Re: Nurses can't draw blood, its always hemolyzed Originally Posted by Altra
Well, let's think about this. Are there new staff in the ER? Different supplies? Or just all of a sudden, *for no reason* there has been a spike in hemolyzed specimens?
But I will ask you something. Why, when the lab calls and claims that certain specimens are hemolyzed, and I say "OK, it took 3-4 of us to get the blood that we sent you, and the pt. is X (known frequent flyer/brittle diabetic/renal failure/crap for veins)"
...
after a few seconds of silence, does the lab say "we'll see what we can do." And 20 minutes later, like manna from heaven, I have results from those specimens!
There are two seperate occasions when we can catch hemolysis. Once the specimen is taken out of the centrifuge we see that its hemolyzed, thus it won't be run, and we'll make the call for a restick. Or we miss it and it gets ran anyway, but the results come out funky where potassium is 6.9 after the patient had been running a 4.0, creatinine levels are all out of whack etc etc. When we see something like this, we go back to the instrument, recheck the racks and see whats wrong with the specimen. More often than not its hemolyzed or diluted (another problem caused by drawing from the line). So then thats when we make the call. Sometimes, results from a hemolyzed specimen will still correlate with what the patient has been running. In that case, we file it, why restick the patient? When the lab calls about hemolyzed specimens and they call fairly quick, that means they caught the hemolysis after spinning it down. If it took some time for them to call, they probably have results but just aren't willing to file it because they caught the hemolysis after the fact. Thats why when we call and you sweet talk us a little bit, bribe us with a late night rendezvous in the morgue, your results magically appear like manna from heaven.
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