Standing orders for inpatients for CBC testing should be avoided as this can lead to over-testing in relatively stable patients. Particularly in patients with longer term hospital stays, there is some evidence that repeated blood testing can have a negative effect on patients including some increase in anemia. Trauma patients often have blood draws repeated frequently even in the absence of indications of hematologic instability on admission.
Conditions: Inpatient, Anemia, Trauma
Diagnostic Tests: Complete Blood Count (CBC)
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Sources
- Frye EB, Hubbell FA, Akin BV, Rucker L. Usefulness of routine admission complete blood cell counts on a general medical service. J. Gen. Intern. Med. Nov-Dec 1987;2(6):373-376. (PubMed)
- Gortmaker SL, Bickford AF, Mathewson HO, Dumbaugh K, Tirrell PC. A successful experiment to reduce unnecessary laboratory use in a community hospital. Med. Care. Jun 1988;26(6):631-642. (PubMed)
- Sandhaus LM, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am. J. Clin. Pathol. Nov 2002;118(5):787-793. (PubMed)
- Sierink JC, Joosse P, de Castro SMM, Schep NWL, Goslings JC. Does repeat Hb measurement within 2 hours after a normal initial Hb in stable trauma patients add value to trauma evaluation. Int. J. Emerg. Med. Jul 2014;7:26-30. (PubMed)
- Thavendiranathan P, Bagai A, Ebidia A, Detsky AS, Choudhry NK. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. J. Gen. Intern. Med. Jun 2005;20(6):520-524. (PubMed)
- Williams SV, Eisenberg JM. A controlled trial to decrease the unnecessary use of diagnostic tests. J. Gen. Intern. Med. Jan-Feb 1986;1(1):8-13. (PubMed)