Blood Sampling

[lvnurs9]

Sometime last year, a friend of a friend who works in another NICU was trying to tell me about another way to draw blood. We were at a bar :) so I obviously don't remember much.

She was saying that you could poke a baby somewhere other then the heels or fingers/toes to get blood. These "areas" are rich in capillary beds and bleed really well.

Does anyone know what I am talking about?? Could you please elaborate?!?!

[RainDreamer, BSN, RN]

Wow, yet another thing my unit is way behind on... I have a poor wee primary (yes, another one) with fulminant MRSA and DIC, and I draw, let's see... CBC, Chem 20, ABG, coags... so... around 6ccs of blood, once a day, plus she gets Chem 10s and CBCs done at least one other time during the day. She's 1.4kg. I'm going to have to look into those guidelines. Usually we only draw that much off the ECMO kids, so it's not as much of an issue.

6 mls a day?! Wow! I assume she has to be transfused pretty often.

[elizabells, BSN, RN]

6 mls a day?! Wow! I assume she has to be transfused pretty often.

Well, if you factor in the other CBCs, Chemistries and ABGs, I'd estimate more like 8ccs/day. And yeah, she gets PRBCs and platelets pretty much every day, and we were doing FFP and cryo for a while to get the DIC under control. After they had me give her Vitamin K (IM! For reasons unknown, as Neofax recommends IV for coagulopathy, and she's got like an inch of edema all over, so it was probably SC anyway) it got a little better. One of those kids with a crit goal of 35 and platelet goal of 50, you know?

[vamedic4, EMT-P]

Well, if you factor in the other CBCs, Chemistries and ABGs, I'd estimate more like 8ccs/day. And yeah, she gets PRBCs and platelets pretty much every day, and we were doing FFP and cryo for a while to get the DIC under control. After they had me give her Vitamin K (IM! For reasons unknown, as Neofax recommends IV for coagulopathy, and she's got like an inch of edema all over, so it was probably SC anyway) it got a little better. One of those kids with a crit goal of 35 and platelet goal of 50, you know?

Yeah...check into those guidelines...that's a lot of blood to be taking.

[mawjood]

mostly in our NICU we usually do arterial puncture or heel

[littleneoRN]

Does anyone have a reference for the guidlines on on amount of blood-letting...um, I mean blood sampling volume per day? I have had concern about this before but haven't been able to find a solid reference.

[mawjood]

what I know that blood draw it supose to be 3-5% from total blood volume some time except up to 10

% as maximmand total blood volume is 80 ml \ kg so I you have prem with 500gm blood draw is 2 ml