----Original Message Follows----
From: Adrian Fogarty <[log in to unmask]>

I agree with this trend, but would go a step further. Why do "routine"
bloods on the pilonidal abscess at all? Granted, you're not delaying the
admission, or the decision to admit, because of the bloods, but it's still
5-10 minutes' wasted time for your junior just taking the bloods and sending
them off (and reinforces their belief that all cases MUST have blood tests
done). If the anaesthetists really want these results preoperatively, and I
very much doubt it, then the surgical house officer should do them as part
of his work up for theatre, rather than the Cas SHO doing them as part of
his work up for admission.

--> Sorry, I did not specify all details while making my point. When I
stated "Bloods sent under code of consultant surgeon of day AFTER case
already accepted" I did not mean I would then have the SHO DRAW the bloods.
I meant the tests MAY now be requested. And...
- In most cases it would be a phlebotomist/nurse/paramedic/student who will
do the blood-letting
- The actual blood would have probably, in this case, already been drawn
into a tube when a venflon was placed or analgesia - saves time and "holes"
made in patient. The SENDING of the test request requires it to be
necessary.
- Occsionally, with more "enlightened" specialty teams, who no longer even
try the request-results-to-delay-having-to-come strategy, the tubes are
labeled and left by the patient's bed for them to do with as they wish.

BTW, I sometimes find even more pleasure in getting the inpatient team
juniors on the "true path" and watching them through tears of joy as they
then fight off the anaesthetist or defend themselves to their registrars...
With which I gladly help. You have just GOT to try this - it's like seeing
your toddler take his/her first steps... (But I do warn them that, even if
they win the argument, they may well still be forced to send the tests to
please someonw with whose kingdom I cannot interfere)

None of us here on the list "invented" this sensible approach, but it makes
sense and the more we push it, the more we define our specialty and make
ourselves indispensible through efficiency. The rest of the hospital will
eventually follow suit.

BTW, I do not condone the use of the words "routine bloods". On this
topic... there are many ways of reaching goals, but one I prefer to leave to
others (and will not criticise them for it) is the use of a SET list of
"standard" investigations for certain presentations prescribed to doctors. I
encourage them to take each case from fresh and WORK OUT what they need.
They are to use the simple formula for each test of "if it comes back as X I
do Y and if it comes back as Z I do W and the test will only be done if Y is
not the same as W". They soon get as quick and efficient at this as they
would be at finding the relevant set list...