A phlebotomist is performing a venipuncture on a patient who is allergic to alcohol. Which of the following is an appropriate antiseptic to use in place of alcohol?

Choice A reason:
Expired tubes may lose their vacuum, which is necessary to draw the correct volume of blood into the tube. The vacuum in blood collection tubes ensures that the correct amount of blood is drawn. If the vacuum is lost, the blood will not be drawn into the tube properly, which can lead to underfilling and affect the test results.

Choice B reason:
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually because of a loss of plasma. While this can occur due to prolonged tourniquet application or dehydration, it is not directly caused by the use of expired tubes.

Choice C reason:
Hemolysis is the destruction of red blood cells, which can release hemoglobin and other intracellular components into the plasma. It can be caused by physical damage, such as from a needle during blood draw, but is not a consequence of using expired tubes. However, if an expired tube causes improper blood draw due to loss of vacuum, it could indirectly lead to hemolysis due to multiple attempts to draw blood.

Choice D reason:
An elevation of the red blood cell count would not be directly caused by using expired tubes. The red blood cell count is determined by the body's production and destruction of red blood cells, not by the collection method or equipment used.

Choice A reason:
The lateral section of the plantar heel is the recommended site for capillary blood collection in infants, particularly those under 6 months of age. This area is preferred because it is sufficiently vascularized for blood collection and poses less risk of injury to bones and nerves compared to other areas.

Choice B reason:
The central area of the heel is not recommended for capillary blood collection in infants due to the higher risk of injury to the calcaneus (heel bone) and potential for calcaneal osteomyelitis, an infection of the bone.

Choice C reason:
The posterior curvature of the heel is also not an appropriate site for capillary blood collection in infants. This area has a higher likelihood of causing pain and injury, as well as being less accessible for a proper puncture technique.

Choice D reason:
The palmer surface of the distal phalanx (fingertip) is not a recommended site for capillary blood collection in infants under 1 year of age. The fingertips of infants are small and more prone to injury, and the procedure may be more painful compared to a heel stick.