The Effectiveness of Using Luer-Lok (Bd Vacutainer®) In Reducing Hemolysis Rates in Busy Emergency Departments

Faruk Gungor,Mustafa Kesapli

doi:10.4172/2167-1168.1000349

Abstract

Introduction: In busy emergency departments, errors made during the pre-analytical phase can cause delayed diagnosis and treatment, and prolonged follow-up periods. The most common error in the pre-analytical phase is hemolysis in blood samples. In this study, we aimed to assess the effectiveness of the Luer-Lok (BD Vacutainer®) method of taking samples in avoiding hemolysis. Materials and Methods: The study was conducted at the emergency department of a tertiary healthcare facility on patients that register at level 1 or 2 of the Emergency Severity Index triage algorithm. Three sets of prospective observations were made, each lasting for five days. In the first period, hemolysis rates were determined. Following a training course on appropriate blood sampling techniques during the second period, hemolysis rates were determined again while Luer-Lok (BD Vacutainer®) was being used. Taking and processing of samples were carried out by the same personnel throughout the study. Assessment of hemolysis was performed by those that were blind to sampling. All the samples were analyzed at the laboratory located inside the emergency department. Results: In total, 2,027 blood samples were sent to the emergency laboratory for analysis. The hemolysis rate was 8.1% in the first period, 5.5% in the second and 1.4% in the third. The difference in rates between the first and second periods was not statistically significant (p=0.0793). The hemolysis rate in the third period was significantly lower compared to the other two periods (p=0.0001). Conclusion: Using Luer-Lok (BD Vacutainer®) may be effective in reducing hemolysis rates in busy emergency departments.

Highlights

In busy emergency departments, errors made during the pre-analytical phase can cause delayed diagnosis and treatment, and prolonged follow-up periods
A sample with hemolysis is unsuitable for many types of analysis; e.g. creatinine kinase, lactate dehydrogenase (LDH), alanine amino transferase (ALT), aspartate amino transferase, (AST), potassium, coagulation tests [3]
An analysis performed by the Working Group on Laboratory Errors and Patient Safety (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the Global Pre-analytical Scientific Committee (GPSC) and involved 391 clinical laboratories has shown that, the rate of hemolysis is between 1-5%

Summary

Introduction

Errors made during the pre-analytical phase can cause delayed diagnosis and treatment, and prolonged follow-up periods. The most common error in the pre-analytical phase is hemolysis in blood samples. We aimed to assess the effectiveness of the Luer-Lok (BD Vacutainer®) method of taking samples in avoiding hemolysis. Due to their nature, emergency departments are often places of panic and chaos. Hemolysis in samples is observed regularly in departments that the patients spend relatively short time in, such as the emergency department [4,5]. An analysis performed by the Working Group on Laboratory Errors and Patient Safety (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the Global Pre-analytical Scientific Committee (GPSC) and involved 391 clinical laboratories has shown that, the rate of hemolysis is between 1-5%.

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Conclusion