Preventing Iatrogenic Anemia
How much is too much blood to draw?
When a physician’s request for lab work is so extensive that the volume of
blood required to perform the tests puts the patient at risk of developing
anemia, it’s too much. But what’s the limit? At what level of volume
depletion does phlebotomy become risky? Unfortunately, there is no universal
Once established, one way to implement it might be to require documentation in the patient’s chart every time blood is sampled. When the predetermined level is met, the required intervention would be triggered. The burden of monitoring the volume can be placed on the nurse, physician, or laboratory, but someone must be given the responsibility in order for the policy to be effective.
Three textbooks share a chart that originally appeared in 1982 in the Textbook of Clinical Laboratory Supervision by Kathleen Becan-McBride. The chart contains suggested maximum amounts to be drawn at one time and throughout a hospital admission, each based on the patient’s weight. Adaptations of that chart appear in Applied Phlebotomy by Dennis J. Ernst MT(ASCP) and the 7th edition of Phlebotomy Handbook by Diana Garza and Kathleen Becan-McBride. Because the origin of the chart is dated, it should serve only as a guide and not implemented without thorough consideration.
This Month in Phlebotomy Today
Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 8th year of publication, are reading about this month:
Feature Article: How Collection Personnel Alter
Test Results, Part I: Hemoconcentration
· Do we need an eyewash station in our patient service centers where all we do is draw blood?
· How do you test an eyewash station?
Phlebotomy in the News: a round-up of articles on phlebotomy and phlebotomists who made Internet headlines in August including these stories:
to the Standards: Arterial Puncture for Routine Lab Work
For subscription rates and to subscribe to Phlebotomy Today, visit www.phlebotomy.com/PhlebotomyToday.html. The current month’s issue will be emailed to you immediately upon subscribing.
Center Looking for Graphic Artist/Web Designer
Center for Phlebotomy Education is searching for an ambitious full-time
graphic artist/web designer to embrace as one of its valued team members.
Successful applicants will have a positive work ethic, an appreciation for a
professional working environment, experience in graphic artwork and web
design, a willingness to relocate to the beautiful, rolling hills of Harrison
County, Indiana, and expertise in design programs including Dreamweaver,
Adobe Photoshop and Adobe Acrobat. Knowledge of phlebotomy will put your
resume on the top of the stack. Send resume and salary requirements to:
Featured FAQ: Discarding Tourniquets
Question: Our Ortho rep suggested that I contact you. Here is my question: Has OSHA ruled that tourniquets in the outpatient setting must be discarded after each patient? Or only when soiled/end of day? I am looking for the actual regulation, not opinion. Thank you.
Response: OSHA would not make such a
mandate. Discarding tourniquets after one issue is more of an infection
control issue than an OSHA issue. OSHA is concerned only with employee injury
and illness, not patient issues. In fact, OSHA doesn't even mention
tourniquets in the Bloodborne Pathogens Standard, so they have no position on
the issue unless the equipment is soiled by blood in such a manner and to
such a degree that it is a potential risk to employees.
Each month, PT--STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's web site. For information on joining Phlebotomy Central, visit www.phlebotomy.com/PhlebotomyCentral.html.
Specimen Collection Safety: “The Two-Finger Stretch”
Do you use the
“two-finger stretch” to anchor veins, i.e., place your index finger above the
intended puncture site and your thumb below to keep the vein from rolling?
Anchoring the vein both above and below the puncture site helps keep the vein
in place; it also puts your finger in position for an accidental needlestick
should the patient jump. Anchor the vein from below is sufficient and a
Product Spotlight: Online Specimen Collection Training Program
The Center for Phlebotomy Education, Inc. announces the introduction of a dynamic online training program for all managers and educators who train specimen collection personnel, and all healthcare professionals who perform blood specimen collection procedures.
PhlebotomyWeb have the ability to assign students and staff to
navigate through each of nine modules at their own pace. All modules
terminate with an exam to measure comprehension. PhlebotomyWeb serves
as a comprehensive supplement to a facility or school’s ongoing training
program, and gives administrators the opportunity to monitor their students’
or staff’s progress through each module. Additionally, PhlebotomyWeb
offers annual competency assessments.
For more information, visit http://www.phlebotomy.com/PhlebotomyWeb.html.
Thanks to a July press release published in PT-STAT!,
Summit Health, Inc. (formerly Retail Health, Inc.) has accepted over 150 new
per diem phlebotomists to draw specimens at health screening events
PT STAT! is a free, monthly educational
service provided by the Center for Phlebotomy Education, Inc., the most
respected authority in phlebotomy. For a complete company profile and product
list for all healthcare professionals who perform, teach or manage specimen
collection procedures, visit us on the Internet at: http://www.phlebotomy.com.
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