Hemolysis of blood specimens transported from ED to laboratory by pneumatic tube

Stair, Thomas O.; Howell, John M.; FitzGerald, Denis J.; Bailey, Scott; Bastasch, Michael D.

doi:10.1016/0735-6757(95)90145-0

Cited by 16 publications

(10 citation statements)

References 2 publications

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“…Our findings are similar to those of Fernandes et al and Stair et al, who also found no statistical difference in hemolysis rates between the two methods of transport of samples from their EDs 8,15. In contrast, Ellis, Hasan, and Steige each found a large increase in hemolysis with the implementation of pneumatic tube systems in their institutions 5,6,16…”

Section: Discussionsupporting

confidence: 90%

“…Ellis and Hasan both led ED-based studies that revealed significantly increased specimen hemolysis rates after pneumatic tube systems were installed 5,6. In contrast, other studies of pneumatic tube use demonstrated no significant changes in hemolysis rates 8,9,11–15. Because of this discrepancy in the literature, and in search of techniques to lower our own institution’s hemolysis rates, we sought to determine whether hemolysis rates of blood samples obtained in the ED were increased when transported in a pneumatic tube system versus being hand carried to the lab.…”

Section: Introductionmentioning

confidence: 99%

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Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?

Phelan

Reineks

Hustey

et al. 2016

WestJEM

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IntroductionOur goal was to determine if the hemolysis among blood samples obtained in an emergency department and then sent to the laboratory in a pneumatic tube system was different from those in samples that were hand-carried.MethodsThe hemolysis index is measured on all samples submitted for potassium analysis. We queried our hospital laboratory database system (SunQuest®) for potassium results for specimens obtained between January 2014 and July 2014. From facility maintenance records, we identified periods of system downtime, during which specimens were hand-carried to the laboratory.ResultsDuring the study period, 15,851 blood specimens were transported via our pneumatic tube system and 92 samples were hand delivered. The proportions of hemolyzed specimens in the two groups were not significantly different (13.6% vs. 13.1% [p=0.90]). Results were consistent when the criterion was limited to gross (3.3% vs 3.3% [p=0.99]) or mild (10.3% vs 9.8% [p=0.88]) hemolysis. The hemolysis rate showed minimal variation during the study period (12.6%–14.6%).ConclusionWe found no statistical difference in the percentages of hemolyzed specimens transported by a pneumatic tube system or hand delivered to the laboratory. Certain features of pneumatic tube systems might contribute to hemolysis (e.g., speed, distance, packing material). Since each system is unique in design, we encourage medical facilities to consider whether their method of transport might contribute to hemolysis in samples obtained in the emergency department.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?

Phelan

Reineks

Hustey

et al. 2016

WestJEM

View full text Add to dashboard Cite

show abstract

“…2 One recent study of 291 samples in routine clinical use in particular showed no increased incidence of haemolysis in the samples transported via PTS. 7 However, samples transported by PTS may not be suitable for all applications. 8 The samples most sensitive to transport changes would be expected to be those taken for blood gas analysis.…”

Section: Discussionmentioning

confidence: 99%

Changes in blood gas samples produced by a pneumatic tube system

Collinson

John²,

Gaze³

et al. 2002

Journal of Clinical Pathology

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Aims: To investigate the effect of a pneumatic tube system (PTS) on the results of samples sent for blood gas analysis to a central laboratory.Methods: Blood gas samples were analysed immediately or sent via the PTS to the laboratory for analysis. In addition, samples sent via the PTS in a pressure sealed container were compared with those sent non-pressure sealed to the laboratory. Results: Samples sent via the PTS had significant alterations in their pO 2 values, which were not seen when samples were carried by hand to the laboratory. There was no effect on pCO 2 and pH values. The use of a pressure sealed container abolished the alteration in pO 2 values seen. Conclusions:Samples for blood gas analysis should be transported via a PTS using a pressure sealed container to avoid artefacts in the pO 2 . R apid sample delivery systems, usually pneumatic tube systems (PTS), have been installed in hospitals to reduce delays in delivering samples from the patient to the core laboratory. The use of such rapid sample delivery systems, combined with electronic data links, would be expected to improve laboratory turnaround times (TATs). This would enable the laboratory to provide an analytical service with TATs comparable to that of a satellite "emergency" laboratory or point of care testing (POCT) facility at less cost.1 Studies have shown that there are no significant effects on analytes, particularly pO 2 , pCO 2 , and pH.2 However, a recent report has shown that there is perturbation of pO 2 values when there is air contamination. 3 We have examined the impact of an air tube delivery system (ASCOM GCT GmbH, Keven, Germany) on blood gas samples analysed immediately or sent via the pneumatic tube system to the laboratory for analysis."The use of rapid sample delivery systems, combined with electronic data links, would be expected to improve laboratory turnaround times" METHODSArterial blood samples were drawn from patients in the intensive care unit (ICU) of a UK district general hospital. The ICU is located in a separate building from the pathology laboratory, but on the same geographical site. All of the hospital wards including the ICU are connected to the central pathology laboratory via a pneumatic air tube delivery system. The ICU is 520 metres from the laboratory, with a median delay from sampling to arrival at the laboratory of 19 minutes (interquartile range, 13 to 23). Ethical permission for our study was obtained from the local research ethics committee. Samples were taken into commercially supplied preheparinised syringes (Mieno Corp, Tokyo, Japan). Visible air bubbles were expelled and the samples capped and processed immediately.A three stage study was performed, as follows:Phase 1. Consecutive samples were drawn in duplicate from patients over a two week period. One sample was analysed immediately on the ICU by a member of the ICU staff. The second sample was capped and sealed in a gas tight plastic envelope and taken immediately, by hand, to the laboratory for analysis by a member of the laboratory staf...

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“…El personal de sala hospitalaria o de las unidades de urgencias produce hasta 9 veces más hemólisis que el personal de unidades de extracción dependientes de laboratorio 13,23,34,35 .…”

Section: Causas De La Hemólisisunclassified