Anyone seeing hemolysis with specimen drawn from the Bio-Flo picc from Angiodynamics? We have seen a few issues, but can't seem to get to the root of why this is happening. We love the catheter but may stop using it because of this.
Are the blood samples being drawn with a syringe or a vacuum tube system? Through the needleless connector or directly from the catheter hub? I recently found a study about high rates of hemolysis (between 5 and 6%) drawing from a short peripehral catheter. I was trying to figure out all of these details from that study, so was curious about the techniques. Do you have an incidence rate for the hemolysis? Lynn
Lynn, We have drawn them using syringe and vacutainer method. We even tried different sized syringes. With and without the needleless connector. It has happened in 7 of the several hundred piccs we have placed over the last 4 months or so. In each case, the labs from a peripheral stick have been normal. Beginning from the time the piccs were inserted on these patients every specimen drawn from the picc, no matter how it was drawn, has been hemolyzed. Interestingly, we haven't seen a report of even an intermittent hemolyzed specimen on any other patients whose labs were drawn from this catheter.
Yes, it is the valved version and we certainly suspect the valve is the problem. The company is working with us and have been very receptive. We have seen a significant drop in our occlusion rate since using this catheter. We would hate to have to stop using it, but we may have to.
Prevailing thoughts now point to reducing hub manipulation to reduce CRBSI. For many this means avoiding use of VADs for blood sampling. So you could change your practice if this product has other great benefits. Lynn
And you can continuously stick those poor kds everytime for a peripheral blood draw as Lynn indicates
I am a big advocate of blood draws through any VAD type period. Why would you want to stick and stick and stick. No patient ever got an infection from phlebotomy. Wrong my dad got a compartment syndrome and than a infection from phlebotomy four years ago for a lab blood draw. He had two weeks of antibiotics and two MD visits for follow up. Who says a peripehral draw is less risk of infection? It is an invasive procedure as well.
Are the blood samples being drawn with a syringe or a vacuum tube system? Through the needleless connector or directly from the catheter hub? I recently found a study about high rates of hemolysis (between 5 and 6%) drawing from a short peripehral catheter. I was trying to figure out all of these details from that study, so was curious about the techniques. Do you have an incidence rate for the hemolysis? Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn, We have drawn them using syringe and vacutainer method. We even tried different sized syringes. With and without the needleless connector. It has happened in 7 of the several hundred piccs we have placed over the last 4 months or so. In each case, the labs from a peripheral stick have been normal. Beginning from the time the piccs were inserted on these patients every specimen drawn from the picc, no matter how it was drawn, has been hemolyzed. Interestingly, we haven't seen a report of even an intermittent hemolyzed specimen on any other patients whose labs were drawn from this catheter.
Are you using the valved version of the Bio-Flo? Maybe the blood flowing through the valves is causing the issue? Just a thought.
Ann Armstrong, RN
PICC Lines
MidMichigan Medical Center, Midland
Yes, it is the valved version and we certainly suspect the valve is the problem. The company is working with us and have been very receptive. We have seen a significant drop in our occlusion rate since using this catheter. We would hate to have to stop using it, but we may have to.
Carla Curry BSN RNIII
Prevailing thoughts now point to reducing hub manipulation to reduce CRBSI. For many this means avoiding use of VADs for blood sampling. So you could change your practice if this product has other great benefits. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
And you can continuously stick those poor kds everytime for a peripheral blood draw as Lynn indicates
I am a big advocate of blood draws through any VAD type period. Why would you want to stick and stick and stick. No patient ever got an infection from phlebotomy. Wrong my dad got a compartment syndrome and than a infection from phlebotomy four years ago for a lab blood draw. He had two weeks of antibiotics and two MD visits for follow up. Who says a peripehral draw is less risk of infection? It is an invasive procedure as well.
kathy Kokotis RN BS MBA
Bard Access Systems