Bleeding patients 'till they're anemic

[sunnycalifRN]

A pet peeve of mine has been how much blood we draw from our patients for lab tests. I'm sure you've received a patient from the ER and in the ER all the standard labs were drawn, including two sets of blood cultures. Then, on admission to ICU, our docs re-order ALL the tests!! Then, we draw labs Q4, or Q6, or Q8, whatever . . . and, of course, if the patients spikes a temp, pan-culture again, even though the first set of cultures was drawn 6 hrs ago!!!

I Google'd iatrogenic anemia and found numerous hits:

Complications of critical care: Lab testing and iatrogenic anemia - Brief Article | Medical Laboratory Observer | Find Articles at BNET

However, when we've had a Jehovah's Witness patient, we're ordered to use pedi tubes for all lab draws and I've noticed that the docs are much more careful about ordering lab tests. The lab told me that for the standard lab tests, their automated analyzers used only tenth's of a ml, but we draw 5 ml.

When I worked at a "famous" hospital as a phlebotomist, years back, we always noticed that on the VIP floor, where the politicians, movies stars and the like went, lab tests were few and far between!! I guess they don't need those chem 7's for VIP's??!! What'cha think??

[WalkieTalkie, RN]

My hospital does a "blood conversation" approach for all patients:

Blood Management Program | Saint Lukes Health System

NoBlood - Transfusion alternatives. Blood management.

[sunnycalifRN]

My hospital does a "blood conversation" approach for all patients:

Blood Management Program | Saint Lukes Health System

NoBlood - Transfusion alternatives. Blood management.

you meant a "blood conservation" approach. In any case, it looks like an excellent approach. I wish that my hospital was so forward thinking.

[flo136]

I agree we take too much blood off. Where I work the new nurses are told to take blood gases every 3 hours. I've let it go a lot longer. They are also slow to rectify low urine output so nearly all our patients are now on dialysis which chews up their Hb as well. Nice one!!

[sunnycalifRN]

ABG's Q3 with no indication? Yep, good example of unnecessary bloodletting. Although each test may only take 2 ml for the ABG and 4 ml for the waste . . . repeated over and over along with the Q4 Chem panels, CBC's, coag's, etc ====> transfusion time!!

[WalkieTalkie, RN]

you meant a "blood conservation" approach. In any case, it looks like an excellent approach. I wish that my hospital was so forward thinking.

lol, yes, conSERvation, not conVERsation... darn auto-correct :)