You did a fingerstick on a patient and cannot seem to get enough blood. This patient is a construction worker with large, callused hands. What could be the problem? What would be a solution to the problem?

Answer 1

The problem is that the calluses on the patient's hands are not allowing the lancet to puncture the capillary bed to produce blood. Two things should be done: the hand should be warmed and a longer lancet should be used. This longer lancet would normally not be used, but it is useful for patients with callused hands. Unless there is a reason not to, you could use venipuncture to collect blood from this patient.