Use of separate venipunctures for IV access and laboratory studies decreases hemolysis rates.

Summary of "Use of separate venipunctures for IV access and laboratory studies decreases hemolysis rates."

Emergency department (ED) patients routinely undergo placement of a saline lock device (SLD) with the aspiration of blood for laboratory testing. Drawing blood through a SLD may result in hemolysis of sample, repeated venipuncture and increased ED length of stay (LOS). The objective of this study was to examine if separate venipunctures for intravenous (IV) access and laboratory studies decrease the rate of hemolysis and ED LOS. The study was conducted at an urban university level 1 trauma center with an ED volume of 55,000. We compared the rate of hemolysis and ED LOS before and after mandating the use of separate venipunctures for IV access and laboratory studies over 1 month. Venipuncture was performed utilizing either a 21 ga needle or an IV catheter (BD Insight Autoguard) with a needless vacutainer. The incidence of hemolysis was calculated and a Student's t test was used to compare groups. The potassium sample redraw and processing time was observed. Blood was aspirated from 315 patients using the SLD. A baseline hemolysis rate of 23.0% (16.7-29.1) was obtained, corrected to 6.7% after factoring a 29.2% redraw rate for critical potassium levels. In the following month, 2,564 samples were obtained using the butterfly needle with a hemolysis rate of 6.6% (5.5-7.5), corrected to 2.0% after applying the 29.2% redraw rate. Avoiding hemolysis, we saved 4.7% of our patients' 56 min of ED stay, and avoided 185 retests over the month. In conclusion, venipuncture from a butterfly needle decreases the rate of hemolysis and may decrease the overall ED LOS.


Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, WCC-2, Boston, MA, 02215, USA,

Journal Details

This article was published in the following journal.

Name: Internal and emergency medicine
ISSN: 1970-9366


DeepDyve research library

PubMed Articles [24463 Associated PubMed Articles listed on BioPortfolio]

Adipocytes in venipunctures cause falsely elevated S-100B serum values.

Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

Context .- Hemolysis is an important clinical laboratory quality attribute that influences result reliability. Objective .- To determine hemolysis identification and rejection practices occurring in c...

Denitrifying Bioreactors for Nitrate Removal: A Meta-Analysis.

Meta-analysis approaches were used in this first quantitative synthesis of denitrifying woodchip bioreactors. Nitrate removal across environmental and design conditions was assessed from 26 published ...

Heparinate but not serum tubes are susceptible to hemolysis by pneumatic tube transportation.

Pneumatic tube transportation (PTT) may induce hemolysis (H) in blood samples. We aimed to compare the H degree before and after PTT implementation in our hospital.

Erythrocyte creatine as a marker of intravascular hemolysis due to left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

Erythrocyte creatine, a marker of erythrocyte age that increases with shortening of erythrocyte survival, has been reported to be a quantitative and reliable marker for intravascular hemolysis. We hyp...

Clinical Trials [4431 Associated Clinical Trials listed on BioPortfolio]

Long Term Effects of Erythrocyte Lysis

In this prospective observational trial, participants with chronic hemolysis will be assessed with echocardiogram for elevated tricuspid jet velocity and other evidence of pulmonary hypert...

Measurement of Carboxyhemoglobin by Gas Chromatography as an Index of Hemolysis

The purpose of this research study is to more accurately measure the amount of true red blood cell breakdown (hemolysis) in newborn babies with potentially problematic blood type mismatch ...

Trial Comparing Proximal Tibia and Proximal Humerus Infusion Rates Using the NIO Intraosseous Device

The investigators sought to compare the intraosseous access success rates of the proximal tibia and the proximal humerus using new Intraosseous access device "NIO" in an adult cadaver mode...

Use of a Ureteral Access Sheath During Ureteroscopy and Its Effect on Stone Free Rate

Patients with upper ureteral or renal stones will be randomized to undergoing ureteroscopy with or without a ureteral access sheath. The sheath is designed to facilitate ureteroscope inser...

An Expanded Access Protocol for Subjects Who Have Completed Clinical Studies Involving Maraviroc

This is an open-label protocol designed to provide continued access to maraviroc to only those subjects who have completed previous studies of maraviroc and continue to receive clinical be...

Medical and Biotech [MESH] Definitions

The application of discoveries generated by laboratory research and preclinical studies to the development of clinical trials and studies in humans. A second area of translational research concerns enhancing the adoption of best practices

A genus of gram-positive, coccoid bacteria consisting of organisms causing variable hemolysis that are normal flora of the intestinal tract. Previously thought to be a member of the genus STREPTOCOCCUS, it is now recognized as a separate genus.

Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are CASE-CONTROL STUDIES; COHORT STUDIES; and CROSS-SECTIONAL STUDIES.

Methods of detecting genetic etiology in human traits. The basic premise of twin studies is that monozygotic twins, being formed by the division of a single fertilized ovum, carry identical genes, while dizygotic twins, being formed by the fertilization of two ova by two different spermatozoa, are genetically no more similar than two siblings born after separate pregnancies. (Last, J.M., A Dictionary of Epidemiology, 2d ed)

Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.

Quick Search

DeepDyve research library

Searches Linking to this Article