The Texas Department of State Health Services (DSHS) says it rejected more than 1,300 newborn screening specimens as unsatisfactory last year because of incomplete saturation, meaning the blood was not allowed to fully soak through the collection device.
"This unsatisfactory reason is often reported in conjunction with a 'Caked or Clotted' designation," a DSHS advisory says. "This happens when additional blood is applied to partially dried, but incomplete spots. This is the largest reason that specimens must be rejected, accounting for more than 30 percent of all rejected specimens. All of these specimens required a redraw and resulted in critical delays to testing of newborns that may have a disorder."
DSHS posted examples of specimens with these problems on its website.
The department offers suggestions and a free tutorial on how to reduce the number of unsatisfactory specimens and ensure prompt testing for all babies:
- Blot the blood directly from the heel onto one side of the paper while watching the opposite side to ensure that the circle is completely filled.
- Use the proper size (<2.0mm length) lancet (e.g., Quick Heel or Tenderfoot). A finger lancet is not recommended.
- Complete one circle at a time. Three good quality circles are better than five poor quality circles.
- Avoid going back and reapplying additional blood to an incompletely filled circle. This may result in caking or clotting.
If you have any issues with the absorbency of the collection kit or any general questions about specimen collection, call the DSHS laboratory at (888) 963-7111, ext. 7333.
Action, Feb. 1, 2011