Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?
BACKGROUND
Our goal was to determine if the hemolysis among blood samples obtained in an emergency department and then sent to the laboratory in a pneumatic tube system was different from those in samples that were hand-carried.


METHODS
The hemolysis index is measured on all samples submitted for potassium analysis. We queried our hospital laboratory database system (SunQuest(®)) for potassium results for specimens obtained between January 2014 and July 2014. From facility maintenance records, we identified periods of system downtime, during which specimens were hand-carried to the laboratory.


RESULTS
During the study period, 15,851 blood specimens were transported via our pneumatic tube system and 92 samples were hand delivered. The proportions of hemolyzed specimens in the two groups were not significantly different (13.6% vs. 13.1% [p=0.90]). Results were consistent when the criterion was limited to gross (3.3% vs 3.3% [p=0.99]) or mild (10.3% vs 9.8% [p=0.88]) hemolysis. The hemolysis rate showed minimal variation during the study period (12.6%-14.6%).


CONCLUSIONS
We found no statistical difference in the percentages of hemolyzed specimens transported by a pneumatic tube system or hand delivered to the laboratory. Certain features of pneumatic tube systems might contribute to hemolysis (e.g., speed, distance, packing material). Since each system is unique in design, we encourage medical facilities to consider whether their method of transport might contribute to hemolysis in samples obtained in the emergency department.
Cleveland Clinic Health Systems, Emergency Services Institute, Cleveland, Ohio.
Michael P
MP
Phelan
Cleveland Clinic Health Systems, Pathology and Laboratory Medicine Institute, Cleveland, Ohio.
Edmunds Z
EZ
Reineks
Cleveland Clinic Health Systems, Emergency Services Institute, Cleveland, Ohio.
Fredric M
FM
Hustey
MetroHealth Medical Center, Emergency Medicine/Emergency Department, Cleveland, Ohio.
Jacob P
JP
Berriochoa
Cleveland Clinic Health Systems, Emergency Services Institute, Cleveland, Ohio.
Seth R
SR
Podolsky
Cleveland Clinic Health Systems, Emergency Services Institute, Cleveland, Ohio.
Stephen
S
Meldon
Cleveland Clinic Health Systems, Quantitative Health Sciences, Cleveland, Ohio.
Jesse D
JD
Schold
Cleveland Clinic Health Systems, Emergency Services Institute, Cleveland, Ohio.
Janelle
J
Chamberlin
Cleveland Clinic Health Systems, Pathology and Laboratory Medicine Institute, Cleveland, Ohio.
Gary W
GW
Procop
D001800:Blood Specimen Collection / Q000295:instrumentation* / Q000379:methods*; D004636:Emergency Service, Hospital; D004867:Equipment Design; D006461:Hemolysis; D006801:Humans; D011786:Quality Control