*slightly hemolyzed* potassium

[holdensjane1]

My patient had an afternoon draw today and his K result came back 4.7. So I went on about my day but when I came home tonight I sudden had a flash back and noticed something I didn't noticed earlier and that was that the potassium was slightly hemolyzed. I had been looking at labs in trend view all day as I usually do and suddenly remembered that I flipped through the summary view at one point to get to something else and it said hemolyzed but I didn't noticed at ththe time. This is not a cardiac patient.

how much will "slightly hemolyzed" affect the the potassium? Will it be enough that it would mask a true value of 3 or below, or even 3.5? Please let me know your thoughts, I feel so bad I can't sleep!

[Grumble88]

Your lab should be redrawing hemolyzed samples, not reporting them, but regardless don't stress about it. If you're really worried call whoever is on shift and report it to them so they can follow up.

[iluvivt, BSN, RN]

Yes...It should have been a redraw.Since K+ is an intracellular cation when the cells break it gets measured as extracellular so the true K level will be inaccurate.How inaccurate depends upon how many cells were broken allowing intracellular cations and an ions to escape

[NurseCard, ADN]

This reminds me of the time that I freaked out and called the doctor because one of my pediatric patients had a potassium of 6.5. First thing the doctor said? "The lab did a fingerstick draw, didn't they?". Since the fingerstick was more likely to hemolyze, the potassium result was inaccurate.

[bossman]

So first STOP WORRYING. Truly hemolyzed at best can report a K at 1 below the level (3.7) and slightly hemolyzed is more likely 0.5. There is no reason to redraw this patient and no need to lose a single minute of sleep. Take it as a good learning point to pay attention because there is 0 harm to this patient. At worst they fall in normal limits and will have no bad outcomes from this.

[CrunchRN, ADN, RN]

Especially with potassium a hemolyzed specimen is completely unreliable.

[Been there,done that, ASN, RN]

Are you saying the initial report that you saw reported "slightly hemolyzed".. was then changed to hemolyzed?

Your lab would have parameters on whether or not, a redraw is necessary.