Assessing Pediatric Trauma Specimen Integrity

Ruth A. Bush; Teresa Mueller; Beverly Sumwalt; Susan A. Cox; Mary L. Hilfiker

doi:10.29074/ascls.23.4.219

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Ruth A. Bush, PhD⇑
1. Research Department, Rady Children's Hospital San Diego, San Diego, CA 92123
Teresa Mueller, CLS
1. Laboratory Department, Rady Children's Hospital San Diego, San Diego, CA 92123
Beverly Sumwalt, CLDir
1. Laboratory Department, Rady Children's Hospital San Diego, San Diego, CA 92123
Susan A. Cox, MS
1. Trauma Department, Rady Children's Hospital San Diego, San Diego, CA 92123
Mary L. Hilfiker, MD, PhD
1. Trauma Department, Rady Children's Hospital San Diego, San Diego, CA 92123

Address for Correspondence: Ruth A. Bush, Research Department (MC 5074), Rady Children's Hospital San Diego, 3020 Children's Way, San Diego, CA 92123, 858.966.4946, rbush{at}rchsd.org

Abstract

OBJECTIVE: This study investigated the quality of trauma specimens by comparing line draws to venipuncture.

DESIGN: The draw type (line or venipuncture); container type (Vacutainer or Microtainer); and suitability for processing (processed/hemolyzed/clotted) of routinely collected trauma specimens was analyzed.

SETTING: The clinical laboratory of a Level I Pediatric Trauma Center.

MAIN OUTCOME MEASURE: Hemolyzed trauma specimens were analyzed according to method of collection, collector, and type of container to identify issues resulting in unusable samples.

RESULTS: The data shows that for 13% of all draws, portions of the results were affected by hemolysis. Sixteen percent of line draws and 6% of venipunctures were hemolyzed (p = 0.04). There was no statistical association with who collected the sample (p = 0.07) or type of container (p = 1.00).

CONCLUSION: Based on this sample of data, the laboratory recommends that, whenever possible, venipunctures be performed for laboratory testing of blood specimens to improve trauma specimen integrity.

ABBREVIATIONS: ED = Emergency Department; EMS = Emergency Medical Services; ID = identification; MLA = medical laboratory assistant; RBC = red blood cells; RN = registered nurse.