We have an on-going problem with haemolysis in A&E (where most bloods
are collected by 'medical emergency assistants' - who all deny that they
ever use a syringe and needle.......). We have investigated this
several times: the most revealing finding is that on the days we put
someone into A&E to collect data there are almost no haemolysed samples
and all the samples are taken using vacutainers correctly. We did
collect some evidence that when using vacutainers in conjunction with
venflons (using the correct adapter) the smallest bore venflons were
associated with a slightly higher rate of haemolysis.
Cathryn
Cathryn Corns
Consultant Biochemist
Clinical Director of Pathology
01702 435555 ext 6614
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Brian Shine
Sent: 16 February 2008 08:37
To: [log in to unmask]
Subject: Re: Haemolysis and different phlebotomy systems (A+E)
We decided to have a look at what was happening at our smaller A&E where
up to a third of specimens had visible haemolysis. Strangely, on the
day our SpR was in the department, we had no haemolysed specimens. We
haven't been able to identify the problem, but we guess that it is to do
with syringe and needle use.
Our junior doctors say that they prefer using syringe and needles to the
BD system.
Best wishes,
Brian
Brian Shine
Consultant Chemical Pathologist
John Radcliffe Hospital
Oxford OX3 9DU
Telephone: 01865 220 475
Fax: 01865 220 348
On 15 Feb 2008, at 17:05, Mainwaring-Burton Richard (RGZ) wrote:
> I concur, and spend significant effort trying to get docs not to stick
> needles into the top of BD vacutainers. Unfortunately replacing a
> removed top generates positive pressure which blows out the lid in
> transit.
>
> I blame the combination of Venflon soft tips and vacutainer vacuum
> levels for the levels of haemolysis in A&E samples, but proving it is
> difficult.
> Anyone for audit ? I have a template.
> Have a gd w/e
>
> with best wishes
> Richard
> Richard Mainwaring-Burton
> Consultant Biochemist
> Queen Mary's Hospital
> Sidcup, Kent
> 020-8308-3084
>
>
> -----Original Message-----
> From: Jonathan Kay [mailto:[log in to unmask]]
> Sent: 15 February 2008 13:33
> To: [log in to unmask]
> Subject: Re: Haemolysis and different phlebotomy systems (A+E)
>
> Do your ED staff always use them as Vacutainers, or do they sometimes
> load them from syringes and needles? Ours often do the latter.
>
> Jonathan
>
> On 15 Feb 2008, at 12:36, Robert Lord wrote:
>
>> We currently use BD vacutainer system for phlebotomy and have
>> relativley high rates of haemolysis using this system in A+E. I would
>> be interested to hear from users of the Sarstedt Monovette system as
>> to whether sample haemolysis is an issue with them. Many thanks.
>>
>> Rob
>>
>>
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