When is it appropriate to do bloods in the Out of Hours period?
Please only consider doing bloods in IUC if it is clinically safe and necessary (ie. it will make a material difference to the patient's management in that OOH period). Example scenarios may include: patient suitable for the community PE pathway (as per BNSSG guidelines), non-blanching rash in a well adult, ?AKI.
The full Sample Standard Operational Procedure is available here
When is it not appropriate to do bloods in the Out of Hours period?
Bloods in children
Troponin (unless in very rare situations, please always discuss with the CC)
Non-urgent bloods where the results will not change care during the OOH period.
Unwell patients who would be better managed with hospital admission.
Considerations
Please be aware that Severnside IUC has no formal transport arrangements for specimens and relies on “home visit drivers” being able to pick them up from base and drop them at the laboratories. A realistic time frame from taking the bloods to getting the result back is 6hours (although may be quicker at quieter times) so please consider this when deciding safe management.
Organising a blood sample
If you think a patient needs an urgent blood sample, please make sure your CLEO notes are clear (consider an SBAR handover). Press "admin" to forward the case for a F2F assessment. This will then be reviewed by the CC.
Taking a blood sample
We have blood taking "kits" at the bases to make it easier to find the equipment you need.
Blood bottles colours and tests:
Blue - Clotting, D.dimer (must be completely full)
Purple_ FBC, ESR
Grey - Glucose
Brown - U+E, LFT, CRP, Calcium
We cannot request investigations on ICE- please use a paper form. Ask the host to add the patient's usual GP surgery code on the form.
Always put your blood sample in a red bag.
Let the host know you have taken an urgent blood sample.
Add clear notes to CLEO and consider adding a one-line summary as the first line in your history box eg. "please chase FBC at around 8pm and contact patient if low platelets". Forward the case using the "CC advice follow up" option. This will add the case to the "consult and hold" queue, which is managed by the CC and will ensure the result is chased up.
Please write clearly in CLEO how you have agreed with the patient for the results to be communicated. For example, if they are normal, we will send a text, we will phone if abnormal.