The specimen of choice that enables the collection of small blood volumes from neonatal or critically ill patients is a capillary blood specimen. This specimen type has gained favour with many physicians for the analysis of blood gases, electrolytes and/or metabolites like glucose, lactate, creatinine or total bilirubin. However, numerous pre-analytical errors can occur during the procurement and handling of a capillary blood specimen such that the quality of test results could be compromised and clinically misleading.
Hemolysis is a common pre-analytical error that can occur during the collection of any blood specimen and is well known to influence the quality of electrolyte and blood gas results. The rate of hemolysis of blood specimens is influenced by patient type (ie. 10-12% emergency patients; 1.5-2% medical wards) and whether laboratory trained phlebotomists (0.5-2%) or nurses (2-10%) are collecting the specimen. To date, few laboratories have been adventurous enough to attempt measurement of hemolysis rates for capillary blood specimen collection.
The neonatal population present unique challenges with respect to the procurement and handling of a capillary blood specimen. In this webinar, pre-analytical errors such as patient identification, specimen collection, handling and transport associated with neonatal capillary blood gas specimens will be discussed.
Martha Lyon, PhD, Clinical Biochemist, Royal University Hospital, Saskatoon, Saskatchewan, Canada