Andrew Trull published a fairly extensive study on this problem in the
winter months at Addenbrooke's. We tried insulated boxes with no success.
The only solutions are either to centrifufge at source or temperature
control the delivery vans. The cold weather shifts the potassium most with
the high temps not overly affecting the results (that said the potassium RR
in the West Indies is about 0.5mmol/L lower than usual UK values!).
Ian Mc
>From: "O'Connor John (Royal Devon and Exeter Foundation Trust)"
> <[log in to unmask]>
>Reply-To: "O'Connor John (Royal Devon and Exeter Foundation Trust)"
> <[log in to unmask]>
>To: [log in to unmask]
>Subject: Delays in separation
>Date: Fri, 15 Apr 2005 08:45:12 +0100
>
>Bit of an old chestnut this one, although I cannot find any discussion on
>the list archive.
>We serve a large rural population with many outlying GP surgeries. Our
>transport system is not all that it could be and a 3 metre wide road in
>Devon could be considered a superhighway. The net result is that there can
>be significant delays in sample separation.
>Pragmatically, we suppress any Potassium results in samples over 6 hours,
>issuing an appropriate sample delay comment instead. Many GP's are less
>than
>happy with this, particularly in patients on ACE inhibitors where an
>available and accurate potassium result is desirable.
>I am aware of studies that relate to cellular potassium leakage in stored
>samples, but has anyone performed any work on van transported samples that
>endure bumpy roads in the sweltering heat of summer and freezing winter
>days?
>I guess the most practical approach is to put centrifuges in the most
>outlying surgeries, but there are health and safety issues connected with
>this. Or persuade the powers that be in Primary care to co-ordinate
>transport appropriately, although this is no easy task when dealing with 3
>PCT's in our catchment area.
>I would be interested to know other laboratories policies / experiences on
>this and will compile a response to the mailing list, if labs wish to send
>me their protocols.
>
>Thanks
>John O'Connor
>
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