Blood Draw Volumes in Pediatrics
How much is too much?
February 2015
Special points of
interest:
 The Pediatric Maximum
Blood Draw Volume
Guideline can be
referenced in
Docushare by searching “Blood Draw Volume Weight Guidelines”.
 The guideline can also
by referenced in
Mosby’s Skills by
searching “Blood
Specimen Collection:
Venipuncture
(Pediatric).
 This guideline was reviewed and approved
by Dr William V Miller,
Director of Clinical
Laboratories and
Transfusion Medicine
and by Dr Timothy Fete,
Chairman, Department
of Child Health.
Inside this issue:
Guideline
2
Guideline
3
References
4
Examples
5
What if?
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Kim Innes RN, BSN, CRNI
Jenn Lawson RN, BSN, CRNI
Iatrogenic Anemia
Iatrogenic anemia is the anemia that results from
blood loss due to repeated venipunctures for the
purpose of obtaining specimens for laboratory testing. This type of anemia is not uncommon; it is most
often seen in seriously ill hospitalized patients who
are tested frequently and in infants with small blood
volumes.
Guideline Development
This guideline was developed as part of a performance improvement initiative. Prior to the development of this guideline, University of Missouri Health Care did not have a weight based reference for drawing blood from infants and children. With the development of this guideline we will educate staff on appropriate
blood draw volumes to reduce the risk of iatrogenic anemia.
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2
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How much blood is needed?
An 8 week old infant is admitted to Pediatrics with vomiting. The
infant weighs 4kg. Lab work has been ordered. According to the
guideline, what is the recommended maximum blood draw volume?
A 6 year old child is admitted to Pediatrics with abdominal pain and fever. The child weighs 20kg. Lab work ordered includes CBC, CMP,
blood cultures, CRP, and pt/ptt. According to the guideline, what is the
recommended maximum blood draw volume?
An 11 year old patient is admitted to PICU with a diagnosis of new onset diabetes mellitus. The patient weighs
43kg. Many blood tests are ordered. According to the
guideline, what is the recommended maximum blood draw volume?
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What to Do if the Ordered Lab Work Exceeds the
Maximum Blood Draw Volume Guidelines

Call laboratory to review minimum quantity necessary for each test
and to see which tests can be combined. When using large tubes,
check with lab for the minimum blood volume of each tube.

If the minimum blood volume needed exceeds the guideline, check
with the health care provider to see if some tests may be obtained at a
later date.

This guideline serves as a reference. It may be necessary to exceed
the maximum recommendation. The health care provider should decide if the volume of blood drawn may exceed the guideline.
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