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Collecting urine, stool, blood and respiratory specimens from children

  • Procedure

Pick the collection method that fits the child and the test, keep the sample clean, take as little blood as possible and comfort the child throughout.

Updated

What it is

Specimens from children need adapted methods. A urine bag is easy to use, but when a sterile sample is needed, usually to check for a urinary infection, it is taken by catheter by a trained professional. Stool in nappies is kept apart from urine. Blood draws use small veins, the smallest volume needed and pain-relief measures, because a child's total blood volume is small. Respiratory swabs need the child held still and a short, honest explanation. Correct labelling and prompt transport matter as much as the collection.

Indications

  • Urine tests (strip, culture) ordered by the clinical team.
  • Stool culture or other stool tests.
  • Blood tests by venipuncture or, in neonates, heel prick, per order.
  • Nasopharyngeal or other respiratory swabs for infection testing.

Contraindications and precautions

  • When a sterile urine sample is needed, usually to check for infection, a bag sample is not used; follow the protocol.
  • Children have a small total blood volume: take only what is needed and record every draw.
  • Nasopharyngeal swab: a rare minor nosebleed is possible; hold the head still and gently.
  • Adhesive bags may rarely cause a mild skin rash.

Equipment

  • Paediatric urine bags, sterile containers, cleansing wipes, plastic wrap for nappies.
  • Small-gauge butterfly needles, paediatric small-volume tubes, tourniquet, antiseptic.
  • Swabs and transport medium as the lab specifies.
  • Labels, request form, gloves; comfort and distraction items; sweet solution for infants if prescribed.

Step by step (and why)

  1. Check the order, the test, the container and transport needs, and identify the child with two identifiers — wrong tubes or labels mean repeating the procedure.
  2. Explain at the child's level, involve the parent and plan pain relief — fear and pain make collection harder.
  3. Urine bag: wash and dry the area, fit the bag, put the nappy on and check often; transfer without touching the inside — a contaminated sample misleads.
  4. Stool: line the nappy with plastic wrap or use a clean container, keeping urine and toilet paper out — mixing spoils the sample.
  5. Blood: hold the child in a comfort position, use distraction and, for infants, breastfeeding or a sweet solution per protocol — these reduce pain.
  6. Choose the vein by age, use the smallest needle and tubes, and escalate after two failed attempts — veins are precious and pain adds up.
  7. Swab: hold a young child with the parent, tilt the head back, pass the swab through a nostril, rotate briefly and withdraw — stillness keeps it quick.
  8. Care for the puncture site per institutional protocol and comfort the child afterwards — it closes the event well for the next time.
  9. Label at the bedside, record the volume of blood taken and send promptly — delays and missing data spoil results.

Complications

  • Contaminated or insufficient samples that need repeating.
  • Bruising or bleeding at the puncture site.
  • Hospital-acquired anaemia from repeated blood draws.
  • Skin irritation from adhesive bags.
  • Minor nosebleed or gagging after a nasopharyngeal swab.

Next step: when to call for help

  • Two failed venipuncture attempts or known difficult access: call a more experienced colleague.
  • A sterile urine sample is needed: inform the team so a trained professional takes it per protocol.
  • Bleeding at the puncture site that does not stop, or a cold, pale limb after a draw: report at once.
  • A child who becomes very distressed or unwell during collection: stop and ask for help.

Test yourself

Think of the answer, then tap the question to see it.

How is a urine bag fitted on a baby boy?

After cleaning, the whole penis is placed inside the bag and the adhesive pressed onto the skin; a nappy goes over it.

How is a stool sample collected from a child in nappies?

Line the nappy with plastic wrap so urine and stool do not mix, then transfer to the container.

Why must blood volumes be minimised and recorded in children?

Their total blood volume is small, so repeated draws can cause anaemia.

When should a nurse escalate a difficult venipuncture?

After two failed attempts, or at once if the child is known to have difficult access.

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Connections

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Urine collection - infants (Medical Encyclopedia) (MedlinePlus, U.S. National Library of Medicine, 2024); Fecal culture (Medical Encyclopedia) (MedlinePlus, U.S. National Library of Medicine, 2024); Nasopharyngeal culture (Medical Encyclopedia) (MedlinePlus, U.S. National Library of Medicine, 2024); Peripheral venipuncture in pediatric patients: a mini-review of clinical practice and technological advances (Journal of Clinical Medicine 14(18):6397) (Journal of Clinical Medicine (open access, CC BY 4.0, PMC12471072), 2025).

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