Effectiveness of practices to reduce blood sample hemolysis in EDs: A laboratory medicine best practices systematic review and meta-analysis
Published Date:Sep 2012
Source:Clin Biochem. 2012; 45(0):1012-1032.
Blood Specimen Collection
Clinical Laboratory Quality Improvement
Emergency Service, Hospital
Hospital Laboratory Organization And Administration
Medical Laboratory Personnel
Medical Laboratory Personnel Organization And Administration
Practice Guidelines As Topic
Pubmed Central ID:PMC4518461
Funding:CC999999/Intramural CDC HHS/United States
W911NF-07-D-0001/DO 0191/TCN 07235/PHS HHS/United States
To complete a systematic review of emergency department (ED) practices for reducing hemolysis in blood samples sent to the clinical laboratory for testing.
A total of 16 studies met the review inclusion criteria (12 published and 4 unpublished).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=0.35–0.57].
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 Unpublished studies made an important contribution to the body of evidence.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.
The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the CDC.
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