Prehospital Blood Draws

[mikie]

Does your service draw blood enroute to the hospital? If yes...

-Private or Public service?
-For what purpose (speeding up lab times?)?
-What are your protocols (some patients, all patients)?
-Is there a 'chain of evidence' issue (ensuring the blood is in fact that patient's despite not having witness the draw)?'

Just curious...

Thanks!

 

[rmellish]

Working both private and public...

Protocol at the private is at the discretion of the responder. Private service actually carries some blood tubes.

The public service is also discretionary, w/o blood tubes. So, we rarely do so.

No chain of evidence issue has been raised to my knowledge in either case.

I would assume the rationale in both cases is to improve time to lab.

 

[medic417]

We draw on all medical if starting an IV. We tape the bag with the tubes onto the IV bag. On cardiac it gives a good reference future draws at the hospital.

 

[rmellish]

Initially I'm sure the protocols for draws were written as for every medical patient with an IV start, but it seems the hospitals often discarded the samples, so it was changed over time.

 

[medic417]

Initially I'm sure the protocols for draws were written as for every medical patient with an IV start, but it seems the hospitals often discarded the samples, so it was changed over time.

The only ones they do not use if we draw is OB. So we no longer draw OB. All others they run labs on.

 

[41 Duck]

No one around here draws prehospital labs.


Later!

--Coop

 

[rmellish]

As an aside, anyone know the "shelf life" of blood drawn into say a 20cc syringe and kept there to be transferred into vacutainers at the hospital. Would that be usable after 5-10mins?

 

[Hastings]

We draw 5 vaccutainers worth of blood on every medical that we begin an IV on. For patients like those having chest pain, seizures, or severe DIB, getting blood during the worst part of the incident can be key. The hospital here GREATLY appreciates it. It really speeds up the system (and saves the patient a second poke.)

 

[Epi-do]

The only time we draw labs, are if we are going to be treating a smoke inhalation patient with a cyanokit. Then we are required to draw labs prior to administration of the medication. We were told the med will affect the color of the blood (as well as everything else about the patient), and make certain tests impossible to perform.

 

[medicdan]

The Fire Department I used to be affilliated with drew labs in a vacutainer for any medical patient they started a line on. I do know that all Intermediates or Medics who drew labs for this hospital had to take a modified phlebotomy course-- to learn the order of the draw, etc.

 

[medic417]

The only thing the hospital supplys us with is blood draw supplys. They provide the vacutainers and we get blood drawn for them. No extra expense for us and actually only adds maybe a minute of extra work.

 

[Kendall]

Is it possible to obtain a sample with a vacutainer from an iv catheter?

 

[Sasha]

Is it possible to obtain a sample with a vacutainer from an iv catheter?

Hospitals I do clinicals at uses something similar to this, (tubes are different though.. They have color tops!) and the blue hub hooks up to a bit of IV tubing, that hooks directly into the catheter's hub. It all comes in a nice little kit, but I've never seen blood draws done at work or where I do FD rides at. Most of the time the RN will deem the IV site itself dirty and start his or her own, so I don't think they'd use the blood even if it was drawn here!

 

[medic417]

Is it possible to obtain a sample with a vacutainer from an iv catheter?

Yes we use something similiar to what Sasha posted.

 

[Jon]

Is it possible to obtain a sample with a vacutainer from an iv catheter?

One common school of thought is to draw off 5-10 cc's of blood and waste it, then draw the needed blood.


At clinicals, 1 hospital based site and 1 non-hospital based site draw labs when possible when the patient is going to 1 hospital. All other local hospitals refuse prehospital labs, "because we don't use the right tubes"

 

[EMTWintz]

As an aside, anyone know the "shelf life" of blood drawn into say a 20cc syringe and kept there to be transferred into vacutainers at the hospital. Would that be usable after 5-10mins?

that is not going to work, it will only take like 5min to clot. some samples need to be whole blood.(meaning they will go into a lavender top tube or light green) this has to be done immediately, to prevent clotting. As far as serum tubes (marble top or red) you need to get it into the tube asap, so that the blood doesnt clot in the syringe
anything you want to know about phlebotomy and blood draws come ask me. Have become a pro at it since it has been my main expertise for the last 7years

 

[medicdan]

Is "The order of the draw" taught to Medics?

 

[medic417]

Is "The order of the draw" taught to Medics?

You better learn that or things get pretty screwed up. But my guess is a lot of the fire department medic mills do not even mention it.

 

[vquintessence]

Lab draws are not used in blanket situations here in urban MA. They simply are discarded a majority of the time. Hell, a bunch of hospitals in the area will discard our IV immediately in non-critical pts. Apparently phlebotomy is too complex for us ambulance drivers. The only pts I'll bother with are STEMI and AMS/?CVA. Can't blame them for distrusting our labs though, it can/has opened the hospitals up to being liable for errors/mismatches/whatever.

 

[BossyCow]

Hospitals I do clinicals at uses something similar to this, (tubes are different though.. They have color tops!) and the blue hub hooks up to a bit of IV tubing, that hooks directly into the catheter's hub. It all comes in a nice little kit, but I've never seen blood draws done at work or where I do FD rides at. Most of the time the RN will deem the IV site itself dirty and start his or her own, so I don't think they'd use the blood even if it was drawn here!

Ours are slightly different. two separate pieces. But they are part of our IV set up bags. If the patient is stable, the ER will generally get new ones, but often ours are used.