The Patient Who Ate Breakfast

In practice

A patient arrives for blood work, and the order includes a fasting glucose and a lipid panel. The medical assistant asks him to state his full name and date of birth, and checks both against the laboratory form. Before gathering the gray and gold tubes the tests call for, she asks when he last ate or drank anything besides water. He says he had coffee with cream and a muffin about two hours ago, because he forgot about the fast. She also asks about medications. He takes a blood thinner, which she notes so she can apply firm pressure afterward. She does not decide on her own to draw the blood anyway, or to send him home. She tells the provider that the patient did not fast. The provider decides to reschedule the fasting tests for another morning and asks her to give the patient the fasting instructions again. She explains that he should have nothing but plain water for eight to twelve hours before the draw, as the provider instructs. She asks him to repeat the instructions back. Then she documents the conversation.