title: Ultrasound study of heel to calcaneum depth in neonates.
abstract: OBJECTIVE
  To investigate whether it would be safe to extend the currently recommended area of sampling to the whole heel in neonates.
  
  
  METHODS
  Eighty newborn infants were studied, weight range 0.56 to 4.34 kg, gestation 24 to 42 weeks. Ultrasound scanning was used to measure the shortest distance between the skin and the perichondrium of the calcaneum.
  
  
  RESULTS
  The shortest depth of perichondrium was in the centre of the heel and ranged from 3 to 8 mm. In 78 of the 80 infants the distance was 4 mm or more. There was a small but significant positive correlation with weight.
  
  
  CONCLUSIONS
  Standard automated lancets for preterm use that puncture to a depth of 2.4 mm may be safely used anywhere over the plantar surface of the heel. The posterior aspect of the heel should be avoided. Reducing the density of heel pricks should reduce the associated pain.
authors.affiliation: Department of Neonatal Medicine, Nottingham City Hospital, Nottingham NG5 1PB. anoo.jain@nottingham.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Jain
authors.forename: N
authors.initials: N
authors.lastname: Rutter
mesh_terms: D001800:Blood Specimen Collection / Q000379:methods*; D002111:Calcaneus / Q000000981:diagnostic imaging; D006365:Heel / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D012015:Reference Standards; D014463:Ultrasonography