When it is medically prudent to restrict the blood volumes taken from any patient, it should be done. It is imperative to the overall quality of care for all patients that discretion is used when following these guidelines. Time to conduct the draw, the cost of equipment to do the draw, and inflexibility to verify or add to the original order without resticking the patient increase at each tier. Each tier consists of less blood than the one above it but the cost for such a procedure is increased. The concerns of nurses and laboratory technologists were discussed and a three-tiered system was designed consisting of adult volumes, volumes for < 20-kg patients, and volumes for < 10-kg patients. It is important to manage the volumes used so that we do not compromise the hematological status of our pediatric patients. These factors result in multiple blood draws.
Because we are a cancer center, many of our patients are on protocols and/or are in the hospital for an extended period of time.
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