Hi All,
I am a nurse and a research student in North East England.
I work clinically and are involved in the clinical skill training which includes venepuncture. I am interested in pre-analytical blood sample haemolysis and this is the basis for my research. I am closely following this communication as it is the basis for
my research.
I hope you won't mind me participating in this discussion.
Nellie A. Makhumula-Nkhoma
Research Student (Part time)
From: Clinical biochemistry discussion list <[log in to unmask]> on behalf of Jonathan Kay <[log in to unmask]>
Sent: 18 September 2017 08:42
To: [log in to unmask]
Subject: Re: Haemolysis in ED
Sent: 18 September 2017 08:42
To: [log in to unmask]
Subject: Re: Haemolysis in ED
A similar problem in Oxford was resolved when a registrar and clipboard arrived from the laboratory to study the process.
Jonathan
> On 18 Sep 2017, at 08:20, MacKenzie, Suzanne <[log in to unmask]> wrote:
>
> David - here's some work done in our lab around the issue
> https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fjournals.sagepub.com%2Fdoi%2Ffull%2F10.1177%2F0036933014529056&data=02%7C01%7Cn.makhumula-nkhoma%40TEES.AC.UK%7Ce920738eb6d949c297b408d4fe68f06d%7C43d2115ba55e46b69df7b03388ecfc60%7C0%7C0%7C636413174038995843&sdata=gkL0ZkQps9MLsVMXcx7MsQAIMjJpSNBpVuRVR9FvL2I%3D&reserved=0
>
> BW,
> Suzanne
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of BARLOW, Ian (NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST)
> Sent: 18 September 2017 08:14
> To: [log in to unmask]
> Subject: Re: Haemolysis in ED
>
> Hi David,
>
> We had a similar issue a few years ago, and the cause was that A/E were using a narrow bore cannula to take the blood. They move to the correct size and it was sorted.
>
> Good luck
>
> Ian
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Wright
> Sent: 17 September 2017 22:13
> To: [log in to unmask]
> Subject: Haemolysis in ED
>
> All
>
> Returning to a topic last discussed 3 years ago, and more recently in an audit of haemolysed samples received. On data taken last year, we found our rates were more or less in keeping with averages.
>
> Briefly, one of our ED sites is currently running with a haemolysis rate between 25 and 35%, causing understandable consternation as the normal rate is just over 10% of samples. We are not seeing this on another ED site, nor increases in any other ward location and are at a loss to understand what the cause is.
>
> This first started a little over 2 weeks ago without any suggestion of a possible causal relationship (phebotomy or bottle change, procedure change, staff change, air tube).
>
> The patients seen normally in ED have a "conversion" rate (patient admitted) of 20%, it's currently around 30% with sicker, elderly patients presenting. This might offer a partial explanation.
>
> Labs are trying to help solve the conundrum, have asked ED to invite in the blood collection product supplier to audit their practice. It's difficult for us to comment upon practices in ED.
>
> Have any other Labs been challenged by increased haemolysis rates in a similar manner and can they share their experiences? It's obviously in Labs interest also to find answers and put solutions in place.
>
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Jonathan
> On 18 Sep 2017, at 08:20, MacKenzie, Suzanne <[log in to unmask]> wrote:
>
> David - here's some work done in our lab around the issue
> https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fjournals.sagepub.com%2Fdoi%2Ffull%2F10.1177%2F0036933014529056&data=02%7C01%7Cn.makhumula-nkhoma%40TEES.AC.UK%7Ce920738eb6d949c297b408d4fe68f06d%7C43d2115ba55e46b69df7b03388ecfc60%7C0%7C0%7C636413174038995843&sdata=gkL0ZkQps9MLsVMXcx7MsQAIMjJpSNBpVuRVR9FvL2I%3D&reserved=0
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Background It is estimated that 70% of all health care decisions affecting diagnosis or treatment involve laboratory testing. The pre-analytical phase of the te...
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>
> BW,
> Suzanne
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of BARLOW, Ian (NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST)
> Sent: 18 September 2017 08:14
> To: [log in to unmask]
> Subject: Re: Haemolysis in ED
>
> Hi David,
>
> We had a similar issue a few years ago, and the cause was that A/E were using a narrow bore cannula to take the blood. They move to the correct size and it was sorted.
>
> Good luck
>
> Ian
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Wright
> Sent: 17 September 2017 22:13
> To: [log in to unmask]
> Subject: Haemolysis in ED
>
> All
>
> Returning to a topic last discussed 3 years ago, and more recently in an audit of haemolysed samples received. On data taken last year, we found our rates were more or less in keeping with averages.
>
> Briefly, one of our ED sites is currently running with a haemolysis rate between 25 and 35%, causing understandable consternation as the normal rate is just over 10% of samples. We are not seeing this on another ED site, nor increases in any other ward location and are at a loss to understand what the cause is.
>
> This first started a little over 2 weeks ago without any suggestion of a possible causal relationship (phebotomy or bottle change, procedure change, staff change, air tube).
>
> The patients seen normally in ED have a "conversion" rate (patient admitted) of 20%, it's currently around 30% with sicker, elderly patients presenting. This might offer a partial explanation.
>
> Labs are trying to help solve the conundrum, have asked ED to invite in the blood collection product supplier to audit their practice. It's difficult for us to comment upon practices in ED.
>
> Have any other Labs been challenged by increased haemolysis rates in a similar manner and can they share their experiences? It's obviously in Labs interest also to find answers and put solutions in place.
>
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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