2016, Cilt 14, Sayı 3, Sayfa(lar) 166-171 |
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Hemolysis: A Problem That Emergency Departments Can Not Get Rid Of |
Giray Bozkaya1, Murat Örmen2, Özge Esenlik1 |
1Sağlık Bilimleri Üniversitesi Bozyaka Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya, İzmir, Türkiye 2Dokuz Eylül Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya Anabilim Dalı, İzmir, Türkiye |
Keywords: Hemolysis, preanalytical error, emergency department |
Purpose: Hemolysis is one of the most important preanalytical factors affecting the laboratory test
results. It is mostly seen in blood samples sent from the emergency department compared to all
samples accepted to the laboratory. If hemolysis is present, the tests affected by hemolysis are not
analyzed and a new blood sample is requested. The delay in laboratory results causes dissatisfaction
both in the physicians and the patients. Even arguments are made with the emergency department
physicians claiming that the cause of the hemolysis is the laboratory. In this study, it was planned to
make a meeting to share knowledge about foremost hemolysis and preanalytical errors with the
physicians in emergency department in order to prevent unnecessary arguements and to give beter
health care. It was aimed to determine the effect of the meeting by making a survey before and after the
meeting.
Material and methods: A presentation was made to 40 emergency department doctors in training
meeeting in May 2016. Beeing a general problem, first the definition of hemolysis was made and it was
explained that the vast majority of hemolysed specimens is seen in samples sent from the emergency
departments worldwide. The hemolysis rate of the emergency department was given besides the causes
of in vitro and in vivo hemolysis, the effect of the hemolysis on the laboratory test results and the efforts
to decrease the hemolysis rates were discussed. Six questions related with these subjects were
prepared and 40 doctors were asked to answer them before and after the presentation. The data related
to the answers to the questions were evaluated according to the numbers and ratios. Besides, the
statistics of hemolysed specimens were taken from the hospital's information system.
Results: The causes of hemolysis question was fully answered correctly by the 30% of the participants
before the presentation. The ratio increased to 60% after thepresentation. Blood collection with
unsuitable devices such as catheters were not known to be a cause of hemolysis by 65% of the doctors
which dropped to 10% after the presentation. It was determined that hemolysis rate of emergency
department compared to all hemolysed samples were between 47-65% in 7 months period this year.
Conclusion: It is thought that, an awareness was created in emergency department doctors about
hemolysis which was defined as “a problem that emergency departments can not get rid of” that slow
down the patient circulation in emergency department. Similar interactions with clinical departments
will help to understand the role of the Medical Biochemists in correct test results.
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