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Variation in phlebotomy techniques in emergency medicine and the incidence of haemolysed samples.
MedLine Citation:
PMID:  21948490     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Phlebotomy is a potential cause of preanalytical errors. We have observed phlebotomy in routine practice in a busy Emergency Department, to see how current practice compares with optimal blood sampling. METHODS: Phlebotomy episodes were audited and compared with standard procedures. A computer-based search of the number of haemolysed samples from Emergency Medicine and hospital inpatients was reviewed. RESULTS: Four different ways of taking blood were observed: cannulation and a syringe (38%), cannula with evacuated tube and adaptor (42%), syringe and needle into vein (14%) and evacuated tube system used conventionally (6%). Where a syringe was used, two methods of transfer into the sample tube were observed; needle kept on with cap piercing (77%) and needle and evacuated cap both removed (23%). On 20 out of 50 phlebotomy episodes (40%), the potassium-EDTA tube was filled prior to the biochemistry serum gel tube. A search of the laboratory computer records for ward-based phlebotomy found 30 of 1034 samples were haemolysed (2.9%). In the 50 phlebotomy episodes in the Majors area of the Emergency Department, 24% produced a haemolysed sample (P < 0.0001). For samples taken from all areas of Emergency Medicine over a seven-day period, 52 of 485 were haemolysed (10.7%; P < 0.0001). CONCLUSIONS: This study has shown that phlebotomy techniques in the Emergency Department deviate from standard practice significantly. This may well be a reason for the much higher frequency of haemolysed samples and with the wrong order of collection the possibility of potassium-EDTA-contaminated samples.
Authors:
J E Berg; P Ahee; J D Berg
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-23
Journal Detail:
Title:  Annals of clinical biochemistry     Volume:  -     ISSN:  1758-1001     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0324055     Medline TA:  Ann Clin Biochem     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Medical School, University of Sheffield, Sheffield S10 2JA.
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