As the number of cases of hospital acquired anemia has increased, the medical community started to pay more attention to the topic of the optimal amount of blood that should be collected. According to a study performed on the patients of a Kansas, Missouri hospital in 2011, programs that are offering phlebotomy training should teach the students about these risks and the ideal blood sample requirements. The same studies indicated that collecting a smaller amount of blood from patients with acute myocardial infarction considerably reduces the risks associated with this particular type of anemia.
The importance of learning about the optimal amount of blood to be extracted via the phlebotomy training comes from the greater morbidity and bad health status associated with the hospital acquired anemia. The research done by Dr. Salisbury and co. show very interesting facts: the average level of blood taken from patients who developed anemia was almost double than for the group of patients who did not develop this condition.
Crunching down the numbers, the patients who developed hospital acquired anemia had approximately 170ml of blood extracted, whereas the non-anemic group of patients had about 83ml of blood extracted for diagnoses purposes. In addition, Dr. Salisbury’s study indicated that the levels of hemoglobin for adult men and non-pregnant women dropped from the normal values to around 11g/dl.
The conclusions of the study were that for each 50ml of blood collected, the risks of developing hospital acquired anemia increases by approximately 18%. It is necessary to point out that the study was performed on various medical facilities in Kansas City and that each institution had its own rules regarding the amount of blood required from the patient. When comparing the data, the study showed without a doubt that the moderate and severe cases of anemia were recorded in the medical facilities that typically required bigger blood samples.
At the same time, the study showed that the category of patients most prone to develop hospital acquired anemia are those typically transferred between the medical facilities and those with extended hospitalization. Dr. Salisbury’s research indicated that during an intermediate hospitalization period, patients who had developed anemia lost approximately 300ml of blood. However, it seems that the highest amount of blood lost by anemic patients occurs during the initial hospitalization phase, when blood samples are mandatory for a correct diagnosis and intervention. The samples collected later only serve the purpose of monitoring the evolution of the condition and the body’s response to the medication.
As the main tool of measurement for the amount of blood collected from patients was the standard tube type used by the medical facilities, the solution to this problem would be to make them smaller. The advantage of using smaller blood tubes as the main solution proposed by Dr. Salisbury’ study is the cost-effectiveness. The other measures indicated by the study include reducing the unnecessary scheduled blood tests, relying more on serum samples, using tubes for pediatric patients or simply asking the phlebotomists to fill the tubes with less blood.