Phlebotomy is not a risk-free event for the patient or the healthcare worker. While rare, injury from needlestick and/or pathogen exposure can occur. Cumulative blood loss due to multiple phlebotomy episodes can result in iatrogenic anemia, particularly in the elderly, children, or those with medical conditions. This anemia can lead to worsened patient outcomes. Employing mechanisms that limit the amount of blood taken has been shown to lessen the severity of iatrogenic anemia. This can range from using smaller-volume collection tubes, consulting about the possibility of add-on testing to previously drawn samples, or adopting a maximum blood volume policy. Addressing duplicate requisitions can limit a patient from being phlebotomized twice. For more information:
Auta A, Adewuyi EO, Tor-Anyiin A, Edor JP, Kureh GT, Khanal V, Oga E, Adeloye D. Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis. Int J Epidemiol 2018;47(6):1972-80. PMID: 30272173.
Chandrashekar S. Hospital-Acquired anemia: A hazard of hospitalization. Glob J Transfus Med 2018;3:83-7
Dale JC, Ruby SG. Specimen collection volumes for laboratory tests: A College of American Pathologists Study of 140 Laboratories. Arch Pathol Lab Med 2003;127:62-68. PMID: 12562229.
Loh, TP, Saw S, Sethi SK. Clinical value of add-on chemistry testing in a large tertiary-care teaching hospital. Lab Med 2012;43(2):82-85.
Society for the Advancement of Blood Management. Anemia prevention and management program implementation guide. The Center for Hospital Innovation & Improvement 2015.
Whitehead N, Williams LO, Meleth S, Kennedy SM, Ubaka-Blackmoore N, Geaghan SM, et al. Interventions to prevent iatrogenic anemia: a Laboratory Medicine Best Practises systematic review. Crit Care 2019;23:278. PMID: 31399052.