Journal
CLINICAL BIOCHEMISTRY
Volume 45, Issue 13-14, Pages 1012-1032Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.clinbiochem.2012.08.002
Keywords
Hemolysis; ED; Phlebotomy/methods; Catheters/indwelling; Clinical laboratory quality improvement; Hospital laboratory organization and administration; Medical laboratory personnel organization and administration
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Funding
- Laboratory Medicine Best Practices Initiative [W911NF-07-D-0001/DO 0191/TCN 07235]
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Objective: To completes systematic review of emergency department (ED) practices for reducing hemolysis in blood samples sent to the clinical laboratory for testing. Results: A total of 16 studies met the review inclusion criteria (12 published and 4 unpublished). All 11 studies comparing new straight needle venipuncture with IV starts found a reduction in hemolysis rates, [average risk ratio of 0.16 (95% CI = 0.11-0.24)]. Four studies on the effect of venipuncture location showed reduced hemolysis rates for the antecubital site [average risk ratio of 0.45 (95% CI = 0.35-0.571]. Conclusions: Use of new straight needle venipuncture instead of IV starts is effective at reducing hemolysis rates in EDs, and is recommended as an evidence-based best practice. The overall strength of evidence rating is high and the effect size is substantial. Unpublished studies made an important contribution to the body of evidence. When IV starts must be used, observed rates of hemolysis may be substantially reduced by placing the IV at the antecubital site. Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the CDC. (C) 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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