When a phlebotomist performs a heel stick for the purposes of obtaining a PKU test, it is important to:

Choice A Reason:
Contacting the physician by paging or calling right away is the most appropriate action when critical values are confirmed on a laboratory test. Critical values are defined as those that indicate the patient is in danger of death unless treatment is initiated immediately. Immediate notification of the responsible licensed caregiver is required so that appropriate clinical action can be taken for the patient. This is a standard procedure compliant with CLIA regulation 493.1109(f) and is essential for patient safety.

Choice B Reason:
Leaving a message at the physician's office number is not an adequate response to confirmed critical values. Messages can be overlooked or not checked until the next business day, which could delay necessary urgent medical interventions.

Choice C Reason:
Calling the physician's office on the next business day is not acceptable when dealing with critical values. The urgency of critical results requires immediate action, and waiting until the next business day could result in significant harm or death to the patient.

Choice D Reason:
Faxing the results to the physician's office with a stat fax cover is not sufficient for immediate communication of critical values. While the fax may indicate urgency, there is no guarantee that the fax will be seen immediately by the physician or their staff. Direct communication through paging or calling ensures that the critical information is relayed without delay.

Choice A Reason:
Povidone-iodine is an antiseptic used for skin disinfection before and after surgery. It has a broad spectrum of antimicrobial activity, but it is not the preferred choice for capillary blood collection due to the potential interference with certain laboratory tests. Povidone-iodine needs to be completely dried to avoid hemolysis of the sample, which can affect test results.

Choice B Reason:
Hand sanitizer is generally used for hand hygiene and not for the disinfection of the site for blood specimen collection. While it is effective in killing germs on the skin, it contains emollients and gelling agents that can contaminate the blood sample and interfere with laboratory tests.

Choice C Reason:
70% isopropyl alcohol is the most commonly used disinfectant for aseptic technique in capillary blood collection. It is effective against a broad range of microorganisms and evaporates quickly, leaving no residue that could contaminate the sample. It is important to allow the alcohol to dry completely before performing the puncture to prevent stinging and sample dilution.

Choice D Reason:
A 10% chlorine bleach solution is not typically used for skin disinfection in blood collection due to its harshness and potential to cause skin irritation and damage. It is more commonly used for disinfecting surfaces and equipment in healthcare settings.