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Pediatric blood volumes: a one-page reference guide
1Clinical Pathology Department, City of Hope National Medical Center, Duarte, CA 91010, USA.
Summary
A new blood volume policy for pediatric lab testing was developed, balancing patient hematological status with procedural costs. While smaller volumes are sometimes necessary, larger volumes may be more cost-effective and maintain lab service quality.
Area of Science:
- Pediatric Hematology
- Clinical Laboratory Science
- Healthcare Policy
Background:
- Pediatric cancer patients often require frequent blood draws due to treatment protocols and extended hospital stays.
- Managing blood draw volumes is critical to prevent compromising pediatric patients' hematological status.
- Concerns from nursing and laboratory staff regarding blood draw volumes were identified.
Purpose of the Study:
- To develop a standardized blood volume policy for pediatric laboratory testing.
- To address the challenges of frequent blood draws in pediatric cancer patients.
- To balance patient safety with operational efficiency and cost-effectiveness.
Main Methods:
- A multidisciplinary team collaborated to create the policy.
- A three-tiered blood volume system was designed based on patient weight (<10 kg, <20 kg, and adult volumes).
- Considerations included blood volume, cost, draw time, equipment, and order flexibility.
Main Results:
- The tiered system aims to reduce blood volume for smaller patients.
- Each successive tier (smaller volumes) incurs increased procedural costs.
- Reduced blood volumes can lead to increased costs and potential decreases in laboratory service quality.
Conclusions:
- Discretion is essential when applying the blood volume guidelines to ensure quality of care.
- Restricting blood volumes is important when medically indicated.
- In non-medically necessary situations, the benefits of smaller volumes may be outweighed by increased costs and reduced lab service quality.
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