Is there any correlation between blood draws through peripheral lines and increased issues with hemolysis?? Many of our EDs have having issues with hemolysis and the most common thread here is that they draw more blood thru peripherals than any other dept in the hospital. anything out there that speaks to this? would a traumatic insertion contribute to hemolysis in the blood specimen?
Lynne Farkas
Trinity Health
There are studies that have identified this hemolysis for samples taken from a PIV. Can't quote the study though. It is related to the technique used to draw the sample usually. 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
Do they use vacutainers or syringes?
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.
Peter
They use mostly vacutainers
Lynne
We found that smaller gauged catheters are usually implicated; I wonder if that's true for you also? I draw labs off of newly placed 24ga PIV catheters all the time and get no calls from the lab complaining about hemolysis.
From clinical experience, I bet that the blood stream from the needle is slamming into the bottom of the tube, rupturing the RBC's. There are 2 options you can try. One is to draw the sample gently with a syringe and transfer it into the tube. The second pertains to using a vacutainer. It requires that the tube be placed into the vacutainer on an angle. This directs the blood onto the side of the tube and prevents the blood from hitting the bottom of the tube directly. I also hold the tube and vacutainer upside down and invert it right side up before changing tubes. I’m not sure if this last precaution is necessary I've had success with just angling the tube.
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.
Just wanted to say thanks...Ive passed on this suggestion.....seems to have lessened the rate of hemolysis already but we will need another 30-60 days to tell for sure
Just wanted to say thanks...Ive passed on this suggestion.....seems to have lessened the rate of hemolysis already but we will need another 30-60 days to tell for sure
Glad to hear it, there is a learning curve to the technique. The trick is to lessen the turbulance as much as possible as soon as the blood enters the tube. The first part of the stream entering the tube is under the greatest vacuume. Which I believe to have greatest potential of hemolyzing. Inverting the tube should also help to decrease hemolylsis. Looking forward to hearing the longer term results.
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.