对创伤患者血型筛查标本中溶血发生率的回顾性分析。
A retrospective analysis of the incidence of hemolysis in type and screen specimens from trauma patients.
作者信息
Shah Kavin G, Idrovo Juan P, Nicastro Jeffrey, McMullen Heather F, Molmenti Ernesto P, Coppa Gene
机构信息
Department of Surgery, North Shore - Long Island Jewish Health System, Manhasset;
出版信息
Int J Angiol. 2009 Winter;18(4):182-3. doi: 10.1055/s-0031-1278350.
BACKGROUND
Hemolysis of blood samples has been a concern in hospitals. Currently, residents and nurses have replaced traditional teams of skilled phlebotomists for both routine and 'stat' blood draws. Although this leads to a decreased operating cost for institutions, the lack of skill and experience leads to a higher percentage of hemolyzed specimens.
OBJECTIVE
To determine the incidence of hemolyzed 'type and screen' blood samples at Staten Island University Hospital (SIUH) (New York, USA).
METHODS
The study group comprised 615 consecutive trauma patients at SIUH between July 2006 and June 2007. Patients were treated according to the Advanced Trauma Life Support protocol. The primary survey for a trauma patient consists of 'airway', 'breathing' and 'circulation'. The primary objective of 'circulation' is to establish vascular access and collect blood samples for analysis. The SIUH in-house laboratory provided all of the reports.
RESULTS
Of the 615 samples collected, 155 samples (25.2%) were hemolyzed.
CONCLUSIONS
The hemolysis rate of 25.2% for type and screen samples is higher than previously reported in the literature. The data suggest that the high rate of hemolysis in these trauma patients is due to the residents' lack of experience and skills required to obtain an adequate blood draw.
背景
血液样本的溶血一直是医院关注的问题。目前，住院医师和护士已取代传统的熟练采血团队进行常规和急诊血液抽取。尽管这降低了机构的运营成本，但缺乏技能和经验导致溶血样本的比例更高。
目的
确定美国纽约斯塔滕岛大学医院（SIUH）“血型鉴定和筛查”血液样本的溶血发生率。
方法
研究组包括2006年7月至2007年6月期间在SIUH连续收治的615例创伤患者。患者按照高级创伤生命支持方案进行治疗。创伤患者的初级评估包括“气道”、“呼吸”和“循环”。“循环”的主要目标是建立血管通路并采集血液样本进行分析。SIUH内部实验室提供所有报告。
结果
在采集的615份样本中，有155份样本（25.2%）发生溶血。
结论
血型鉴定和筛查样本25.2%的溶血率高于此前文献报道。数据表明，这些创伤患者的高溶血率是由于住院医师缺乏获取足够血液样本所需的经验和技能。
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