Pediatric Surgical Nurses Association
1 Thing Nurses and Patients Should Question
Released December 1, 2022
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Don’t routinely repeat labs hemoglobin and hematocrit in the hemodynamically normal pediatric patients with isolated blunt solid organ injury.
Preset timed interval measurements of hemoglobin and hematocrit are no longer indicated as early detectors of instability. Clinical instability is defined by physiologic criteria such as age-specific tachycardia or hypotension, tachypnea, low urine output, altered mental status, or any significant clinical deterioration that warrants increased level of care and investigation. Therefore, the routine use of repeat laboratories studies in children with isolated solid organ injury who have physiologically normal vital signs for their age is not necessary.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a health professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician or nurse.
The American Pediatric Surgical Nurses Association, Inc. (APSNA) is a dynamic, vibrant organization of members representing various nursing roles including bedside nurses, perioperative nurses, advanced practice nurses, nurse managers and nurse educators. To that end, APSNA leads the way in providing a variety of resources aimed at meeting your practice needs.
Since 1992, APSNA has grown in scope and numbers. Pediatric surgical nurses work in a team-oriented environment. The broad scope of pediatric nursing practice is what makes this field both challenging and rewarding. To learn more about this organization, visit us at www.apsna.org
How This List Was Created
Once the American Pediatric Surgical Nurses Association, Inc. (APSNA) received an invitation from the Institute of Pediatric Nursing (IPN) to participate in the initiative, the APSNA Board was queried to identify pediatric nursing practices that should be modified based on evidence. The identified practice was presented to experts from APSNA’s Board of Directors, General Membership and Trauma Special Interest Group (SIG). The preliminary statement was reviewed and revised by content experts from both within and outside of the organization. Subsequently, the statement was submitted to the APSNA Board for final discussion and review. The final statement was reviewed and approved by the American Academy of Nursing.
Sources
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Acker S, Petrun B, Partrick D, Roosevelt, G, Bensard D. Lack of utility of repeat monitoring of hemoglobin and hematocrit following blunt solid organ injury in children. J Trauma Acute Care Surg. 2015; 79: 991-994.
Fallon S, Delemos D, Akinkuotu A, Christopher D, Naik-Mathuria B. The use of an institutional pediatric abdominal trauma protocol improves resource use. J Trauma Acute Care Surg. 2016; 80: 57-63.
7 Golden J, Mitchell I, Kuzniewski S, Lipskar A, Prince J, Bank A, Stylianos S, Rosen G. Reducing scheduled phlebotomy in stable pediatric patients with blunt liver or spleen injury. J Pediatr Surg. 2014; 49: 759-762.
Holmes JF, Lillis K, Monroe D, Borgialli D, Kerrey B,Mahajn P, Adegais K, Ellison A, Yen K, Atabaki S, Menaker J, Bonsu B, Quayle KS, Garcia M, Rogers A, Blumber S, Lee L, Tunik M, Kooistra J, Kowk M, Cook L, Dean JM, Sokolove PE, Wisne DH, Ehrlich P, Cooper A, Dayan PS, Wootton-Geroges S, Kuppermann N, Pediatric Emergency Care Applied Research Network (PECARN). Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013; 107-116.
