Drawing Blood Samples

[Canmedic]

I would like to hear from any medics who regularly draw blood samples from their patients, and under what type of protocol they do this...I would like to propose something to my medical director, and this is within our scope of practice in Alberta, but not many services do this.

Mike Kesthely
FF/Paramedic

[ALSfirefighter]

Canmedic,

Where I am at drawing blood samples is mostly a courtesy. With Diabetics and Altered Mental Status being protocol for drawing. I attempt to draw blood on every patient I treat depending on the severity of the condition of course. We also carry troponin blood tubes that we draw on all cardiac patients. Just thought I reply to let ya know. Good luck!!

[N2DFire]

Way back about 10 years ago when I first started our protocol was to draw blood on AMS & Diabetic calls. For some reason there were a lot of problems with this (improper draws, poor handling, etc) and it was removed from our protocol.

Times they are a changin and we are now doing a lot more stuff in the field that we didn't do before, but I just don't see blood draws coming back to us until we start doing blood gases in the field (which for where I am will be about the same time we replace our ground units with hover craft *L*)

Side note - while working ER time - Medics can draw blood no problem (and usaully do w/o orders)

Take Care - Stay Safe
Stephen

[Paramark14]

I always try to get labs on diabetics, CP's, altered LOC. It can give the ED a baseline (ie; CK, BS, ETOH, etc.) that can help direct their tx. Problem is that we only carry clot tubes (red top) and EDTH tubes (purple). If the ED doc. orders any coag or funky chems. that require whole blood, the pt. has to be redrawn. Get with your lab and ask them what they draw on stat ER pts. Most labs have a set of tubes they draw on all ED pts. to cover all the bases so they don't have to redraw if the doc orders more tests. Carry the tubes they recommend.

Mark EMTP
Indiana

[renegade]

My service rourinely draws "labs" in the field as well as in th ER, by both Medic's and Advanced EMT's. The decision per our protocol is at the EMTP/AEMT descretion.

Yes, Our Medical Director is one of the few that listen to us and THEN makes the decision

NorthWestern Indiana

[This message has been edited by renegade (edited November 07, 2000).]

[ME93]

We do not draw labs in the field for the most part any longer due to a lot of the time when you arrive at the ER most of them just throw them away. Mostly due to time delay when the labs were drawn to the time they reach the lab at the hospital. I always draw on cardiac patients however.

[This message has been edited by ME93 (edited November 07, 2000).]

[Quint1Medic]

When I went through paramedic training in Delaware ten years ago, we drew labs - we had one set of tubes for traumas, one set for medical patients. That's the only system I've been in that routinely drew labs.

[9C7]

We draw bloods in the field on any patient we start an IV on. It's basically as a courtesy. The only rule of thumb is to not blow a line just to get bloods. If there's a problem, worry about the IV and let the ED get the labs drawn.
We use the Vaccutainer system. Quick and easy.


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Stay Safe.
You asked for my opinion, now you have it. Any similarity to another opinion, living or dead, is purely coincidental.

[nyaemt98]

In Nassau County, Long Island NY, we draw blood samples as a courtesy.

I usually draw blood on all IV/Saline Locks, except, if the IV is not too stable. I WILL NOT delay patient transport to get blood.

I usually draw bloods in all the tubes, approx. 6, b/c I can never remember which tubes the different hospitals we service use.

The ED nurses are always happy to get them especially on critical patients. It allows them to immediately send the specimens for evaluation.

As a note of advice, always label the tubes with the patients name, dob and SSN or PCR/ACR# for traceability.

Best of luck.

[AXMAN620]

i work in rural ohio, for three seperate county services, two of the three we draw blood on each iv un-less it compromises the line. our hospitals use them and it results in quicker diagnossis in the ed. ( mi cva and type and cross for traumas) it mostly is a coutisy for the ed and it saves the pt. a stick when we do all three things at one time.( start the line, draw six tubes and do a gluco-scan).

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SEE YA' @ THE BIG ONE!

[Medic700]

Here it depends on the situation if we draw labs or not. I do want to tell you that when you are dealing with lab draws that you need to kep in mind the order fo draw set by NCCLS. This will help the results be more accurate and help keep confusion of what is going on. I great two tube combo that can be used for almost every test is the green tiger top and the lavender. I deal wiht lab tests and draws every day and it is vital that they are drawn and dealth with properly.

Medic700

[mike m]

i ve been a medic for alot of years nowand i regularly draw blood on all my patients.usually on ams,cardiac and diabetics.in my system we have the luxury of starting iv s on standing orders.but most ok all its good to take blood if you know the receiving hosoital is busy that day.it does speed up the patient wait time,also it is a good way to help out the er nurses,it saves them alot of timeand it also creates a good relationship beyween the medics and the er staff.also if you have a ctitical patient,especially elderly,the vacuum may collapse the vein so i like to get the meds onboard then worry about the bloods later.

[Litch]

We used to draw boods routinely, but the samples were hemolyzed a lot by the time the blood got to the lab, so we stopped doing it routinely. If I'm using the patient's last good vein for my IV, I will drw labs, to be nice to the nurses.

[medic951]

Each Paramedic here has a choice if they are going to draw in the field or not. It is very common for all to draw tubes for diabetics and cardiac patients. If your service works very closely with the ER and other hospital departments, the door to drug situation in cardiacs can greatly be cut down in some cases. I've been in both situations where the lab draws no matter what and throws your samples away. We just began to work closer with the lab department and ER closer and let them realize what medics do in the field. Once they notice we all are working towards better patient care and not after each other jobs, things went smooth on both sides of the line. I feel the need for blood draws in the field are greatly needed as long as patient care is not delayed.

Grant
NREMT-P,I/C

[N3UEA]

We routinely don’t draw blood only because the hospitals toss it & draw their own anyway. The one hospital that does accept the blood we draw only accepts it form the Medics employed by that hospital (they have trained us to do it their way). Typically I only draw it when starting a line & then only if time & circumstances permit, i.e., my partner can de doing other needed ALS skills or if the patient is stable.

[Paramark14]

Baseline prehospital labs are important and directly affect tx of the patient in the ED and on the floor. We do our best to draw them when possible.
But, as a former lab tech I can see the other side of things. Before a sample is run a bench tech. must be sure of at least four things 1)the sample is labeled correctly and from the right pt. 2)the sample was drawn correctly, 3)the sample was not contaminated, 4)their instruments are calibrated and operating correctly.
When the tech puts out their final report they initial it verfying that the results are true. Bottom line: they don't trust blood draws in the field. They don't know who drew the sample and under what circumstances it was obtained.
Have a "sit down" with the lab director and design a protocol for pre-hospital blood draws that they and you are comfortable with. Set-up some clinical time for your medics to learn how the lab operates and develope a working relationship with the lab personnel.

Mark
NREMTP
Indiana

[keahi520]

Here in Maryland we have a protocol to draw bloods on any unconscious, altered mental status, and/or drug OD patient.

However, we also can draw bloods for patients that we think can benefit... CP,diabetics,traumas,etc.

No matter what we are only allowed to draw the purple tops and red tops.

[firefighter_aemt]

In Buffalo Ny we draw bllods for the hospitals as a courtesy. But the hospitals around here all want two reds, a blue a purple aand two yellows. I draw blood on all patients for the exception of Cardica Arrest...The Hospital can draw the bloods arterial when the patiet gets to the ED. But here it is just a courtesy for the hopsitals. The one that dosn't take are bloods is children's I don't know why tho ....

[northshorefire2]

We draw blood on several types of ALS patients. To see the Austin/Travis Co. SOC's (including blood draws), go to:

http://www.ci.austin.tx.us/ems/emscp.htm

They are available in PDF format @ 2MB

[buzzmedic]

Blood draws are in our protocals for most every medical involving chest pain, diabetic, altered LOC and the like. We are a hospital based hostpital. The other hospital in town won't accept any blood draw in the field.

[rchildress]

Our service allows us to draw blood however we never do so. The main reason I do not draw is because the hospitals in our region to us that when we bring them samples they have no way of keeping a chain of custody procedure. So if I gave them blood then in the bio-box is went.

[Resq14]

I haven't seen or heard of blood being drawn in these parts for several years. I think it's mostly because, like has been said before, the hospitals immediately draw their own set upon our arrival if they want them.

Ours just get tossed in the red circular filing cabinet