Okay, now that I've gotten your attention, I didn't really mean it...or did I =)
First and foremost I am not a nurse, I'm a technologist in the stat lab with a whopping 1 month of experience. Now, there's been some bad blood brewing recently between the lab and the ER. The issue, hemolyzed blood specimens. For the past 4 days, it seems as if EVERY single specimen sent from the ER is hemolyzed. We call because we need a restick, the ER gets ******, we get the tubes, its still hemolyzed, we get ******, we call again, they get more ******, we get the tubes, we get more ****** etc. etc. Its gotten to the point where the clerks won't even document a hemolyzed specimen and we have to speak to the Doctor directly. I'm just curious as to why all these specimens drawn from the lines are hemolyzed. Enlighten me.
P.S. Feel free to rant off about the lab and I'll try my best to shed some light upon your qualms.
I used to have this problem when getting lab draws from PICC lines. At least once a week I'd have to redraw someone. And it always happened on my worst days, when I did not have time for such things.
The last part is underlined for a reason. It wasn't Murphy's Law at work there.
A nice lab person who sometimes picked up OT and worked as a phlebotomist pointed out what my problem might be. My tubes were not completely filled. I new where the min. point to fill them was and did just that much, especially if the PICC was being uncooperative. Seems when I was having a bad day, I was less patient with letting the tubes fill.
The lab person told me I will have less problems/redraws if I just let the vacuum pressure do the work, fill each tube until all vacuum pressure is gone. Better to spend an extra two minutes drawing from an uncooperative PICC than have to redraw.
I started filling all tubes completely. Its been two years since then. I can honestly say, I have never once had to redraw since then. Maybe once or twice.
Maybe the ER people feel rushed and are not filling the tubes completely.
I have the same problem in ER.. the lab is always calling 2 hours after we cold call for the results hold up Oh sorry its hemolyzed.. I think we as RNs should just start writing the lab techs up cause they're unsupervised during nights and fall asleep and let tubes just sit there!
This has been an incredibly interesting and educational thread for me. I've been a nurse for over 25 years. Sometimes my bloods are great, sometimes, I run a string of hemolyzed. I never knew why.
Although I won't be drawing bloods for a while now, I'm definitely going to remember this thread when I do again. Thank you to the original poster who brought this up. I seriously can't recall a thread that helped me so much.
This has been an incredibly interesting and educational thread for me. I've been a nurse for over 25 years. Sometimes my bloods are great, sometimes, I run a string of hemolyzed. I never knew why.
Although I won't be drawing bloods for a while now, I'm definitely going to remember this thread when I do again. Thank you to the original poster who brought this up. I seriously can't recall a thread that helped me so much.
I agree! I too am a 25 year veteran. I hope and pray that I NEVER have to draw blood again, but if I do this has been very helpful!
Also wanted to add that people who work in the lab can do this many times every day, sometimes nurses only do blood draws a few times a week, or even less depending on the setting. It is like in the glory days when we had an IV team (maybe some systems still do) - they started IVs all day and were much more skilled as a result. Bear this in mind when we do things wrong with venipunctures.
Specializes in Nurse Leader specializing in Labor & Delivery.
Are the nurses drawing the blood when they start an I.V.? When I was in school I did some extra training at a different L&D than I work at now, they had recently stopped having the nurses draw blood when they started an I.V. stating it caused the blood to be hemolyzed...we do it at the L&D I work at now and the lab has never complained so I am not sure which hospital is correct.
We ALWAYS draw L&D labs at the IV start, and we've never had problems.
eriksoln, BSN, RN
2,636 Posts
I used to have this problem when getting lab draws from PICC lines. At least once a week I'd have to redraw someone. And it always happened on my worst days, when I did not have time for such things.
The last part is underlined for a reason. It wasn't Murphy's Law at work there.
A nice lab person who sometimes picked up OT and worked as a phlebotomist pointed out what my problem might be. My tubes were not completely filled. I new where the min. point to fill them was and did just that much, especially if the PICC was being uncooperative. Seems when I was having a bad day, I was less patient with letting the tubes fill.
The lab person told me I will have less problems/redraws if I just let the vacuum pressure do the work, fill each tube until all vacuum pressure is gone. Better to spend an extra two minutes drawing from an uncooperative PICC than have to redraw.
I started filling all tubes completely. Its been two years since then. I can honestly say, I have never once had to redraw since then. Maybe once or twice.
Maybe the ER people feel rushed and are not filling the tubes completely.