No statistically significant difference in the rate of hemolysis is observed when emergency department nurses collect coagulation blood samples directly via catheter hub or via extension tubing connected to the intravenous (IV) catheter hub, according to a study published in the January issue of the Journal of Emergency Nursing.
To evaluate which blood collection method yielded the lowest hemolysis rate, Mary Stauss, R.N., M.S.N., of the Cooper Medical Center in Camden, N.J., and colleagues conducted a prospective, two-group, randomized study involving 121 adult patients treated in the emergency department. Blood specimens were either collected directly from the catheter hub (Group 1) or via extension tubing connected to the IV catheter hub (Group 2).
The researchers detected no statistically significant difference in hemolysis rates between the two groups. When drawing coagulation blood samples through a peripheral IV catheter, either at the hub or through extension tubing, the hemolysis rates were high at 32 percent (Group 1) and 30 percent (Group 2). Nurses had difficulty accurately predicting whether or not the sample they drew was hemolyzed. However, when taking into account nurse-reported difficulty of the insertion, ease of draw, and blood flow, samples rated as not difficult were less likely to be hemolyzed than those rated as difficult to insert or draw.
"We found that neither method made a difference in hemolysis rates in this study. Difficulty of IV catheter insertion, ease of blood draw, and problems with blood flow during specimen collection were associated with a significantly higher hemolysis rate than samples rated as having no difficulty. It seems that the difficulty of specimen collection may be an important factor associated with hemolysis of coagulation specimens," the authors write.
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