In message <[log in to unmask]>, Mike Collins MSc FIBMS
<[log in to unmask]> writes
>
>
>> When staffing an out of hours service, often single-handedly, Medical
>> Laboratory Scientists need to make decisions on how to report serum
>> potassium results in haemolysed specimens.
>
>As an MLSO who is often in this situation I suggest that the
>correct action is to report the potassium result together with a
>comment. Moderate visible haemolysis of a sample does not
>necessarily indicate that the potassium result is incorrect.
>Repeat non - haemolysed samples often have the same potassium
>result as the earlier haemolysed sample.
> Patients treated with haemoglobin - based blood substitutes can
>appear grossly haemolysed but because the haemoglobin is not
>derived from cell lysis there is no increase in potassium.
>Mike Collins
>
>
>Mike Collins MLSO3
>Chemical Pathology & Immunology
>The General Infirmary at Leeds,
>Old Medical School, Thoresby Place
>Leeds LS1 3EX, UK
>[log in to unmask]
>44 (0) 113 392 2915
I agree, our policy is to report the result and the state of the sample.
It is not unusual to receive a second sample from (junior) medical staff
and find that the potassium on the second non-haemolysed specimen is
identical to the first within the CV of the method.
Incidentally is it (just) a sign of old age or are junior medical staff
becoming worse at phlebotomy as they now have so many assistants to take
blood. ? Our out-of-hours samples are now generally atrocious, small
and frequently haemolysed.
--
Trevor Gray
Dept. of Clinical Chemistry,
Northern General Hospital,
Sheffield
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