The effect of blood drawing techniques and equipment on the hemolysis of ED laboratory blood samples

Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention

“…We believe that directed interventions focusing only on leading causes of haemolysis would result in a likely reduction of haemolysed blood specimens. A directed intervention aimed at reducing haemolysis should focus on drawing blood from the antecubital fossa (32), use needles with large bore gauge > 22 (32), fully fill test-tubes (16,32), perform VBSC by venipuncture instead of through intravenous catheters (18,19,27,28), Compared to our previous study (12), the percentage of haemolysed specimens still was more common in specimens drawn from men, and the over-all increase of mildly haemolysed specimens noted was also due to an increase for male specimens. This increase could not be explained by the increase in median age of participating sampled patient, as age was not significantly increased in the multiple logistic regression model.…”

“…For example they were updated and informed about the use of stasis, how to store and handle the test tube prior to sampling. In short, the large scale intervention included three parts: 1) it mandatory studying of the national VBSC guidelines (10) prior to education; 2) 2h lectures of which the first included VBSC practices and stressed practices important for the occurrence of haemolysis (15)(16)(17)(18)(24)(25)(26)(27)(28)(29)(30), and the second regarding collection of microbiological specimens. The first lecture also contained information regarding local non-adherence to preanalytical practices (4-9); 3) participants were to adequately respond to five written examination questions regarding VBSC guidelines and if passed examination they received a VBSC competence certificate valid for four years.…”

Obtaining Blood Samples From Peripheral Intravenous Catheters: Best Practice?

“…Overall, these results reflect higher hemolysis rates when laboratory specimens are collected from newly inserted intravenous catheters and when Vacutainers are used with new or established intravenous catheters. Furthermore, in 1 study, 6 not only did collection of blood samples from intravenous catheters increase hemolysis, but tests were canceled 20 times more often when samples had been collected from intravenous catheters rather than venipuncture.…”

Detection of Hemoglobin-Based Oxygen Carriers in Human Serum for Doping Analysis: Screening by Electrophoresis

“…Because such complexes are present physiologically (at low concentrations) in serum, it was necessary to eliminate these before electrophoresis of the serum samples. In the context of doping controls conducted on athletes, it is pertinent to consider the potential increase of such complexes in the case of hemolysis associated with exercise (10 ) as well as sample collection (11 ). The use of concentrated antibodies is highly advised to ensure efficient removal of the Hb-Hp complexes in the cases of abnormally high Hp concentrations.…”