Sliwa C M
Emergency Department, University of California, Davis, Medical Center, Sacramento, USA.
J Emerg Nurs. 1997 Jun;23(3):228-31. doi: 10.1016/s0099-1767(97)90012-x.
Most trauma patients in the emergency department have multiple hematocrits drawn to monitor hypovolemia. These venipunctures are painful to the patient and frustrating for hospital staff when venipuncture sites are difficult to locate.
The purpose of this study was to determine whether the hematocrit values of blood samples obtained with saline lock devices agree or are different from those blood specimens obtained by standard venipuncture. If they agree, can the traditional venipuncture route of blood collection be replaced by collection from a saline lock device?
The study used a quasiexperimental, repeated measures design. The research was conducted at a teaching, regional level I trauma center with annual ED visits of 65,000. Each subject had hematocrit samples obtained by venipuncture (control) according to standard trauma protocols. Within 5 minutes of obtaining each control specimen, a hematocrit sample was obtained with a saline lock device (experimental) after a 5 ml discard volume was obtained.
Results were analyzed by measures of central tendency and paired t test. There were no differences in mean hematocrit values in blood obtained by saline locks (41.1 +/- 4.4) and those drawn from direct venipunctures (41.0 +/- 3.9).
Obtaining samples for determination of hematocrit values from a saline look device is an accurate method of obtaining serial hematocrit values.
急诊科的大多数创伤患者会多次采集血细胞比容以监测血容量不足情况。这些静脉穿刺对患者来说很痛苦，而且当静脉穿刺部位难以找到时，医院工作人员也会感到沮丧。
本研究的目的是确定使用生理盐水锁装置采集的血样的血细胞比容值与通过标准静脉穿刺采集的血样的血细胞比容值是否一致或不同。如果一致，传统的静脉穿刺采血途径能否被从生理盐水锁装置采血所取代？
本研究采用准实验、重复测量设计。研究在一家一级区域教学创伤中心进行，该中心每年急诊科就诊人数为65000人。每个受试者按照标准创伤方案通过静脉穿刺（对照）获取血细胞比容样本。在获取每个对照样本后的5分钟内，在弃去5毫升血液后，通过生理盐水锁装置（实验）获取血细胞比容样本。
通过集中趋势测量和配对t检验对结果进行分析。通过生理盐水锁采集的血液的平均血细胞比容值（41.1±4.4）与直接静脉穿刺采集的血液的平均血细胞比容值（41.0±3.9）没有差异。
从生理盐水锁装置获取用于测定血细胞比容值的样本是获取系列血细胞比容值的准确方法。
