Disease screening blood collection room

The disease screening blood collection room is the lowest-cost and most efficient "health outpost" in the entire public health prevention and control system - it only uses a few milliliters of blood to capture early signs of the disease 3 months to 2 years before symptoms appear, greatly advancing the intervention window for many malignant and chronic diseases.

If you have ever rushed to the community screening blood collection site at 8 o'clock in the morning, you must be familiar with the cool smell of iodine. The plastic seats were filled with people clutching their sleeves. The nurse in the blue isolation gown moved as fast as double speed. She removed the needle, tied the tourniquet, inserted the needle, changed the tube, pulled out the needle and handed the cotton pad. The whole set of actions was completed in five seconds, and her mouth was still busy: "Don't rub the cotton pad while it's pressed. I'll tear it off in half an hour! Next!"

It’s not that no one has an opinion. During the two months I worked in the blood collection room to assist in the screening, almost every day I met someone with a frown and asked: "Is there nothing wrong with me? Why are I drawing so many tubes of blood? Are you trying to make money from me?"

The statement of standing on the side of medical care is true. Last year, we conducted targeted liver cancer screening for the elderly, and 17 abnormalities were detected in alpha-fetoprotein (AFP). Further examination showed that 3 were early-stage liver cancers. After surgery, they can now buy groceries and pick up their grandchildren normally. If you wait until the liver area hurts and the person turns yellow before going for a check-up, it will basically be in the middle and late stages. The treatment is expensive and painful. How can it be cost-effective to draw a tube of blood?

But patients’ concerns are not unreasonable. I saw a 30-year-old young man undergo a physical examination when he was employed. He was deceived into checking a full set of 12 tumor markers, and one of them, cytokeratin 19 fragment, was slightly elevated. He was so frightened that he suffered from insomnia for half a month and went to the hospital for three check-ups. Finally, it was discovered that he stayed up late the night before to catch up with the plan and drank three cans of energy drinks. Not to mention the money spent, he suffered a serious crime for nothing.

The "Population Disease Screening Guidelines" issued by the Chinese Center for Disease Control and Prevention in 2023 has actually already provided a compromise plan: blood sampling screening is not "the more complete, the better". For healthy people aged 20 to 35, routine screening only requires blood routine and liver and kidney function. For those over 40 years old, markers corresponding to high-risk cancer types are added, and for those with family medical history, targeted items are added. There is no need to draw a dozen tubes for a complete set of tests.

It’s interesting to say that there are still many little controversies hidden in the blood collection room that only those in the industry know about. For example, what needle is used during batch screening? Older nurses prefer to use negative pressure steel needles, which are fast and can return blood in one second. During the peak period, more than 200 needles can be collected in one morning. However, people with thin blood vessels are prone to bruises; young nurses prefer to use butterfly-wing soft needles, which have less pain and less damage to blood vessels. However, it takes ten seconds longer to take one needle. When there are many people, the queue can be queued outside the door. Nowadays, many community screening sites have changed to separate windows. The elderly, children, and people with thin blood vessels have a window to remove soft needles, and others use the regular window. This can be said to have figured out the balance between efficiency and experience.

The last time I went for a blood test, the blood vessels were so thin that the nurse patted my arm several times, which made me hurt. Just when I was about to open my mouth to say something, she laughed and said, "Be patient, you haven't drank water this morning, and your blood vessels are as flat as a thin thread. I'll pat you twice to give you a drumbeat, so as not to inject two more painful needles." Sure enough, I got the shot with one shot. I later learned that many people think that nurses are heavy-handed, but they are actually doing it to avoid suffering. There was also the matter of pressing cotton pads. The nurse told me not to rub them a hundred times, but someone still held the cotton pads and rubbed them vigorously. The arms were bruised for a week. They came to the nurse to ask if they were broken, and they had to explain it again every time with dumbfounding.

Wait until 6pm to go to the blood collection room. The smell of iodophor has almost dissipated. The nurse puts the bar code on the last tube of blood and puts it into the cold chain box. These blood samples with body temperature will then be sent to the laboratory. The string of numbers that come out will either be a reassuring "no abnormality" or a reminder of "re-examination recommended." This place is not big, the things on display are simple, and it is even noisy all year round, but if you think about it carefully, how many people's health hurdles have been quietly passed in just a few milliliters of blood.