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National Guideline Clearinghouse | Effectiveness of practices to reduce blood sample hemolysis in EDs: a Laboratory Medicine Best Practices systematic review and meta-analysis.

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National Guideline Clearinghouse | Effectiveness of practices to reduce blood sample hemolysis in EDs: a Laboratory Medicine Best Practices systematic review and meta-analysis.

Laboratory Medicine Best Practices

Guideline Title

Effectiveness of practices to reduce blood sample hemolysis in EDs: a Laboratory Medicine Best Practices systematic review and meta-analysis.

Bibliographic Source(s)

Heyer NJ, Derzon JH, Winges L, Shaw C, Mass D, Snyder SR, Epner P, Nichols JH, Gayken JA, Ernst D, Liebow EB. Effectiveness of practices to reduce blood sample hemolysis in EDs: a laboratory medicine best practices systematic review and meta-analysis. Clin Biochem. 2012 Sep;45(13-14):1012-32. [25 references] PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.

This guideline meets NGC's 2013 (revised) inclusion criteria.

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Effectiveness of practices to reduce blood sample hemolysis in EDs: a laboratory medicine best practices systematic review and meta-analysis. - PubMed - NCBI

2012 Sep;45(13-14):1012-32.

Effectiveness of practices to reduce blood sample hemolysis in EDs: a laboratory medicine best practices systematic review and meta-analysis.

Heyer NJ1, Derzon JH, Winges L, Shaw C, Mass D, Snyder SR, Epner P, Nichols JH, Gayken JA, Ernst D, Liebow EB.

Author information

Abstract

OBJECTIVE:

To complete a 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A total of 16 studies met the review inclusion criteria (12 published and 4 unpublished).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=0.35-0.57].

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.