Using paediatric blood bottles for adult tests to reduce blood volumes would be hard to implement

Silverstein and colleagues advise using paediatric blood bottles to reduce blood volumes for routine adult testing to minimise the amount of blood drawn.1 Although fine in theory, this would be very hard to implement. In most trusts, the processing of adult samples is almost entirely automated; additional steps are required to process paediatric samples. These include manually pipetting the sample into two additional containers (as a false bottom insert is required for small samples) and manually relabelling the sample. These steps add chance for error, add to plastic waste, and greatly increase the cost per test owing to the labour involved, which, when handling thousands of samples weekly, would be considerable. There is also the preanalytical process to consider—paediatric bottles are not compatible with the processes for vacutainers, and thus can increase risk of blood spillage.Replacing a large portion of laboratory equipment nationwide is possible but would require substantial investment….
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