Which of the following is an appropriate technique when preparing a site for venipuncture after applying antiseptic?

Choice A Reason:
CLIA, or the Clinical Laboratory Improvement Amendments, sets standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results. While CLIA provides a framework for laboratory operation, it does not offer specific guidelines for chemical spill cleanup.

Choice B Reason:
OSHA, or the Occupational Safety and Health Administration, provides regulations to ensure worker safety, including protocols for handling hazardous materials. However, OSHA itself does not provide the specific cleanup procedures; instead, it requires workplaces to follow certain safety practices.

Choice C Reason:
SDS, or Safety Data Sheets, provide detailed information on chemicals, including their properties, health hazards, protective measures, and safety precautions, including spill response and cleanup procedures. In the event of a chemical spill, the SDS contains the most direct instructions for safe and effective cleanup, making it the primary reference for a phlebotomist in this situation.

Choice D Reason:
The CDC, or Centers for Disease Control and Prevention, focuses on public health and disease prevention. While the CDC provides guidelines for infection control and laboratory safety, it is not the primary resource for chemical spill cleanup procedures.

Choice A Reason:
The recommended heel stick depth of 2.0 mm is based on the need to minimize the risk of injury to the infant. Penetrating deeper than this can increase the likelihood of hitting bone, which in infants can be as close as 2.0 mm under the skin of the plantar surface of the heel. This depth is sufficient to obtain a blood sample without risking injury to deeper tissues or bone.

Choice B Reason:
A depth of 2.5 mm may be too deep for some infants, especially preterm or very small infants, where the calcaneus (heel bone) is closer to the surface. While this depth might still be safe for some infants, it does not provide the same margin of safety as the 2.0 mm recommendation and could potentially lead to bone puncture or other injuries.

Choice C Reason:
A depth of 3.0 mm significantly increases the risk of bone puncture, especially in infants with less subcutaneous fat or in those who are preterm. This depth could easily breach the protective layer of skin and subcutaneous tissue, leading to a higher risk of osteomyelitis, an infection of the bone, which can be a serious complication in infants.

Choice D Reason:
A depth of 3.5 mm is considered too deep for a heel stick procedure and is likely to cause injury to the infant. This depth would almost certainly penetrate the bone in most infants, leading to severe pain, potential for infection, and other complications. It is well beyond the safe range recommended by CLSI and should be avoided.