Anemia screening

What is anemia?

Anemia is a lower-than-normal hemoglobin concentration. Hemoglobin is a protein in your red blood cells that delivers oxygen to your organs and tissue. The normal hemoglobin concentration varies with age, sex, and environmental factors such as chronic lung disease and smoking.

Across the globe, an estimated 2.4 billion people, predominantly women, are anemic and half of them have iron deficiency anemia.

The World Health Organization has defined anemia as a hemoglobin concentration of less than 12 g/dL in adult females and less than 13 g/dL in adult males.

Three categories of anemia

• Mild anemia (hemoglobin concentration 10 – 13 g/dL in males, 10 – 12 g/dL in females)
• Moderate anemia (hemoglobin concentration 8 – 9.9 g/dL)
• Severe anemia (hemoglobin concentration less than 8 g/dL)

Why do we screen for anemia?

To improve our patients’ outcomes after surgery, UF Health now screens adult patients for anemia prior to elective surgical procedures.

Data shows that anemia is a risk factor for complications like infections, stroke, acute kidney injury, heart failure, longer stay in the hospital, and higher probability for a blood transfusion, which further increases your risk for complications.

As anemia can occur without any major symptoms, many patients are not aware that they are anemic. Some patients develop symptoms like tiredness, weakness, shortness of breath, pale skin, dizziness, or even chest pain.

How anemia screening works

We use a technology that can noninvasively check your hemoglobin level in just a few seconds. This is done at check-in in addition to checking your blood pressure, heart rate, and body weight. There is no charge for this screening.

Screening positive for anemia

If your screening reveals a low hemoglobin level your physician will discuss the next steps with you. If you need a surgical procedure, your doctor may order a lab test to confirm or rule out anemia.

The lab test includes a blood draw. At the lab, two small blood tubes are taken. The first one is to confirm or rule out anemia. If anemia is confirmed, the second blood sample is analyzed for the reason of your anemia.

A dedicated PBM nurse will check your lab values. If anemia is ruled out, there is no need for any other testing. If your screening for anemia is positive but you do not have a planned surgical procedure, your primary care physician will be informed to discuss next steps with you.

If you are suffering from iron deficiency anemia, and there is a planned surgical procedure, we can make an appointment at our infusion center to give you a dose of intravenous iron.

IV iron infusions

The best and fastest way to treat iron deficiency anemia is to give an iron infusion.

IV iron can be given as a one-time infusion at our infusion center. This procedure takes about one hour. A healthcare worker will give you the IV iron through a needle placed in your vein.

There are some potential side effects from IV iron infusion.

• Swelling or puffiness
• Itching
• Rash
• Fever
• Chills
• Headache

All these side effects usually resolve without treatment or can be treated at our infusion center. There is a very rare risk of a more severe and potentially life-threatening iron reaction. The nurses at the infusion center will monitor you for any reactions and there is always a doctor available if any problems occur.

Next steps

Your body needs some time after the iron infusion to fill its low iron stores and build new hemoglobin that will become part of your new red blood cells. The aim is to increase your hemoglobin as much as possible before your planned surgical procedure.

During your surgical procedure, we will check your blood again and analyze your hemoglobin.

Questions about anemia and patient blood management?

We are happy to answer your questions. Learn more about patient blood management or send an email to pbm@ad-anesth.ufl.edu.