title: A new device to relieve venipuncture pain can affect haematology test results.
abstract: BACKGROUND
  In vitro diagnostic tests play a key role in patients' management (e.g., guiding red blood cell transfusions). The aim of this study was to evaluate the impact of an innovative device (Buzzy®) which is claimed to be able to relieve venipuncture pain by means of cold and vibration. This device was applied during collection of venous blood by venipuncture for conventional haematology testing.
  
  
  METHODS
  Blood was drawn from 100 volunteers by a single, expert phlebotomist. A vein was located in the left forearm without applying a tourniquet but using a subcutaneous tissue transilluminator device, so that venous stasis was avoided. Blood samples were collected with a 20G straight needle directly into 4 mL K3EDTA vacuum tubes. In sequence, external cold and vibration was established by Buzzy® on the right forearm -5 cm above the venipuncture site- for 1 minute before venipuncture and continued until the end of the same procedure already performed in the left forearm. Conventional haematological tests were performed using the same instrument (Sysmex® XE-2100D) in all cases.
  
  
  RESULTS
  When Buzzy® was applied before drawing blood, erythrocyte counts and associated parameters (i.e., haemoglobin and haematocrit) were higher, whereas platelet number, leucocyte count and differential were lower. Statistically and clinically significant differences (P<0.001) were observed for erythrocytes, haemoglobin and haematocrit.
  
  
  CONCLUSIONS
  From a practical perspective, cold-induced haemoconcentration promotes the efflux of water, diffusible ions and low molecular weight molecules from the vessel, thus increasing the concentration of other blood analytes at the puncture site. These variations may influence test results, especially for erythrocytes, haemoglobin and haematocrit. The novel Buzzy® device should, therefore, be used with caution when collecting blood for conventional haematological testing because of the observed bias introduced in some parameters.
authors.affiliation: Post-Graduate Programme of Pharmaceutical Sciences, Department of Medical Pathology, Federal University of Parana, Curitiba, Parana, Brazil Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Lima-Oliveira
authors.affiliation: Department of Pathology and Laboratory Medicine, Clinical Chemistry and Haematology Laboratory, Academic Hospital of Parma, Parma, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.affiliation: Post-Graduate Programme of Pharmaceutical Sciences, Department of Medical Pathology, Federal University of Parana, Curitiba, Parana, Brazil.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.affiliation: Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Marise Danielle Raulino
authors.initials: MD
authors.lastname: Campelo
authors.affiliation: Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Katharyne Soares Adala
authors.initials: KS
authors.lastname: Tajra
authors.affiliation: Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: dos Santos Gomes
authors.affiliation: Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Carlos David
authors.initials: CD
authors.lastname: Valentim
authors.affiliation: Clinical Laboratory Bioanalise, Teresina, Piaui, Brazil.
authors.forename: Sylvio José Colonna
authors.initials: SJ
authors.lastname: Romano
authors.affiliation: Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Picheth
authors.affiliation: Post-Graduate Programme of Pharmaceutical Sciences, Department of Medical Pathology, Federal University of Parana, Curitiba, Parana, Brazil Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy.
authors.forename: Gian Cesare
authors.initials: GC
authors.lastname: Guidi
mesh_terms: D000328:Adult; D001772:Blood Cell Count / Q000379:methods; D001800:Blood Specimen Collection / Q000379:methods*; D002634:Chemotaxis, Leukocyte; D003080:Cold Temperature / Q000009:adverse effects; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006400:Hematocrit; D006452:Hemoglobinometry / Q000379:methods; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000009:adverse effects / Q000295:instrumentation*; D018962:Phlebotomy / Q000009:adverse effects*; D015203:Reproducibility of Results; D014172:Transillumination; D014661:Vasoconstriction; D014732:Vibration / Q000009:adverse effects