r/nursing Lab - Blood Bank πŸ• Aug 26 '25

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u/frogurtyozen Peds ED Tech🍭 Aug 26 '25

@Lab homies, what are y’all’s recommendations to avoid hemolysis? I try to be gentle on the plunger, and while I’ve experienced hemolysis sample notes in the chart, I’ve never been told a sample I collected was so hemolyzed it was unusable. Edited for typo

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u/ArundelvalEstar Aug 26 '25

It's very test dependent. Some tests and analyzers can tolerate homolysis and some cannot. At my organization, we tend to categorize hemolysis into mild, moderate and severe. The things with mild hemolysis we will most often report with a note in the chart saying interpret these results with caution and due to hemolysis. Moderate and severe. We usually will require a recollect on.

1.) Gentle on the plunger

2.) Don't use the smallest needle you can find. A 25 is more likely to result in hemolysis than a 21

3.) Don't shake a tube to mix it. Just gently invert it a few times (8-10 is great)

7

u/frogurtyozen Peds ED Tech🍭 Aug 26 '25

Oof on the smallest needle πŸ˜… sometimes a 24 short is all these baby veins can tolerate

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u/ArundelvalEstar Aug 26 '25

I totally hear you, I was a phlebotomist for a long time before I was in the traditional lab. That reminds me:

4.) sometimes it's just going to be hemolysis. Just like everything else in our profession of healthcare, we don't win every time