5.2 Thromb Haemost. Freeze-thawing may produce phospholipid rich membrane microvesicles from platelet damage which may then mask the presence of a lupus anti-coagulant [89]. The erythrocytes will hemolyze if they get in contact with the alcohol used for disinfection of the sampling site [7]. A syringe system permitting slow manual drawing of blood may be superior [4]. Epub 2017 Feb 27. Hemolysis of as few as 0.5 % of the erythrocytes from a specimen (~0.07 g/dL or 0.05 mmol/L free hemoglobin) can increase the cK+ by 0.5 mmol/L [14]. In the 50 phlebotomy episodes in the major area of the emergency department, 24% produced a hemolysed sample (P < 0.0001). Rochester, MN: Davies Printing Company, 1986: 141-46. Stability of the vitamin K-dependant factors has been reported to be 24h at room temperature [4, 5, 83, 88]. An official website of the United States government. However there may also be higher citrate concentration (i.e., 3.8% or 129mmol/L) leading to greater calcium binding and longer clotting times. Reducing preanalytical laboratory sample errors through - PubMed Implementing procedures to avoid hemolysis and a reduction in time from the draw to the intra-analytical phase will move the laboratory closer to the goal of zero defects. Extremes of temperature (e.g., both refrigerated or high) should be avoided. Methodology and clinical applications of ion-selective electrodes. Plasma samples frozen at minus 20C remain stable for 2weeks for most coagulation parameters [36, 49]. and transmitted securely. It can also activate partial thromboplastin time (aPTT), cause an increase in D-dimer, tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI), an exercise-induced adrenaline release on platelet aggregation and an increase in platelets [4, 15, 36]. b) short term plasma storage: PPP should be stored at room temperature (2025C) or at 80C until analysis. 2008;99:41626. Raijmakers MT, Menting CH, Vader HL, van der Graaf F. Collection of blood specimens by venipuncture for plasma-based coagulation assays: necessity of a discard tube. The pre-analytical phase is the most vulnerable part of the total testing process and is considered to be among the greatest challenges to laboratory professionals. 2014;12:15629. Ensuring quality has become a daily requirement in laboratories. 2017 Jul;50(10-11):568-573. doi: 10.1016/j.clinbiochem.2017.02.021. aspirin, thienopyridines) should be stopped at least 10days before sampling, if possible [8, 15]. Denmark, Your practical guide to critical parameters in acute care testing.. Blood samples for coagulation analyses should not be shaken. Blood venous sample collection: Recommendations overview and a checklist to improve quality. DOI: 10.7754/Clin.Lab.2016.151224. Lippi G, Franchini M, Montagnana M, Salvagno GL, Poli G, Guidi GC. J Thromb Haemost. For some analyses, especially platelet function assays, buffered citrate solution or other anticoagulants are used. Haemostasis. Delay in separating serum or plasma from blood cells: May result in metabolic changes in the sample. As more laboratories use electronic readers for orders and patient identification, one of the major sources of error will decrease. Smoking around the time of phlebotomy enhances platelets aggregability, and induces a procoagulant state in plasma [41, 42]. Working groups were formed according to the methods of training, clinics, and services. Thus, the testing process lends itself to designing a systematic approach to error detection and correction, hopefully before data are reported. 2013;24:6669. Semin Thromb Hemost. Guder WG, Narayanan S, Wisser H et al. 2010;104:293301. 12 % of the reference value for cK+ (3.5-5.0 mmol/L). In-vitro clots may develop in samples where the blood is slow to fill the collection container, where there is prolonged use a tourniquet, or when considerable manipulation of the vein by the needle has occurred. Working group for preanalytical phase EFoCC, laboratory M. Patient identification and tube labelling - a call for harmonisation. 2006;17:3945. Pre-analytical issues in the measurement of circulating microparticles: current recommendations and pending questions. Perinatal/pediatric hemostasis subcommittees working G. ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. This will avoid serum contamination by EDTA which can cause false elevations of potassium and false decrease of calcium. Preanalytical considerations in blood gas analysis - PMC Sommer SR, Warekois RS. 3.3 Adcock DM, Kressin DC, Marlar RA. Right or wrong sample received for coagulation testing? The lists can be used as checklists when a specific problem is encountered, or as a tool to supplement or expand the knowledge of the staff involved in laboratory medicine, e.g. b) For analysis in platelet-rich plasma The preparation of platelet-rich plasma (PRP) for platelet function analysis requires that centrifugation is performed at 200250g for 10min without application of a rotor brake [8, 15]. Once the blood sample has been centrifuged, plasma can remain on the cells in a capped primary tube until testing, or it can be aliquoted and stored in a secondary tube. Thromb Haemost. Centers for Disease Control and Prevention: http://www.cdc.gov. Under-filling increases the dilution of the sample due to the volume of liquid anticoagulant, and may increase the clotting time due to the excess calcium-binding citrate present [4, 5, 47]. Hemolysis. Air Entrapment. 2012;43:110. Springer Nature. Other BS have been developed for the large population of patients with atrial fibrillation (AF) that require oral anticoagulant therapy (e.g. Ozgonenel B, Rajpurkar M, Lusher JM. Zurcher M, Sulzer I, Barizzi G, Lammle B, Alberio L. Stability of coagulation assays performed in plasma from citrated whole blood transported at ambient temperature. 2013;39:8349. Geneva; 2010. http://www.euro.who.int/__data/assets/pdf_file/0005/268790/WHO-guidelines-on-drawing-blood-best-practices-in-phlebotomy-Eng.pdf?ua=1. Contraception. These situations must be avoided. Boudaoud L, Divaret G, Marie P, Bezeaud A. Salvagno GL, Lippi G, Montagnana M, Franchini M, Poli G, Guidi GC. By establishing a standardized system to recognize pre Correspondence to van Dongen-Lases EC, Cornes MP, Grankvist K, Ibarz M, Kristensen GB, Lippi G, Nybo M, Simundic AM. Some of the observations have a larger impact on the measurement result than others. Vol. Blonshine S, Alberti R, Olesinski RL. PubMed Central According to the recommendations of the EFLM, tube labelling must be done, before or after venipuncture, in the presence of the patient. This idea started from labeling the sample automatically A standardized sequence of blood sampling must be respected in order to avoid carry-over between tubes [3]. If a tourniquet needs to be used, it should immediately be released when the first tube starts to fill [48]. 2015;36:325864. PubMed Unfortunately, we seem to 2008 Sep;45(Pt 5):463-6, Nutt L, Zemlin AE, Erasmus RT. 1991;115:8167. Citrate, theophylline, adenosine and dipyridamole (CTAD) is a cocktail of additives that prevent in-vitro platelet activation recommended for measurement of platelet-activation markers such as -thromboglobulin or platelet factor 4 (PF4). Ervin K, Azizi K, Chu C, Davis C. The rate of glycolysis in whole blood samples at room temperature (22C). Strenuous exercise also promotes the release of microparticles by platelets and triggers a transient procoagulant condition, which is mirrored by increased thrombin generation, platelet hyperreactivity, increased activity of clotting factors, compounded by an increased fibrinolytic activity [41, 43]. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. Register Patient with document scans by CrelioHealth Lab services The aPTT can be falsely prolonged or shortened and AT and fibrinogen decreased by in vitro haemolysis [5, 49, 59, 60]. Rodeghiero F, Castaman G, Tosetto A, Batlle J, Baudo F, Cappelletti A, Casana P, De Bosch N, Eikenboom JC, Federici AB, Lethagen S, Linari S, Srivastava A. 2010;126:e18895. Google Scholar. For the transport, a box maintaining blood tubes in a steady vertical position should be used. Managing Post-analytical Errors Before hemolysis. Laboratory testing issues for protein C, protein S, and antithrombin. The calcium ions in plasma are diluted by the intracellular compartment, which has a lower cCa2+. The IT method is effective in preventing hemolysis-induced pre-analytical errors. Appropriateness of physician order - Whether the request was placed without indication or placed with Thromb Res. If this is done diligently, it can be considered as one of the best screening tests of the risk of bleeding [7, 9, 10]. Patients should not be studied after meals associated with a high fat content, so as to avoid the formation of chylomicrons in plasma, which will interfere with light transmission aggregometry [15, 37]. Epub 2017 Oct 10. It may be necessary to remove part of the citrate solution from the sampling tube prior to drawing blood [35, 36, 44] (Table2). Thrombosis J 14, 49 (2016). 3rd ed. During transportation, samples should be transferred vertically in the shortest possible time [36]. Lippi G, Rossi R, Ippolito L, Zobbi V, Azzi D, Pipitone S, Favaloro EJ, Funk DM. How to Avoid Pre-analytical Errors in Arterial Blood Collection for Frozen aliquots should be transported on dry ice [36]. Pre-, Post- & Analytical Errors - Westgard Gresele P. Subcommittee on platelet physiology of the international society on T, Hemostasis Diagnosis of inherited platelet function disorders: guidance from the SSC of the ISTH. Standardization of pre-analytical variables in plasma microparticle determination: results of the international society on thrombosis and haemostasis SSC collaborative workshop. 2013;131 Suppl 1:S47. Describe the type and rates of errors in the three stages of the laboratory testing process. David Plaut is a chemist and statistician in Plano, TX. Saunders Company, 2002. CAS Federici AB, Bucciarelli P, Castaman G, Mazzucconi MG, Morfini M, Rocino A, Schiavoni M, Peyvandi F, Rodeghiero F, Mannucci PM. The plasma is aliquoted to a secondary tube, taking care not to include the residual platelets that may have precipitated at the bottom of the centrifuge tube. 2007;83:15963. PREANALYTICAL ERRORS: A CONTINUOUS CHALLENGE Washington DC: AACC Press, 2000. Care must be taken to follow manufacturers expiry dates. The term pre-analytical phase describes all actions and aspects of the medical laboratory diagnostic procedure that occurs prior to the analytical phase [1]. Cattaneo M, Cerletti C, Harrison P, Hayward CP, Kenny D, Nugent D, Nurden P, Rao AK, Schmaier AH, Watson SP, Lussana F, Pugliano MT, Michelson AD. Pre-analytical errors can occur at the time of patient assessment, test order entry, request completion, patient identification, specimen collection, specimen transport, or specimen receipt in the laboratory. These centrifugal forces appear to be the best condition for preparing PRP for light transmission aggregometry (LTA) studies, both in terms of the degree of contamination of PRP by other blood cells and of platelet reactivity [15]. 2012;58(9-10):911-7, Lillo R, Salinas M, Lopez-Garrigos M et al. Lippi G, Becan-McBride K, Behulova D, Bowen RA, Church S, Delanghe J, Grankvist K, Kitchen S, Nybo M, Nauck M, Nikolac N, Palicka V, Plebani M, Sandberg S, Simundic AM. mild platelet function disorders) to avoid the bias of subjective investigator evaluation of haemorrhagic symptoms and to reduce the need for expensive laboratory investigations [7, 8, 29]. Google Scholar. Blood samples should be collected after the subject has rested for a short period (at least 5min) [15]. Effects of drugs on clinical laboratory tests. Lippi G, Plebani M, Favaloro EJ. If tubes need to be transported this should be done with care in order to avoid unnecessary agitation. Google Scholar. 2012;10:254454. Thromb J. However, the focus of the article is not restricted to this application only, as electrolyte values can also be measured on venous blood, capillary blood, plasma, and serum. Clin Chem Lab Med. Makhumula-Nkhoma N, Teggert AK, Young JS. WebThe pre-analytical phase begins: When the test is ordered by the physcian. doi: 10.18295/squmj.2017.17.03.008. Ann Biol Clin (Paris). cCa2+. Extended tourniquet application might produce unnecessary venous stasis or in-vitro haemolysis, which could introduce spurious and clinically meaningful biases in the measurement of several haematologic parameters [47]. If a pathological parameter is obtained on a frozen sample, this parameter is suggested to be re-tested on fresh plasma. How are pre-analytical errors prevented in your laboratory? 4. Reduced concentrations of protein S can be caused by functional impairment of this protein by differences in modulation of its activity by other plasma proteins that change during the oral contraceptives use or by changes induced in the protein S molecule that impair its anticoagulant activity [24]. Poorly handled frozen material may also causes shortening of aPTT or PT [5]. Laboratory Evaluation of Hemostasis. Errors europepmc.org/articles/PMC3428256/, This content was produced in its entirety for ADVANCE Healthcare Network (1985-2019, now Elite Healthcare) and features original contributions from a qualified and experienced editorial team or was provided to ADVANCE by credible industry experts or qualified healthcare professional(s). Bach J, Haubelt H, Hellstern P. Sources of variation in factor VIII, von Willebrand factor and fibrinogen measurements: implications for detecting deficiencies and increased plasma levels. 27509185, Explore selected articles curated by biochemist and journalist Chris Higgins, Presented by Ana-Maria Simundic, PhD, Prof. of Medical Biochemistry, Zagreb University, Zagreb, Croatia. Errors in patient preparation, specimen collection, anticoagulant Thromb Haemost. Vox Sang. Preventing pre-analytical errors to reduce costs and ensure positive patient outcomes. Cornes M, van Dongen-Lases E, Grankvist K, Ibarz M, Kristensen G, Lippi G, Nybo M, Simundic AM, Working Group for Preanalytical Phase EFoCC, Laboratory M. Order of blood draw: Opinion Paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE). 2012;38:56575. 2009;31:4627. Implementing procedures to avoid hemolysis and a reduction in time from the draw to the intra-analytical phase will move the laboratory closer to the goal of zero defects. Antecedents of anemia, iron supplementation, hospitalization or blood transfusion can also guide the clinician [11, 12]. A discard tube is also recommended when samples are subject to platelet function analysis and for thrombin generation measurements [2, 4, 8, 47]. WebCorrect patient identification, for example, seems to be the most important step taken to avoiding preanalytical testing errors. Clin Lab. 2014;24:2530. Mixing samples is an important way to prevent in-vitro clot formation. That means handling stress, getting good women's health care, and nurturing yourself. Tietz Fundamentals of clinical chemistry. Bognor Regis: Wiley-Blackwell, 2nd Edition. 2014;4:2337. Preventable laboratory errors occur through all phases of testing process. National Library of Medicine Chen YW, Chen JK, Wang JS. Polack B, Schved JF, Boneu B. Groupe dEtude sur lHemostase et la T. Preanalytical recommendations of the Groupe d'Etude sur l'Hemostase et la Thrombose (GEHT) for venous blood testing in hemostasis laboratories. Samples with a very high or very low cCa2+ may be affected by a small positive or negative bias even with electrolyte-balanced heparin. see also Ann Clin Biochem. This article provides useful tips for avoiding preanalytical errors on electrolyte parameters; tips which you can incorporate in your standardized procedures and training of your staff. 2. Lippi G, Salvagno GL, Montagnana M, Lima-Oliveira G, Guidi GC, Favaloro EJ. Kitchen S, Olson JD, Preston FE. 2010 Jan;36(1):16-20, Favaloro EJ. 9. Recognizing and Reducing Analytical Errors and Sources of Both results were statistically significant. The discriminant power of bleeding history for the diagnosis of type 1 von Willebrand disease: an international, multicenter study. 3min at 1000g) used before performing dilute thrombin time and ecarin clotting time, was not validated [78]. J Thromb Haemost. Effect of oral contraceptives on the anticoagulant activity of protein S in plasma. Favaloro EJ, Adcock Funk DM, Lippi G. Pre-analytical variables in coagulation testing associated with diagnostic errors in hemostasis. Unable to load your collection due to an error, Unable to load your delegates due to an error. Air entrapment is probably one of the most common and most easily remedied sources of error in blood gas analysis. This volume varies from brand to brand, but the term dead space makes it possible to give a multiple-system guideline. Abstract. 2.1 Procedures for the collection of arterial specimens. WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy. A study [6] showed that the difference between cK+ in samples drawn from a peripheral catheter after 3 mL of fluid were discarded and from a venipuncture from the other arm is 0.37 mmol/L. Catheters are used for multiple sampling to measure pH, blood gases, and electrolytes. DOI: 10.7754/Clin.Lab.2016.151224. Pre-analytical errors: their impact and This BS, related to the number and the severity of bleeding symptoms, is based on a standardized questionnaire and used to evaluate haemorrhagic symptoms [7, 29]. Interference in coagulation testing: focus on spurious hemolysis, icterus, and lipemia. As more laboratories use electronic readers for orders and patient identification, one of the major sources of error will decrease. 3.9 Am J Clin Pathol 2000; 113: 429-52. The referring physician should also have done a proper physical examination in order to detect signs of coagulopathy. The site is secure. At two months, either RT or IT methods were introduced, and data collected in the second two months were compared with the initial two months to assess changes in the number of samples rejected. Because samples that are rejected must be recollected, which gives potential delay in patient management, phlebotomists must be fully aware of the common reasons why specimens are rejected (Table4). 2. Background: Our aim was to compare the routine training (RT) method with the intensive training (IT) method, described for the first time by our group, for preventing pre-analytical errors in induced hemolysis. Pre-analytical errors. Provided by the Springer Nature SharedIt content-sharing initiative. It has been demonstrated that protein S activity is unstable, with a statistically significant loss of activity demonstrated at 8h while fibrinogen, protein C and antithrombin activity appear to remain relatively constant when stored at room temperature for up to 7days [83]. 5.1 In: Burritt MF, Cormier AD, Maas AHJ, Moran RF, O'Connell KM, eds. Consumption of caffeine should be discouraged within the 2h prior to sampling [4, 15]. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Thromb Res. Any sample that has been dropped should be discarded. 2012;10:43746. Avoiding Pre-analytical Errors The PRP should then be transferred to a capped polypropylene tube and a platelet count performed. The interference observed in lipemic samples is most evident with readings using wavelengths lower than 500 nm and can be prevented with readings at 650 nm or above, and/or using higher dilutions of the test sample, or can be abated in high hypertriglyceridemic specimens (i.e., > 1,000 mg/dL) using high speed micro-centrifugation, lipid extraction with organic solvents such as fluorine-chlorinated hydrocarbon, or lipid-clearing agents such as LipoClear (StatSpin Inc., Norwood, MA) and n-hexane.9. For additional information on this or related content, please email, Sexual Assault Nurse Examiner (SANE) Core Course, What Not to Say at Work: Career-Limiting Habits and Behaviors, Now Available: The 2021 Holiday Guide for Healthcare Professionals. Washington DC: AACC Press, 1989. Am J Clin Pathol. Lippi G, Ippolito L, Zobbi V, Sandei F, Favaloro EJ. b) pre-operative assessment: For preoperative investigations, some guidelines are available. The CLSI guidelines on the collection of blood specimens for coagulation testing recommend the use of sodium citrate in 105109mmol/L (3.2%) tubes. However, to completely metabolize the lipids intake, sampling after at least 8h (better 12h) fasting and reduced activity (bed rest) is recommended [4, 38]. Clin Chem 1991; 37,10: 1730-33. According to the CLSI, a first discard tube (or a non-additive tube) is unnecessary for routine coagulation assays [47]. Four different ways of taking blood were tested to see the effect on hemolysis: cannulation and a syringe (38%); cannula with evacuated tube and adaptor (42%); syringe and needle into vein (14%); and evacuated tube system used conventionally (6%).6 Where a syringe was used, two methods of transfer into the sample tube were observed needle kept on with cap piercing (77%) and needle and evacuated cap both removed (23%). 2015;71:708. Plasma is generally prepared by centrifugation of a whole blood sample. Avoiding Pre-analytical Errors in the Laboratory. Article Prior to testing, frozen plasmas should be thawed rapidly at 37C (to prevent denaturing fibrinogen) and tested immediately. During storage the blood-cell metabolism continues. A quality laboratory manager should verify the length of tourniquet application and forearm clenching in order to eliminate this source of laboratory error and safeguard quality throughout the total testing process [48]. PubMed ODonnell J, Laffan MA. 1 shows, an addition of 0.05 mL liquid heparin to 1 mL whole-blood sample (Hct 45 %) will dilute the plasma phase by 10 %. DK-2700 Brnshj The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Degrees of hemolysis. Samples: From the patient to the laboratory. General laboratory techniques and procedures. In: Siggaard-Andersen O, ed. 2011 Oct;57(10):1349-50, Felder RA. Blood Coagul Fibrinolysis. Blood. The findings of our search have been grouped into different subtopics. Abstract. Arch Pathol Lab Med. The .gov means its official. Clin Chem Lab Med. In order to minimize misinterpretation of laboratory results, blood samples should be collected from fasting subjects in the morning between 7 and 9a.m. and from subjects who have refrained from smoking for at least 30min [4, 8, 15, 36, 37]. This phase is part of the total laboratory procedure consisting of several stages and beginning with the physician requesting the performance of a laboratory investigation on a patient. Plasmas that are lipemic and icteric may also affect analytic results by interfering with optical absorbance or impeding light transmittance [49]. Some studies evaluated the need for discard tubes in a variety of others coagulation tests (e.g. Delays in transport may affect in particular the labile factors (FV, FVIII), leading to prolonged clotting times and in vitro loss of factor activity [2, 83]. Vascul Pharmacol. Each laboratory should have guidelines for rejection of samples; some criteria are obligatory: inappropriate collection tubes and additives, outdated tubes, error in patient identification or lack of identification, insufficient volume, haemolysed specimens, identification of a clot, inadequate volume, haematocrit >50% or <30% for the PFA, platelet count <100,000/L for PFA and platelet aggregation All samples deemed unacceptable due to pre-analytic handling and unfulfilled transport requirements should be rejected [46, 8]. During storage, samples should remain capped [5]. Epub 2011 May 13. For these samples, due to the variable heparin neutralization by platelet factor 4 (PF4), the delay before centrifugation should not exceed 1h for a sample collected in citrate and 4h in CTAD. Aliquoted plasma is stable for 4h when refrigerated, except for plasma for PT-INR and PT-sec, which should not be refrigerated [2, 5, 47]. 2012;103:7982. Sample transportation is one of the major factors contributing to delays in returning high-quality clinical laboratory results to the patient bedside. Pre-analytical errors: their impact and how to minimize them Bolliger D, Seeberger MD, Tanaka KA, Dell-Kuster S, Gregor M, Zenklusen U, Grapow M, Tsakiris DA, Filipovic M. Pre-analytical effects of pneumatic tube transport on impedance platelet aggregometry. Semin Thromb Hemost. Biochem Med (Zagreb). Nicotine and cocaine addictions interfere with some hormones. 2013;132:e1527. All authors read and approved the final manuscript. 2011;155:3044. Toffaletti J, Ernst P, Hunt P, Abrams B. Pregnancy is associated with increase in fibrinogen, factors VII, VIII, X, VWF, D-dimer concentration and with increase in levels of prothrombin fragments 1+2 and thrombin-antithrombin III complexes. Evaporation can also occur when a sample is stored opened in a refrigerator. Becton, Dickinson and Company (BD) Diagnostics : http://www.bd.com. 2015;13:31422. 918-231. Other anti-coagulants, e.g. The change in pH affects numerous conditions in the sample, among others protein's capacity to bind calcium, since hydrogen ions compete with calcium for binding sites on albumin and other proteins. 2003;163:236892. Biochem Med (Zagreb). Analyses should be performed within 3h. For unknown reason, protein S is labile. Singla P, Parkash AA, Bhattacharjee J. A quantitative analysis of bleeding symptoms in type 1 von willebrand disease: results from a multicenter European study (MCMDM-1 VWD). avoid 1 Flowchart of the pre-analytical phase from bedside to bench in biomedical metabolomics and lipidomics projects. eJIFCC 2003; 13,1: 1-5. OBrien EC, Simon DN, Thomas LE, Hylek EM, Gersh BJ, Ansell JE, Kowey PR, Mahaffey KW, Chang P, Fonarow GC, Pencina MJ, Piccini JP, Peterson ED. Crit Care Med 2003; 31,6: 1654-58. J Thromb Haemost. 5. 1997;77:8258. 2011 Nov;48(Pt 6):562-5, Olayemi E, Asiamah-Broni R. 6. Mayo Medical Laboratories. PubMed When sampling from catheters, an important aspect to consider is dilution or contamination by flush solution. analytical errors Lacroix R, Judicone C, Poncelet P, Robert S, Arnaud L, Sampol J, Dignat-George F. Impact of pre-analytical parameters on the measurement of circulating microparticles: towards standardization of protocol. Effect of pneumatic tube transport on rotational thromboelastometry. Haemophilia. When immediate analysis is not possible, plasma is most stable when incubated at room temperature, instead of 4C or 37C, most likely because of more activation and degradation of coagulation proteins at these temperatures [2]. These changes tend to me more pronounced in women taking third generation combined oral contraceptives than on second generation [21]. Tosetto A, Castaman G, Rodeghiero F. Bleeders, bleeding rates, and bleeding score. Available from Radiometer as AS 92, Code no. Conclusions: Thrombosis Journal Here are some case examples of preanalytical errors that occurred over a period of one week at a local hospital. PubMed CAS Rao LV, Okorodudu AO, Petersen JR, Elghetany MT. Lippi G, Salvagno GL, Adcock DM, Gelati M, Guidi GC, Favaloro EJ. Potassium. when updating procedures or when conducting refresher training. Narayanan S. The preanalytical phase - an important component of laboratory medicine. 2009;20:45865. Accessed 17 Nov 2016. Errors Am J Clin Pathol. WebMETHODS: A retrospective study was conducted to identify the rates and the types and frequencies of pre-analytical errors in the laboratory and analyze them according to the departments of patients, the sections of the laboratory, and the wards of the hospital.

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