Effects of Pneumatic Tube Transport on Blood Gas and Supplemental Analytes.

BACKGROUND: Pneumatic tube transport of blood gas samples is a common method of delivery within a facility. The effects of pneumatic tube transport on blood gas analysis has been studied. However, other analytes that are often assessed in blood gas analysis (eg, electrolytes, metabolites, and oximetry) are not typically included in these studies. We sought to investigate the impact of pneumatic tube transport on some of these other analytes. METHODS: The study was conducted at the blood gas laboratory at the University of Utah Hospital. A split sample comparison was performed. Both samples were walked to a pneumatic tube station, where one sample was sent via tube to the blood gas laboratory, while the other sample was walked back to blood gas laboratory. We examined 2 samples from each of the 27 different pneumatic tube stations in this hospital. Results were graphed with upper and lower control limits set to conform to acceptable College of American Pathologists proficiency testing evaluation criteria. Data were compared using the Student t test. RESULTS: Differences between walked and tubed specimens were neither clinically nor statistically significant. CONCLUSIONS: Pneumatic tube transport of blood gas specimens is acceptable for blood gas and supplementary analytes, as evidenced by multiple points of evaluation, including statistical analysis, clinical judgment, and concordance with regulatory guidelines.

Improved Success Rate of Arterial Puncture for Blood Gas Analysis Through Standardization.

BACKGROUND: Arterial puncture for blood gas analysis is a common procedure in hospitals. The aim of the study is to determine if standardizing technique elements of the arterial puncture process could improve the success rate of technicians through the full scope of an academic medical center. METHODS: The study is conducted by the Blood Gas Laboratory at University of Utah Health's main campus. During the baseline period, technicians tallied whether arterial puncture attempts were successful or unsuccessful from December 2014 through February 2015. A small team reviewed the steps of performing arterial puncture and selected segments of the process for standardization. Starting in March 2015, staff were trained individually in the standard processes. All staff continued to tally outcomes of puncture attempts through March 2017. RESULTS: During the baseline period, the puncture success rate was 83.6%. From April 2015 through March 2017 the success rate was 89.2%. CONCLUSION: Standardizing arterial puncture technique for blood gas analysis leads to fewer punctures.

Safe Reduction of Blood Volume in the Blood Gas Laboratory.

BACKGROUND: Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes. METHODS: This study was conducted in 1 of the adult ICUs at the University of Utah Hospital. Over a baseline period a standard adult 3 mL blood gas syringe was utilized. Subsequently the standard adult syringe was replaced by a 1 mL syringe produced by the same manufacturer with the same heparin concentration. RESULTS: The change to the 1 mL syringe had no effect on specimen integrity in regards to laboratory's ability to process the specimen. With use of the 1 mL syringe there was a 60% reduction in the volume of blood drawn compared with the baseline period. CONCLUSION: Standardizing the 1 mL syringe for Blood Gas Laboratory tests will reduce patient blood loss without appreciably affecting specimen rejection relative to current rates.