one A 68-year-old woman She was admitted to the hospital after contracting pneumonia. He continued to receive antibiotics and after 2 days his condition started to improve. As long as she was admitted to the hospital, she continued to donate blood for daily tests.
On the third day in the hospital she complains of fatigue and on the fourth day laboratory results show that her hemoglobin and hematocrit levels have dropped significantly. To make sure the test results were accurate, the woman’s blood was drawn again to repeat the test. On the fifth day, his hemoglobin level rose to 7.0 g/dL, which was 2 notches lower than the hemoglobin level at admission.
The woman was given a transfusion. On the seventh day, the patient’s hemoglobin level stabilized at 8.5 g/dL and the doctor decided to discharge her. Even on the day of discharge, a nurse comes to draw the woman’s blood and the patient asks her, “Were all these tests really necessary?”
The above case illustrates a common occurrence. A significant amount of blood is taken from patients, especially in critical care. Lack of medical knowledge or inexperience of disease-causing physicians is a trigger for excessive laboratory testing. Most of these tests are unnecessary and lead to further tests which do not benefit the patient but can cause hemoglobin and hematocrit levels to drop.
On the other hand, when the hospital staff takes blood from a patient for testing, it is important to adhere to its guidelines. Usually 50 to 60 ml of blood is drawn for each set of tests and the same amount of blood is drawn for repeat tests, while for most laboratory tests about 3 ml of blood is sufficient and this amount The test can also be retaken.
The relationship between blood volume and anemia resulting from clinical examination or treatment was first described in 2005, when it was found that blood drawn from adult patients was proportional to hemoglobin and hematocrit levels. That is, for every 100 ml of blood drawn, the hemoglobin level in the body decreases by an average of 0.7g/dl.
A study of average patient admissions to hospitals also found that 65% of patients had a hemoglobin drop of 1.0g/dl or more due to routine daily testing, and 49% had anemia overall. Is.
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