• Douglas P Barnaby, Andrew Wollowitz, Deborah White, Scott Pearlman, Michelle Davitt, Laura Holihan, Polly Bijur, and E John Gallagher.
• Department of Emergency Medicine of Albert Einstein College of Medicine, Bronx, NY.
• Acad Emerg Med. 2016 Feb 1; 23 (2): 204-7.

ObjectivesThe objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will reduce rates of sample hemolysis.MethodsThis was an observational study of hemolysis rates before and after implementation of a "butterfly-only" phlebotomy protocol. Weekly hemolysis rates, generated by the central laboratory, were collected and the proportion of hemolyzed specimens before and after protocol implementation were compared.ResultsPrior to institution of the butterfly-only protocol, 11.3% of specimens sent from the emergency department were reported as hemolyzed. During the postintervention period, only 4.3% of specimens were hemolyzed for a proportionate decrease of 62% and an absolute decrease of 7.0% (95% confidence interval = 6.6% to 7.3%).ConclusionsUse of a butterfly-only phlebotomy protocol cuts hemolysis rates by more than half when compared with IV catheter phlebotomy.© 2016 by the Society for Academic Emergency Medicine.

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