LQCL2402 - CMLE - Evaluation of Abnormal Chemistry Results in Specimens Drawn From Intravenous Lines-Evaluation of Abnormal Chemistry Results in Specimens Drawn From Intravenous Lines

Evaluation of Abnormal Chemistry Results in Specimens Drawn From Intravenous Lines

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The document discusses the importance of identifying and correcting preanalytic errors in clinical chemistry, focusing on potential sources of measurement error in specimens drawn from intravenous lines. An example case of an 88-year-old woman with metastatic ovarian cancer is presented, where abnormal chemistry results were suspected to be due to contamination from the IV line. Guidelines emphasize proper phlebotomy techniques, such as collecting samples distal to the IV entry site, pausing infusions before collection, and using tourniquets to reduce contamination risks. Common IV fluid compositions and their potential impact on lab results are detailed, with examples like D5NS causing markedly abnormal results if contaminated. Strategies for detecting contaminated specimens include autoverification tools like feasibility limits and delta checks, which can prompt the rejection of results. The case in the document was resolved by re-drawing a specimen from the opposite arm, confirming the initial abnormal results were due to preanalytic error. Effective communication between lab personnel and healthcare providers is crucial for resolving such issues, ensuring patient safety and maintaining data integrity. The text stresses the collaboration between medical laboratory scientists and the pharmacy when troubleshooting cases of contamination and the need for continuous adjustments in fluid compositions based on patient chemistry results during hospital admissions.

Keywords

preanalytic errors

clinical chemistry

measurement error

intravenous lines

phlebotomy techniques

IV fluid compositions

contaminated specimens

autoverification tools

patient safety

data integrity