposed-blade lancet goes deep into the skin to reach the capillary blood, and it hits pain nerves on its path. Patients must use a new lancet for every prick. Repeated use dulls the blade, making each subsequent prick more painful, as well as introducing risk of infection.

Safety - Safety-type lancets have spring-loaded blades that automatically retract. Safety lancets are more hygienic because the blade only comes out when it punctures the skin, and then it retracts. After retraction, the blade doesn't pose a hazard for either punctures or contamination. This type of lancet has the advantage over the exposed-blade lancet of being more user-friendly for at-home blood tests by those who are squeamish about finger pricks or have needle phobia, since the blade is never seen.

Vacuum - Another type of lancet has a built-in vacuum. These lancets penetrate the skin 20% as deep as standard lancets and pull out the blood from the capillaries via vacuum. Because capillaries are at different depths in different parts of the body, vacuum-equipped lancets enable the user to draw blood from sites other than fingertips.

Laser - Laser lancets were used about 15 years ago, and they fell out of favor because they essentially bored a hole into the fingertip, which is much more painful and injurious than traditional blade lancets.

Preparations to Help Reduce Fingerstick Blood Draw Pain

When obtaining a sample of capillary blood, a finger prick blood draw is a common method. Even though it's a straightforward process, there are tweaks that can help patients better tolerate this type of blood draw. Both the lancet type and the preparation for and pricking of the finger can affect patients' pain tolerance. It is important to remember, though, that patients must always follow the lancet manufacturer's instructions step-by-step.

1. Washing hands with antibacterial soap instead of using alcohol. Alcohol wipes dry out and constrict the skin in such a way that the subsequent puncture is more painful and the blood doesn't flow out smoothly.

2. Pricking the side of the finger helps with the perception of pain because the fingertips aren't damaged and painful after the prick.

3. Selecting a lancet with a smaller gauge can also help reduce pain to what some manufacturers describe as a barely perceptible level. Lancet depth can also impact pain levels, however it is important to note that blade length will affect the amount of blood drawn. Therefore the number of blood drops required for the test must also be considered when selecting a lancet.

Let us know if your patients have a preferred lancet type and any finger prick hints.