Laboratory Data

1. Type and crossmatch. Indicated for significant blood loss.

2. Guaiac test for occult blood. Is patient really bleeding? Many substances ingested by children, including red food coloring and iron supplements, look like blood.

3. CBC. Stable hematocrit can give clinician a false sense of security. Hematocrit declines only after extravascular fluid enters the intravascular space. A significant drop may not occur for hours.

4. PT and PTT. The first steps in evaluation of a primary coagulopathy or disseminated intravascular coagulation.

5. Liver transaminases. Indicated if clinician suspects liver failure as the cause of a clotting abnormality.

6. Serum electrolytes, BUN, creatinine. Obtain, along with urinalysis, if HUS is strongly suspected.

7. Stool studies. Include bacterial culture, C difficile toxin assay and Wright stain (to demonstrate eosinophils seen in allergic colitis), if suggested clinically.

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