c5-VOLUME REQUIREMENT CALCULATIONS.docx

VOLUME REQUIREMENT CALCULATIONS =============================== Iatrogenic anemia is caused by blood loss due to repeated venipunctures in a short period of time. Older adult patients, pediatric patients, and patients who are underweight are most susceptible to phlebotomy-induced iatrogenic anemia....

VOLUME REQUIREMENT CALCULATIONS =============================== Iatrogenic anemia is caused by blood loss due to repeated venipunctures in a short period of time. Older adult patients, pediatric patients, and patients who are underweight are most susceptible to phlebotomy-induced iatrogenic anemia. Older adult patients can be at higher risk due to medications that can suppress bone marrow production, which increases the risk of anemia. They can also be at risk due to decreases in nutritional intake, especially if they have experienced extreme weight loss. Because many older adult patients see several medical professionals, they can have a significant amount of blood collected by each professional, which can increase the risk of iatrogenic anemia. For patients who have cancer, both the cancer treatments and the effect of the disease on the body can increase the risk for iatrogenic anemia. Infants-especially those who are premature or had a low birth weight-have a risk of iatrogenic anemia due to a lower volume of blood. To help prevent iatrogenic anemia, it is important to understand the implications of collecting too much blood in a short period of time. Be willing to communicate any concerns with the appropriate health care professional. If you have a venipuncture request that seems excessive, check with the nurse or provider to ensure that the patient will not be put at risk. Contact the provider if the medical requisition requires blood tests that will collect more than the recommended amount. The provider can order different tests, reduce the number of tests, or order only the most essential tests. Blood specimen collection should be limited to 1% to 5% of total blood volume within a 24-hour period and to 10% of total blood volume over an 8-week period for pediatric or critically ill patients. To calculate infant blood volume, perform the following calculation. - Convert the infant\'s weight from pounds to kilograms. - Divide pounds by 2.2. (For example, 6.2 lb. ÷ 2.2 = 2.82 kg.) - Multiply the number of kilograms by 100. (For example, 2.82 x 100 = 282 ml.) - Convert blood volume in milliliters to liters. (For example, 282 ml ÷ 1,000 = 0.28 l.) Document the amount of blood collected in each tube so the total amount of blood removed over time can be calculated. Collect only the minimum required amount of blood to avoid causing iatrogenic anemia, which can lead to shortness of breath, fatigue, and the need for blood transfusions. Communicate regularly with the supervisor or laboratory manager to provide the best care for all patients. Discuss any concerns you have about provider ordering patterns or the timing of a patient\'s collection requests with your supervisor or the laboratory supervisor.