Assessing Pediatric Trauma Specimen Integrity (Research AND REPORTS‪)‬

A high-functioning pediatric trauma team relies on the critical tool of rapid laboratory diagnostics. When blood specimens are unusable because of hemolysis, critical time and patient-care resources must be redirected to obtain repeat blood draws. In addition to time lost, within a pediatric population there is the additional risk of repeated blood collections resulting in iatrogenic anemia, (1) as well as the anxiety of blood draws for both the child and the family. The quality of patient specimens is an important determinant in laboratory testing. It has been estimated that 90-95% of diagnostic delays can be attributed to problems associated with error in the pre-analytic phase of laboratory medicine. (2) In most clinical laboratories, hemolyzed specimens cannot be used for testing in blood bank, coagulation studies, and most chemistry procedures. (3) Research is being undertaken to look at issues of specimen procurement and specimen handling to identify issues and to implement quality improvement methods. Factors of interest that result in hemolyzed specimens include: over-manipulation of the extremity at the draw site, intravenous catheter size, Vacutainer pressure, over-shaken or vigorously shaken tubes, utilization of an improperly sized tube or a tube without the proper additive, method of transport, and transport time to processing. (3,4)