Minimizing preanalytical errors in capillary

blood sample collection and handling

Useful tips to avoid preanalytical errors in
blood gas testing: electrolytes
Oct 2003

Gitte Wennecke

Preanalytical errors are said to be the reason for up to 75 % [1] of all errors in laboratory
medicine. The diagnostic consequences depend on the magnitude of the preanalytical error.
In worst case, these errors may lead to mistreatment of patients; in all cases, these errors
are an extra workload for the hospital staff involved. It is in the interest of everybody
involved in laboratory medicine and the safety of the patients to keep the preanalytical
factors under control. One way to avoid preanalytical errors is to implement standardized
procedures and educate all staff involved in all phases of the sampling process: from
patient preparation to analysis of the sample.

This article provides useful tips for avoiding preanalytical errors on electrolyte
parameters; tips which you can incorporate in your standardized procedures and training
of your staff. The article is a part of a series of articles dealing with preanalytical errors in
blood gas testing.

May 21, 2015

Presented by Martha Lyon, PhD, Clinical Biochemist, Royal

University Hospital, Saskatoon, Saskatchewan, Canada
Playback

Slides

The specimen of choice that enables the collection of small blood volumes from neonatal or
critically ill patients is a capillary blood specimen. This specimen type has gained favour with
many physicians for the analysis of blood gases, electrolytes and/or metabolites like glucose,
lactate, creatinine or total bilirubin. However, numerous pre-analytical errors can occur during
the procurement and handling of a capillary blood specimen such that the quality of test results
could be compromised and clinically misleading.

Hemolysis is a common pre-analytical error that can occur during the collection of any blood
specimen and is well known to influence the quality of electrolyte and blood gas results. The rate
of hemolysis of blood specimens is influenced by patient type (ie. 10-12% emergency patients;
1.5-2% medical wards) and whether laboratory trained phlebotomists (0.5-2%) or nurses (2-
10%) are collecting the specimen. To date, few laboratories have been adventurous enough to
attempt measurement of hemolysis rates for capillary blood specimen collection.  

The neonatal population present unique challenges with respect to the procurement and handling
of a capillary blood specimen. In this webinar, pre-analytical errors such as patient identification,
specimen collection, handling and transport associated with neonatal capillary blood gas
specimens will be discussed.

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