Preventing Hemolysis

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What is hemolysis?

Hemolysis is the breakage of, or damage to, the membrane of red blood cells that results in leakage of hemoglobin into the surrounding fluid. Hemolysis is a common, yet preventable problem.

How is hemolysis detected?

Hemolyzed serum or plasma will have a pink or reddish hue, making it easy to visually detect.

Why is preventing it important?

Hemolysis can greatly impact the validity of test results. In many cases a hemolyzed specimen requires a repeat collection from the patient.  This could lead to delays in diagnosis/treatment, additional patient discomfort and dissatisfaction as well as additional expenses.

What are the main causes?

Hemolysis may be caused by improper specimen collection, processing, or transportation. 

What can you do to prevent it?

When collecting specimens:

  Do not leave tourniquet on for longer than one minute

  Allow alcohol to dry completely before puncturing the skin

  Use a properly sized needle; 20-22 gauge needles work best for routine collections

  Do not remove the needle from the vein with the vacuum tube still engaged

When processing specimens:

  Make sure sample is not exposed to extreme heat or cold

  Allow blood to clot completely prior to centrifugation

  Avoid vigorous mixing or shaking of tubes

  Do not centrifuge specimens at higher speed or for longer than necessary

When transporting/shipping specimens:

  Make sure sample is not exposed to extreme heat or cold

  Do not subject the specimen to significant jostling or jarring.

Tests commonly* impacted by hemolysis: 

•       Fungitell® •       Anti IgA
•       ImmuKnow® •       C1 Functional
•       Chronic Urticaria •       C1 Inactivator/Complement
•       Plasma Histamine •       C1q/Low Level IgA 
•       MBL Pathway Function •       Tetanus/Diptheria/Hib/MBL Oligomer
•       Pneumococcal/Pneumo Avidity •       PCR assays

 

*This list is subject to change and not comprehensive of all tests potentially impacted by hemolysis