September 2023 Quick Question: Hemolysis

Our September 2023 Quick Question was a poll that asked, “What unit sends most of your hemolyzed specimens?” The poll received 32 answers:

1. Newborn ICU: 8 [25%]
2. Emergency room: 20 [63%]
3. Other ICU sources: 3 [9%]
4. Remote phlebotomy site: 1 [3%]

Thanks to all for your responses. Although visible plasma hemolysis may indicate in vivo pathology, most instances arise from “ex vivo” specimen collection issues. A 23-gauge needle can disrupt RBCs if blood is collected with excessive force, as can mechanical disruption, however, most cases are traced to the collection through an IV starter apparatus or a vascular access device. This accounts for hemolyzed specimens from the ER and ICUs, as detailed by the Center for Phlebotomy Education. “PIVO” is a commercial catheter designed to reduce hemolysis during IV starts [Fritsma Factor has no financial relationship with PIVO]. Please send us your experiences wth hemolysis and describe how you’ve managed the problem