How do lab draws work on your unit?

[sergel02, BSN]

The question just randomly popped into my head as I was drawing some blood for labs the other day, and it made me wonder how it works in pediatrics.

In adults at my hospital, nurses draw from the central lines, and lab comes and does venipuncture for those without central lines (other hospitals have the nurses do the puncture), and it's always towards the end of night shift in the morning.

In peds, do your patients get their labs drawn every day as well, or only when needed? Who does them, and do the kids go to your treatment room for it?

[KelRN215, BSN, RN]

Oncology patients will have labs drawn daily but most pediatric patients do not. Some never have labs drawn throughout their hospitalization. When I worked in the hospital, phlebotomy came to the unit once a day in the morning. They would only poke a patient twice and they would only draw labs for each patient once/day. They were also only available to come to the floors from 7a-3p. So any labs needed outside of that time or a second draw of the day, it was up to the nurse to draw. If phlebotomy had missed the patient twice, alternative options were the NICU, Anesthesia or the Transport Team as they were used to difficult sticks. Central line draws are done by nurses. Lab draws via venipuncture were rarely done in the treatment room on my floor.

[adventure_rn, MSN, NP]

Not peds exactly, but in NICU we draw all of our own labs. Strangely enough, most of our labs are done with a capillary heel stick, much like a finger poke for a blood sugar in adults. We have tiny little microtainers (~0.5 mL), and we squeeze drops of blood out of the baby's heel into the microtainer one drop at a time. We also draw up some heel stick labs into a capillary tube (for instance, to run a point of care cap blood gas). For larger volumes (> 1 mL), nurses either perform a venipucture or an art stick. If kids have arterial lines (either peripheral or umbilical), we draw off of the line. Conversely, in NICU it isn't common practice to draw off of central venous lines for labs. In the units where I've worked, NICU nurses would get called all of the time to draw labs on neonates in the ED, since lab never draws from such tiny kids; they'd also get called to other units like ED to start IVs.

I actually wrote a post a while back that mentions the topic

https://allnurses.com/general-nursing-discussion/its-a-whole-1023144.html

[jrt4]

We do both. Mostly for peripheral sticks phlebotomy is drawing them but some nurses prefer to do their own. Only nurses will draw from our central lines.

[sergel02, BSN]

Thanks for the responses everyone. Seems like it's pretty similar to the adult world. Except NICU, but that's a whole other world anyway haha