Recommended Blood Labs for Bedridden Patients
For bedridden patients, a comprehensive panel of blood tests should include complete blood count, comprehensive metabolic panel, inflammatory markers, and coagulation studies to monitor for complications and guide treatment decisions.
Core Laboratory Tests
Complete Blood Count (CBC)
- CBC with differential should be performed for all bedridden patients to assess for infection, anemia, and overall hematologic status 1
- The presence of an elevated WBC count (≥14,000 cells/mm³) or a left shift warrants careful assessment for bacterial infection 1
- Manual differential is preferred to assess bands and other immature forms, especially when infection is suspected 1
Metabolic and Electrolyte Assessment
- Comprehensive metabolic panel including glucose, electrolytes, renal function (BUN, creatinine), and liver function tests should be performed 1
- Serum electrolytes should be closely monitored, especially in patients at risk for fluid and electrolyte imbalances 1
- Blood glucose monitoring is essential, with bedside glucose checks recommended before meals in eating patients or every 4-6 hours in non-eating patients 1
Inflammatory and Infection Markers
- C-reactive protein (CRP) should be measured to assess for inflammation and potential infection 1
- Procalcitonin (PCT) should be considered when bacterial infection is suspected but not clearly evident 1
- Blood cultures (at least two sets from different anatomical sites) are recommended when infection is suspected, especially in febrile patients 1
Additional Critical Tests
- Serum lactate measurement is strongly recommended to estimate and monitor the extent of tissue hypoperfusion and shock 1
- Arterial or venous blood gas analysis should be considered in patients with respiratory distress or suspected acid-base disturbances 1
- Troponin levels should be checked in patients with suspected cardiac involvement 1
Specialized Testing Based on Clinical Scenario
For Suspected Urinary Tract Infection
- Urinalysis and urine culture should be performed only if UTI symptoms are present (not for asymptomatic patients) 1
- For catheterized patients, catheter should be changed prior to specimen collection 1
For Suspected Respiratory Infection
- Pulse oximetry should be performed for patients with respiratory rates >25 breaths/min 1
- Consider viral testing using nucleic acid amplification test panels in patients with respiratory symptoms 1
For Crush Injury or Immobility Complications
- Creatine kinase (CK) levels should be monitored to assess for rhabdomyolysis 1
- Coagulation studies (PT/INR, PTT) should be performed to assess for hypercoagulable state 1
Frequency of Monitoring
- Initial comprehensive panel should be performed upon becoming bedridden 1
- Follow-up testing frequency should be determined by clinical status, with more frequent monitoring for unstable patients 1
- For stable bedridden patients, routine labs should be repeated at least weekly to monitor for complications 1
Important Considerations
- Blood sampling should be coordinated to minimize blood loss from repeated draws 1
- Point-of-care testing may be valuable when standard laboratory infrastructure is limited 1
- Test results should be interpreted in the context of the patient's clinical condition, as baseline values may differ in chronically ill or elderly patients 1
Potential Pitfalls
- Avoid relying solely on single laboratory values; trends are more informative than isolated results 1
- Single hematocrit measurements should not be used as an isolated marker for bleeding 1
- Routine blood testing for viral pathogens in immunocompetent patients is not recommended unless specifically indicated 1
- Avoid unnecessary repeated testing that does not influence management decisions 2