drawing labs in triage

My ED doesn't draw labs in triage but they do urine tests to expedite pregnancy tests(to females of child bearing age of course) and UA's(if a patient is complaining of illness and other reasons I am sure). I don't work the ED but I have friends who do and we at times like to share stories of whats happening in the ED and the Floors. They did at one point talk about drawing blood in triage but that idea was shot down faster than a doctor saying no to a patient asking for 2mgs of IV dilaudid for a sprained finger.

We only do lab draws in triage when the lobby is backed up and patients aren't moving into the back. Typically, even on our busiest days, our patient flow is pretty efficient. We register at the bedside whenever possible, or do a quick, simple registration in triage, and the full registration in the back. The vast majority of our labs are drawn in the back by RNs or Techs. Our turnaround times are pretty good, often with labs completed by the time the physician is in the room.

Do you have Nurse Initiated Protocols?

We tend to draw labs in triage when the wait time (in the waiting room) starts to approach 30-45 mins [meaning: Pt. has been sitting in waiting room awaiting stretcher in ED for 30-45 mins. This doesn't count the time it might additionally take for an ER doc to sign up and see pt. once said pt. finds an empty spot in our crowded ER].

Discretion for ordering labs/x-rays etc. usually rests with triage nurse/charge nurse. There are protocols in place to facilitate this...

cheers,

Urine, nose and throat swabs in triage. XR and CT if they are waiting for a while. I draw blood when i start an IV unless the vein is going to blow, and I always try to draw blood just in case so I don't have to cause more pain to my pts. Now that doesn't mean I wont use a 16 on the drunk guy staying on the call bell.

Thanks for the replies. Yes, we have ANI's...Advanced Nursing Interventions. These ANI's allow the triage nurse to initiate labs, urine, a few CT scans, and a few meds on a variety of symptoms. (chest pain, renal colic, head injury, pneumonia, upper and lower abdominal pain, etc...) What we see happening is if I order an abdominal pain ANI, labs may not be drawn for 3 or 4 hours later. I am not sure why. We are working on that, also. That defeats the purpose of ordering an ANI.

Our triage process has gone through alot of changes over the past couple of years. We are doing a quick triage now and sending pts straight back if there are open rooms. The problem lies with when our wr times increase. Do you guys have a process when you triage a pt and know you will draw their labs in triage? We are presently trying to come up with a solution to that process.

Thank you!

Teresa