Last updated March 14, 2022

Prevention of Blood Specimen Hemolysis in Peripherally-Collected Venous Specimens

Decision Options

Before the Draw Preparation and Equipment Selection

Education of the staff performing phlebotomy may decrease hemolysis. (B)
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Low (partial) vacuum tubes result in less hemolysis. (B)
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Direct venipuncture with straight needles is less likely to cause hemolysis than blood collection through intravenous catheters. (B)
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The type of personnel performing phlebotomy does not influence hemolysis. (C)
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Stainless steel needles are less likely to cause hemolysis than intravenous catheters; Teflon catheters are less likely to cause hemolysis than Vialon™ catheters. (C)
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There is conflicting evidence regarding the influence of needle or catheter gauge on hemolysis. (I/E)
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There is conflicting evidence regarding hemolysis with syringes vs. vacuum tubes. (I/E)
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During and after the Draw

Hemolysis is less likely when blood is drawn from the antecubital fossa. (B)
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Drawing blood through needleless connectors does not increase hemolysis. (B)
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Minimize tourniquet time by removing the tourniquet after identifying the venipuncture site while preparing equipment and as soon as good blood flow is established. (C)
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Filling vacuum tubes to their recommended volume decreases hemolysis. (C)
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Properly functioning pneumatic tube systems using short distance and slow speeds do not increase hemolysis. (C)
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Drawing blood through extension tubing attached to an intravenous catheter does not increase hemolysis in adults. (C)
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There is insufficient evidence regarding the impact on hemolysis of blood flow rate into the vacuum tube. (I/E)
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There is insufficient evidence to determine if the number of venipuncture attempts affects hemolysis. (I/E)
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There is insufficient evidence as to whether perceived difficulty of intravenous catheter insertion is associated with an increased risk of hemolysis. (I/E)
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There is insufficient evidence to determine if the volume/frequency of venipunctures performed influences hemolysis. (I/E)
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There is insufficient evidence to determine if monitoring hemolysis rates and providing feedback to the staff performing phlebotomy decreases the incidence of hemolysis. (I/E)
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Recommendation Grading

Overview

Title

Prevention of Blood Specimen Hemolysis in Peripherally-Collected Venous Specimens

Authoring Organization

Publication Month/Year

July 1, 2018

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Emergency care, Hospital

Intended Users

Nurse, laboratory technician

Scope

Prevention

Diseases/Conditions (MeSH)

D006461 - Hemolysis, D001769 - Blood, D001800 - Blood Specimen Collection

Keywords

hemolysis, Blood Specimen, Venous Specimens