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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