Anamnese vor der Blutentnahme

Anamnese vor der Blutentnahme is the short structured set of questions asked before anyone reaches for a tourniquet, and it is a screening step instead of a clinical assessment. The pharmacy is deciding one thing only, namely whether to draw at all today and under what conditions, and it is not forming an impression of the person's health.

The questions are few and they stay the same every time, which is why they belong in the Standardarbeitsanweisung as a fixed form instead of in the memory of whoever is on shift:

• Whether the person takes an anticoagulant, and which one, matters because the site will need longer compression afterwards.
• Whether a clotting disorder is known has to be asked every time.
• Whether they have ever fainted during a draw or at the sight of blood matters, because a vasovagal reaction is the most common incident in this setting. A reclined position chosen in advance makes it much easier to manage.
• Whether one arm should be avoided applies after breast surgery with lymph node removal, on the side of a dialysis shunt and around a fresh injury or infusion.
• Whether they have eaten matters if the requested analytes require Nüchternheit.
• How they are feeling right now is the last of the questions.

None of that produces a judgement about the person. An answer either changes the technique, such as a reclined position and longer compression, or it moves the draw to another day, or it ends with the pharmacy declining and referring the customer to a physician. Declining is a legitimate outcome and it should feel like one to the team.

The Anamnese is often confused with Aufklärung und Einwilligung, and the two happen one after the other, though they do opposite jobs. In the Anamnese the customer gives the pharmacy what it needs to decide whether to proceed, whereas consent gives the customer what they need to decide whether to accept. Both are documented and both are kept.

Two habits make the difference in practice, and both of them are about the record. The answers are written down instead of remembered, because an undocumented question is indistinguishable from a question never asked if Haftung is later raised. The screening is repeated at every appointment instead of being copied from the file, because medication changes between visits. For a venöse Blutentnahme the anticoagulation and fainting questions matter most.