Therapeutic Phlebotomy Guidelines . h�b```�~Vv>!b`��0p,p`h�d�]�����gTVP$}�|�S�]�v�S)�^�r��Q������D2wtt0vt����R -��`�P�PNƩ�����8�En0�`�efgz���x������ҍ� \��=�!�s20Y�i���n�],������( � �3&� stream endstream According to guidelines from the Hemochromatosis Management Working Group (Barton et al, 1998), therapeutic phlebotomy should be initiated in men with serum ferritin levels of 300 ug/L or more and in women with serum ferritin levels of 200 ug/L or more, regardless of the presence or absence of symptoms. 1 0 obj Frequency and Duration of Phlebotomy: One time only Weekly Every _____ weeks Other, please specify _____ Hold phlebotomy if Hgb < _____ Misc Orders NS 500ml as needed, if patient is symptomatic or if orthostatic blood pressure does not resolve after 30 min General Monitoring Guidelines for Hemochromatosis I… %PDF-1.4 x��}i��F��|]E���� 6Dy �t��,�n��e�U=���DUq��$K����w��@�+b"�"�w�|��L����m�?���w�}��ٟ����w٫_^��R5UV7&�w���m^}uE�e���_���S��^��R�S�n^5��d�e�,lv�~5q�ͯ��Շ�W��v���S�;h9伝�g����c6�����[.e.td��X;˨+����6L]���_g��l�m��|5Ҷ6���jc��y�������,����\�,\��E���m��" �+}�,����r��r�c���$��=��d��_w������4���W��O�_4~74�B���`˵�v�&�P�� �ɻ�r���V�_��� �no��7��j{������k�S-�������7[g�ta+�U%��D�Een���Q6On�`��+�>�^���. The patient's health status must be medically stable enough to tolerate the therapeutic phlebotomy process. Emily (Amy) Antle, RN, MPH, FNP, AOCNP ®, is a nurse practitioner at the University of New Mexico Cancer Center in Albuquerque. 453 0 obj <>/Filter/FlateDecode/ID[<1A5620FA77ADB84BB45F75E3E20FB652><4E275BFF89979244B76A4AD02147EFAB>]/Index[429 50]/Info 428 0 R/Length 115/Prev 157561/Root 430 0 R/Size 479/Type/XRef/W[1 3 1]>>stream PURPOSE . endobj “Therapeutic phlebotomy” means the removal of whole blood from a donor for the purpose of medical treatment. 26:2A-2 et seq., commonly known as the Blood Bank Licensing Act and Patients may be bruised. This is a condition called hemochromatosis. endstream endobj 430 0 obj <>/Metadata 14 0 R/PageLayout/OneColumn/Pages 427 0 R/StructTreeRoot 20 0 R/Type/Catalog>> endobj 431 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 432 0 obj <>stream Regular phlebotomy treats people who have too much iron in their blood, such as with hemochromatosis, or who are producing too many red blood cells, such as with polycythemia. Guidelines for Blood Bank . ≙x-i�`��&Ї����DP��$="O����^T'���es-�u���.�MNq��?W�'#��x�l�����|q7�V��B�MV�>�O�O��F�b���T������:k����������j�j��1��ߧq�ޑ�O��f1�ݼ9�nf����m�[s3Y�o���_����������n!y��� 4 0 obj Phlebotomy Procedure Therapeutic phlebotomy is performed in a medically supervised environment. Hereditary hemochromatosis can be difficult to diagnose. 429 0 obj <> endobj Its used to make hemoglobin, which oxygenates your cells. Vitalant minimum is 11.0 for whole blood or 12.0 for double red cells. Clinical applications of therapeutic phlebotomy Kyung Hee Kim,1 Ki Young Oh,2 1Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, 2Department of Physical Medicine and Rehabilitation, Soonchunhyang University, Cheonan Hospital, Cheonan, South Korea Abstract: Phlebotomy is the removal of blood from the body, and therapeutic phlebotomy is the preferred … All exam questions are multiple‐choice with one best answer. 1. <>/ProcSet [/PDF /Text ] endstream endobj startxref Therapeutic Phlebotomy - for hemochromatosis, polycythemia vera INFUSION SERVICES ARE AVAILABLE by appointment (Please note that we cannot accommodate weekend treatments at this time.) Cambridge Monday – Friday: 8:30-5:30 pm Everett Mon, Wed, Thurs: 8:30 am-5 pm. 8:8-1.3 Licensure (a) Application for an initial license to conduct a blood bank, as required under the provisions of N.J.S.A. The patient's blood pressure, pulse and hemoglobin/hematocrit are checked prior to each phlebotomy. �|�5տ>�q����yz��բY]�K��!�Ѫ��]��V軘ܯ�ꏼ'Ӛ�1`y4+�$Q'�?��l����������}U,[�c�r0{.ƌ�~YAh�׺U�J�r���w�.���E�T-��zL��% L���j~M{�j�������l��ل����\�G���n���-72�-��z��T����������~]��;���������s�F��q��έ-O���lA�����vy��K"P$. Therapeutic phlebotomy can be a life-saving treatment for patients with too much iron in their blood. %%EOF UPDATED PHLEBOTOMY PROCEDURES Presented by: Helen Maxwell Executive Director, ASPT 1 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard—Sixth Edition December, 2010 . Phlebotomy uses large, hollow needles to remove blood specimens for lab testing or blood donation. Another indication for phlebotomy is iron overload from hemochromatosis, chronic iron overdose or long term transfusion of chronic anemias. h�bbd```b``��� �i��f��� ��̎�3A$�.X/�L�ǀ��`�*X�6X�2��P��D&���el v�V�$�We`bd`��g`�ƨ� N %��O�F͊�qu8���LnnW�uu�$�=�eu�,�����������B)eX�%w��&Ӈ7���/����4�6dhx %PDF-1.5 %���� Tuesday: 1-5 pm HOW TO REFER A PATIENT TO THE INFUSION ROOM - phone or EPIC message Standardizing Best Nursing Practice for Implanted Ports: Applying Evidence-based Professional Guidelines to Prevent Central Line-Associated Bloodstream Infections … THERAPEUTIC PHLEBOTOMY FLOWSHEET Time Time Amount Time Time Amount Time left Infusion. x WHO guidelines on drawing blood: best practices in phlebotomy Declaration of interests Conflict of interest statements were collected from all contributors to the guideline development, the consultant contracted to undertake background reviews and the peer reviewers of the final document. hemoglobin, hematocrit, ferritin, and therapeutic end points. r When you have too much iron in your blood, it can cause damage to your heart or liver. h��Ymo��+����.���rN\����5�A��l��dH p���gH�vײ��� �1����C��:+��� USᅉT���2 CLSI 2011 STANDARDS Clinical Laboratory Standards Institute 2 . Phlebotomy (aka venesection) may be recommended quite frequently for a person who has just been diagnosed with iron overload, especially if thei… Phlebotomy Initiate Saline Lock (preferably 18 - 20 g in anticubital fossa) only if IV fluid replacement is ordered Perform therapeutic phlebotomy. The center will need a physician's order to complete the therapy. CardioMed Supplies is please to introduce THERASAFE, our latest therapeutic phlebotomy set which provides safety features for both the patient and healthcare provider.. Start performing a therapeutic phlebotomy with the GenesisBPS line of products. Therapeutic phlebotomy is a blood draw that’s done to treat a medical problem, such as having too much iron in your blood. In 2008, and beta-thalassaemia major, sickle cell anaemia, the American College of Cardiology/American Heart Diamond-Blackfan anaemia or myelodysplastic Association published guidelines and recommended syndromes that require multiple blood transfusions. 2016). Therapeutic phlebotomy is a procedure to remove blood from the body. Therapeutic Phlebotomy Form –This form is used to document a physician’s request for a therapeutic collection. =��e��K�ս. Attending Physician’s Request for Therapeutic Apheresis (BS 702) – This form is used to document a physician’s request for a Therapeutic Apheresis procedure. 1. Hyperferritinemia attributable to iron overload is resolved by therapeutic phlebotomy. Scope: All personnel drawing blood specimens, i.e., by direct phlebotomy or venous/arterial lines. 5 0 obj Therapeutic phlebotomy (TP) is often requested for patients with testosterone-induced polycythemia to lower the hematocrit, at least as a temporary measure while adjusting the dose of medication. Reviewing these diagnoses will help nurses understand why phlebotomy is an important part of treatment. You may be able to undergo therapeutic phlebotomy at your local blood donation center. Therapeutic phlebotomy fees may be applicable for therapeutic collections. Therapeutic phlebotomy: The removal of a specific amount (volume) of blood from a patient for treatment of a specific condition or disease. The patient MUST call to make an appointment. Each step in the process carries risks - both for patients and health workers. 3 0 obj Therapeutic phlebotomy is used to remove excess iron and maintain low normal body iron stores in patients with hemochromatosis. GUIDELINES FOR THERAPEUTIC PHLEBOTOMY PERFORMED BY THE CLINICAL SERVICE Policy: Therapeutic phlebotomies are performed on outpatients and inpatients on a Monday-Friday, 0800-1630 basis either in the DeGowin Blood Center Patient Services area or on the inpatient unit. � ��� x�3R��2�35W(�*T0P�R0T(�Y@���@QC= P A�J��� �1Tp�W� studies, and evidence-based guidelines. Health workers may receive needle-stick injuries. Therapeutic phlebotomy services that Carter BloodCare offers and the required process for physicians to get a patient started. But, like anything else, there can be too much of a good thing when it comes to iron in the blood. Vitalant does not perform ferritin/CBC testing. In hemochromatosis, therapeutic phlebotomy is a procedure that removes blood from a person’s body with the specific goal of reducing iron overload.Therapeutic phlebotomy involves the same procedure as blood donation; the primary difference is the frequency of how often we give blood. Appropriate Maximum Phlebotomy Volumes Purpose: To provide a guideline for performing safe phlebotomy procedures on our neonate, infant and pediatric population. Typically, therapeutic phlebotomy consists of (i) removal of 1 unit (450 to 500 ml) of blood weekly until the serum ferritin level is 10 to 20 ug/L, and (ii) maintenance of the serum ferritin level at 50 ug/L or less thereafter by periodic removal of blood. Procedure: The following chart outlines the guidelines for blood drawing that is practiced at Description Enhanced convenience and unparalleled safety. :*��FԚx�ZIMNhcI��B��� tH�'R��C($��4� <> Therapeutic Phlebotomy Procedure This information will help you know what to do after your therapeutic phlebotomy (fleh-BAH-toh-mee) procedure. No health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, controlled clinical trials, observational studies, or evidence-based guidelines regarding the practice of performing therapeutic phlebotomy via central line for the treatment of hemochromatosis were identified. Do not permit phlebotomy if hemoglobin is below . Early symptoms such as stiff joints and fatigue may be due to conditions other than hemochromatosis.Many people with the disease don't have any signs or symptoms other than elevated levels of iron in their blood. The usual indication for phlebotomy is an abnormally high hematocrit (primary or secondary polycythemia). endobj Typically, therapeutic phlebotomy consists of <> 1.1 To safely remove a specific amount of blood from a patient with a clinical indication as ordered. endobj <> Remove mL of whole blood (250 – 500 mL as tolerated) Frequency: Once every week(s) if: Hgb greater than 120 g/L OR Hct greater than 0.45 OR (In contrast, phlebotomy is a mechanical reduction in the number of red cells.) We follow the latest evidenced based guidelines from the American Society for Apheresis (ASFA) in making clinical therapeutic apheresis decisions and our SOPs are in line with those recommendations. The patient should have a written request from the physician which specifies the amount to be drawn, the frequency of bleeding, and/or a Hgb or Hct level at which the patient should be bled. 478 0 obj <>stream stream Phlebotomy is a procedure that removes blood from the body. /ExtGState <>>>/Length 9838 >> (INS P&P for Infusion Nursing. According to guidelines from the Hemochromatosis Management Working Group (Barton et al, 1998), therapeutic phlebotomy should be initiated in men with serum ferritin levels of 300 ug/L or more and in women with Your body needs a certain amount of iron. A report will be sent to the ordering physician or other authorized health professional. Default will be 12.5 (female)/13.0 (male) whole blood or 13.3 for double red cells, if not specified. Hemochromatosis may be identified because of abnormal blood tests done for other reasons or from screening of family members of people diagnosed with the disease. 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