Our Emergency department does the blood sampling for the
clinical chemistry and hematology tests. For patients that probably have an
myocardial infarction they give the patient a venflon needle. The
blood sampled first from the Venflon 2 needle with Luer-lock and then
the patient is given a infusion (and Streptokinase). Because of the
streptokinase is is of cause undesirable to do an venipuncture for blood tests.
However, we very often find hemolysis when the venflon needle is used.
The emergency dept. most often uses the small pink Venflon 2
needle (OHMEDA, Sweden);with a 1.0 mm diameter, 32 mm long = 20 G/32 mm) though
sometimes the ticker 1.2 mm (18 G) version is used.
We detect the hemolysis on our Hitachi 917 using the
serum indexes (we use Becton Dickinson Hemogard Lithiumheparin plasma tubes). We
set our limits of each test separately. The hemolysis limits (H limit) were
found in an investigation with plasma's spiked with fresh hemolysate. Our
criteria are a deviation of 10% from the original value.
Does anyone have an solution to prevent the occurance of this
cause of hemolysis by using an other technique/procedure or the of needle or are
we the only lab with this problem?
Dirk Bakkeren
Clinical Chemist
Diaconessenhuis Eindhoven