Evaluation of the wrist tightening technique as a pre-analytical interference in the potassium dosage
Keywords:
Potassium, Fist clenching, Phlebotomy, Pre-analytical, PseudohyperkalemiaAbstract
Objective: To evaluate potassium alterations in relation to wrist grip frequency by the research participants, seeking to contribute to a better understanding of the quantitative aspects regarding the use of wrist grip technique during phlebotomy, to verify how often wrist may contribute to potassium elevation. Method: Two blood samples were collected from each individual. At first, keeping the hands relaxed during phlebotomy and secondly, pumping the fist clenching the phlebotomy procedure to evaluate potassium changes in relation to the frequency of wrist tightening. Results: In general, it was observed that there were changes in practically all dosages and that individuals could have been misdiagnosed with hyperkalemia and could be submitted to unnecessary treatments. Conclusion: The technique of wrist tightening during phlebotomy should be avoided, since a significant percentage of the cases presented a potassium elevation that does not correspond to the individual's normal serum potassium level.
References
Asirvatham J, Moses V, Bjornson L. Errors in Potassium Measurement: A Laboratory Perspective for the Clinician. N Am J Med Sci. 2013;5(4):255-259.
Walker H, Hall W, Hurst J. Clinical Methods: The History, Physical and Laboratory Examinations. 3rd ed. Chapter 195. Boston: Butterworths; 1990. Serum PotassiumClinicalMethodsNCBI.
Sevastos N, Theodossiades G, Archimandritis A. Pseudohyperkalemia in Serum: A new Insight into an Old Phenomenon. Clin Med Res. 2008;6(1):30-32.
Meng Q, Wagar E. Pseudohyperkalemia: A new twist on an old phenomenon. Crit Rev Clin Lab Sc. 2014 Oct:1-11.
Forsman R. Why is the laboratory an afterthought for managed care organizations? Clinical Chemistry. 1996;42(5):813-816.
Stankovic A, Smith S. Elevated serum potassium values: the role of preanalytic variables. Am J Clin Pathol. 2004;121:105-112.
Asirvatham J, Moses V, Bjotnson L. Errors in Potassium Measurement: A Laboratory Perspective for the Clinician. N Am J Med Sci. 2013;5(4):255-259.
Baer D, Ernst D, Willeford S, Gambino R. Investigating elevated potassium values. MLO. 2006 nov:24-31.
Don B, Sebastian A, Cheitlin M, Christiansen M, Schambelan M. Pseudohyperkalemia caused by fist clenching during phlebotomy. The new England Journal of Medicine. 1990 mai:1290-1292.
Narayanan S, Guder W. Preanalytical Variables and Their Influence on the Quality of Laboratory Results. eJIFCC. 2001;13.
Narayanan S. The preanalytic Phase. Am J Clin Pathol 2000;113:429-452.
Skinner S, Adelaide M. A cause of erroneous potassium levels. The Lancet. 1961 march:478-480.
Hartmann R, Auditore J, Jackson D. Studies on thrombocytosis Hyperkalemia due to release of potassium from platelets during coagulation. J Clin Invest. 1958:37:699-707.
Potássio. [Bula]. Goiânia: Doles Reag. Equip. para Laboratórios Ltda.
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