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Venipuncture versus peripheral catheter: do infusions alter laboratory results?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hambleton, Victoria Lerma Gómez, Ignacio Arribas Andreu, Francisco A. Bernabeu
Description	Author Affiliation: Hambleton VL ( Alcalá de Henares, Spain. Electronic address: vlermah@gmail.com.); Gómez IA ( Alcalá de Henares, Spain.); Andreu FA ( Alcalá de Henares, Spain.)
Abstract	INTRODUCTION: Our aim was to evaluate the equivalence between analytic parameters from blood samples obtained from a saline solution lock device used for the infusion of drugs and those from venipuncture. In our emergency department, patients bearing a saline solution lock device have blood extracted by venipuncture to avoid possible contamination of the sample. METHODS: Adults from the emergency department with a saline solution lock device who required laboratory tests were selected as candidates for this cross-sectional observational study. Infusions were halted and flushed with 0.9% saline solution; 2 minutes later, 2 mL of blood was drawn and discarded, and the corresponding laboratory tubes were filled. Immediately after, another sample was withdrawn from the opposite extremity by venipuncture. Both samples were analyzed for hematology, biochemistry, venous blood gases, and coagulation parameters. Concordance was evaluated by use of the intraclass correlation coefficient with its 95% confidence intervals; Bland-Altman plots were used to illustrate the percentage of samples with differences exceeding 2 SDs. The mean differences were also checked to detect those exceeding the laboratory's systematic error. RESULTS: An intraclass correlation coefficient of over 0.9 was achieved for all parameters except for pH, partial pressure of carbon dioxide, and partial pressure of oxygen. Differences of over 2 SDs were found in fewer than 10% of all parameters. None of them exceeded 3 SDs, except for pH and venous blood gases. All parameters showed differences below the laboratory's accepted systematic error except for pH and venous blood gases. DISCUSSION: Blood samples extracted from a peripheral catheter with or without drug infusions are valid for the analysis of hematology, biochemistry, and coagulation parameters but not for venous blood gases. Nurses should know the benefits of using an existing peripheral catheter for drawing blood samples for laboratory analysis even when infusing commonly used drugs. Emergency nurses should consider collecting blood specimens from a venous access device regardless of the type of drug infusions administered, because it is a safe, simple, and fast technique, which is time efficient when treating patients with limited venous access sites. This procedure reduces patient discomfort and the risk of complications related to venipunctures.
File Format	HTM / HTML
ISSN	00991767
Issue Number	1
Volume Number	40
e-ISSN	15272966
Journal	Journal of Emergency Nursing
Language	English
Publisher	Elsevier
Publisher Date	2014-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Nursing Catheterization, Peripheral Methods Catheters, Indwelling Statistics & Numerical Data Emergency Nursing Phlebotomy Adult Cross-sectional Studies Female Humans Male Prospective Studies Reproducibility Of Results Comparative Study Journal Article Observational Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Nursing

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Intravenous Catheters and Blood Samples. (Journal: Journal of Emergency Nursing Volume: 42 Issue: 2)

Nursing blood specimen collection techniques and hemolysis rates in an emergency department: analysis of venipuncture versus intravenous catheter collection techniques.

Are Peripheral Venous Catheters Necessary in Intensive Care Units?

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Venipuncture versus peripheral catheter: do infusions alter laboratory results?