Easy and Painless Blood Draw from an IV Line

Table of Contents:

1. Introduction
2. The Problem of Hemolysis in Blood Samples
3. Hemolysis Rates in Hospital Settings
4. The Fragility of Red Blood Cells
5. Preventing Hemolysis from Line Draws 5.1. Don't Draw from a Line Unless Using Technology Designed for It 5.2. Limit Line Draws to Large Gauge Cannulas 5.3. Draw Directly into the Tube with a Tube Holder
6. The Limitations of Behavioral Approaches
7. Implementing Technology for Drawing from Peripheral Lines 7.1. Introduction to Pivo from Valano Vascular 7.2. Benefits of Using Pivo
8. The Future of Phlebotomy and Line Draws
9. Conclusion

Article:

Preventing Hemolysis in Blood Samples: A Solution for Line Draws

Introduction Drawing blood for laboratory testing is a crucial part of patient care. However, one of the biggest challenges faced by medical professionals is hemolysis, the breakdown of red blood cells. When blood samples are hemolyzed, they become unusable for testing, leading to delays in diagnosis and treatment. In this article, we will explore the problem of hemolysis in line draws and introduce a solution that can significantly reduce the occurrence of hemolyzed blood samples.

The Problem of Hemolysis in Blood Samples Hemolysis occurs when red blood cells rupture, releasing their contents into the surrounding plasma. This can happen during the process of drawing blood, particularly when using an intravenous (IV) line. IV lines, primarily designed for infusing fluids, are not optimized for drawing blood. As a result, the mechanical stress exerted on red blood cells during a line draw can lead to a higher rate of hemolysis compared to traditional venipuncture.

Hemolysis Rates in Hospital Settings Studies have shown that samples drawn from IV lines in hospital settings have significantly higher hemolysis rates compared to those drawn by laboratory phlebotomists. In emergency departments, where a large number of patients receive IV needles, the hemolysis rate can be as high as 25%. This is a cause for concern as delayed lab results can impact patient care and treatment decisions.

The Fragility of Red Blood Cells Red blood cells are delicate and fragile. They can be compared to fragile crystal orbs that are easily damaged under mechanical stress. When blood is drawn using a device not specifically designed for it, the chances of hemolysis occurring increase significantly. To prevent hemolysis, it is essential to draw blood samples using technology specifically designed for line draws.

Preventing Hemolysis from Line Draws There are several strategies that can be implemented to prevent hemolysis when drawing blood from a line:

1. Don't Draw from a Line Unless Using Technology Designed for It The first and most effective step to prevent hemolysis from line draws is to avoid drawing from a line altogether, unless using technology specifically designed for this purpose. By utilizing devices designed for line draws, the risk of hemolysis can be significantly reduced.

2. Limit Line Draws to Large Gauge Cannulas If drawing from a line is necessary, it is crucial to limit it to large gauge cannulas. Larger gauge numbers correspond to smaller diameters, meaning that large diameter IV sets (such as 14s and 16s) are less likely to result in hemolyzed samples. It is important to note that using 18 or 20 gauge IV lines significantly increases the risk of hemolysis, while 22 gauge or larger virtually guarantees it.

3. Draw Directly into the Tube with a Tube Holder Another technique that can help prevent hemolysis is drawing directly into the tube using a tube holder, rather than a syringe. Many people tend to pull too hard on the syringe, creating negative pressure that can damage fragile red blood cells. By utilizing a tube holder and avoiding excessive negative pressure, hemolysis rates can be reduced.

The Limitations of Behavioral Approaches While the above strategies can be effective in reducing hemolysis, they heavily rely on the decisions and actions of the healthcare professional performing the blood draw. This introduces the challenge of sustaining behavior change facility-wide and system-wide. Hemolysis rates tend to fluctuate when healthcare professionals revert to old habits, leading to inconsistent results over time.

Implementing Technology for Drawing from Peripheral Lines To address the limitations of behavioral approaches, technology designed specifically for drawing blood from peripheral lines has been developed. One such device is Pivo from Valano Vascular. This device attaches to the lure of the IV set and includes a flexible internal flow tube that extends beyond the catheter tip. By positioning the flow tube where the blood flow is more normal, hemolysis rates can be significantly reduced.

Benefits of Using Pivo Samples drawn with Pivo have been found to reduce the frequency of hemolysis by up to 56%. This technology offers a promising solution for patients with peripheral IV lines, allowing blood samples to be drawn with greater success and significantly less hemolysis. Moreover, Pivo provides a more comfortable experience for patients who no longer need to undergo multiple needle sticks each day.

The Future of Phlebotomy and Line Draws As more facilities adopt the concept of "one-stick hospitalization," the training and use of devices like Pivo are likely to become prevalent. Phlebotomists who acquire the skill of drawing blood from lines using this technology will become highly valuable to the nursing profession, the lab, and the patients they serve. The implementation of technology-designed solutions is poised to revolutionize the way blood is drawn from peripheral lines, eliminating the need for multiple sticks and reducing the rejection of samples due to hemolysis.

Conclusion Preventing hemolysis in blood samples is crucial for accurate laboratory testing and timely diagnosis. By utilizing technology designed for line draws and implementing strategies such as limiting line draws to large gauge cannulas and using tube holders, healthcare professionals can reduce the occurrence of hemolyzed samples. Furthermore, the introduction of devices like Pivo offers a promising solution that significantly minimizes hemolysis rates and improves patient comfort. As the healthcare industry continues to embrace innovative solutions, the future of phlebotomy and line draws looks promising, with improved outcomes for patients and healthcare professionals alike.