Blood Collection Hemolysis in Emergency Departments

Collection of blood specimen by venipuncture is a daily practice in many emergency departments around the world. With the fast paced nature of emergency departments in mind, hemolysis remains an ongoing clinical problem that needs to be addressed. Hemolysis is defined as the rupture of red blood cells with release of hemoglobulin and other intracellular contents into plasma. When this occurs, the blood is unsuitable for lab testing so a second specimen must be obtained, which delays a timely diagnosis and appropriate treatment. In addition, increases cost, staff workload, patient discomfort, and length of stay. An extensive amount of research has been conducted and analyzed on this issue. These studies have shown a variety of factors in the preanayltic phase of care (i.e., prior to laboratory analysis) including equipment, anatomic site, tourniquet time, technique, personnel, and education to have a significant association with blood sample hemolysis. With the purpose of increasing awareness, utilizing the best evidence in practice, and reducing the amount of money, resources, and time being wasted, an improved protocol for this problem is being proposed