Required section · Section 5 of 6

Learner decision

The capillary blood-lead screen in the case table is at or above the current CDC BLRV. The BLRV identifies children with higher exposure than most peers; it is not a safe concentration and not a toxicity threshold.

For an initial capillary result from 3.5 to 9 micrograms/dL, CDC recommends venous confirmation within 3 months. This interval is CDC guidance and must be applied with current jurisdictional or local rules. The laboratory reports the capillary result as a screen with specimen type, then supports venous confirmation and routes notification and reporting through policy.

Capillary collection can be contaminated. Apply the locally approved soap-and-water skin preparation, first-drop and collection-device procedure. Reject an inadequately collected or suspect specimen and recollect it; report the specimen type. A discordant venous result is the confirmed specimen-type result and does not identify why the capillary screen differed.

Release a capillary screen as a screen, preserve specimen type in the report, and route venous confirmation through the defined workflow.

Workflow showing a capillary blood-lead screen reported with specimen type, rejection or recollection after collection failure, and a confirmed venous whole-blood result under CDC and local rules. — Figure 1Capillary screening, rejection or recollection, and venous confirmation pathway.

Ordering exercise

Put the laboratory actions in order after an initial capillary screen at or above the BLRV.

1. Obtain venous confirmation

For the CDC 3.5 to 9 micrograms/dL range, obtain confirmation within 3 months under current jurisdictional or local rules.
2. Release venous result

Release the validated venous whole-blood result through local reporting and notification policy.
3. Release the capillary screen

Report the measured capillary screen with specimen type and local workflow.

Knowledge checks

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Knowledge check 1

A capillary lead specimen has a documented collection failure or suspected contamination. What is the laboratory action?

Choose one option.

Reject the suspect specimen, recollect using the approved procedure, and report specimen type

Release it as a confirmed venous result

Use smear morphology to decide whether to release it

Knowledge check 2

How should the laboratory handle a capillary screen and a different venous confirmation result?

Choose one option.

Report each result with specimen type and treat the venous whole-blood result as confirmation without inferring the capillary result’s source

Average the two results into one lead concentration

State that the capillary specimen was contaminated

Knowledge check 3

Which report wording is bounded for an initial capillary result at or above the BLRV?

Choose one option.

Capillary blood-lead screen at or above the BLRV; specimen type reported; venous confirmation is required under CDC and current jurisdictional or local rules.

Confirmed lead toxicity; begin treatment.

Below a safe lead concentration.

Section status

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