• Paula Tanabe, Demetrios N Kyriacou, Franklyn Garland, and Demetrious Kyriacou.
• Institute for Health Services Research and Policy Studies, Northwestern University, Feinberg School of Medicine, 417 S. Jefferson #408, Chicago, IL 60607, USA.
• Acad Emerg Med. 2003 Aug 1;10(8):897-900.

ObjectivesTo evaluate simultaneously several possible risk factors for blood bank specimen hemolysis.MethodsThis was a prospective cohort study of emergency department and labor and delivery patients to estimate the effect of various factors on the risk of blood bank specimen hemolysis. Study variables included patient demographics, type and gauge of needle or catheter, anatomic location of venipuncture, and patient care area. Hemolysis was determined by blood bank laboratory technicians. Cox proportional hazards multivariate regression modeling was performed to estimate the adjusted relative risks for hemolysis.ResultsOf the 605 subjects with complete data, 194 (32.1%) subjects had blood specimens drawn directly with a steel needle, and 411 (69.1%) had specimens drawn through a Vialon (BD Medical Systems, Inc., Sandy, UT) intravenous (IV) angiocatheter. The overall risk of hemolysis for all was 7%, 10% for Vialon IV angiocatheters and 1.5% for steel needles. In the multivariate analysis, the factors most closely associated with hemolysis were the use of Vialon IV catheters and sampling from an anatomic site other than the antecubital area.ConclusionsBlood bank specimens drawn from Vialon IV catheters (particularly smaller gauge catheters) and from veins outside the antecubital area are at significantly increased risk to hemolyze.

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