Prevention of Blood Specimen Hemolysis in Peripherally-Collected Venous Specimens

Publication Date: July 1, 2018
Last Updated: March 14, 2022

Decision Options

Before the Draw Preparation and Equipment Selection

Education of the staff performing phlebotomy may decrease hemolysis. (B)
320000
Low (partial) vacuum tubes result in less hemolysis. (B)
320000
Direct venipuncture with straight needles is less likely to cause hemolysis than blood collection through intravenous catheters. (B)
320000
The type of personnel performing phlebotomy does not influence hemolysis. (C)
320000
Stainless steel needles are less likely to cause hemolysis than intravenous catheters; Teflon catheters are less likely to cause hemolysis than Vialon™ catheters. (C)
320000
There is conflicting evidence regarding the influence of needle or catheter gauge on hemolysis. (I/E)
320000
There is conflicting evidence regarding hemolysis with syringes vs. vacuum tubes. (I/E)
320000

During and after the Draw

Hemolysis is less likely when blood is drawn from the antecubital fossa. (B)
320000
Drawing blood through needleless connectors does not increase hemolysis. (B)
320000
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)
320000
Filling vacuum tubes to their recommended volume decreases hemolysis. (C)
320000
Properly functioning pneumatic tube systems using short distance and slow speeds do not increase hemolysis. (C)
320000
Drawing blood through extension tubing attached to an intravenous catheter does not increase hemolysis in adults. (C)
320000
There is insufficient evidence regarding the impact on hemolysis of blood flow rate into the vacuum tube. (I/E)
320000
There is insufficient evidence to determine if the number of venipuncture attempts affects hemolysis. (I/E)
320000
There is insufficient evidence as to whether perceived difficulty of intravenous catheter insertion is associated with an increased risk of hemolysis. (I/E)
320000
There is insufficient evidence to determine if the volume/frequency of venipunctures performed influences hemolysis. (I/E)
320000
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)
320000

Recommendation Grading

Overview

Title

Prevention of Blood Specimen Hemolysis in Peripherally-Collected Venous Specimens

Authoring Organization

Publication Month/Year

July 1, 2018

Last Updated Month/Year

January 9, 2023

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, nurse practitioner, physician, physician assistant

Scope

Prevention

Diseases/Conditions (MeSH)

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

Keywords

hemolysis, Blood Specimen, Venous Specimens