Was a blood test recently ordered for you? When the results came back, did the doctor tell you that your test had been hemolyzed? When lab reports indicate that a blood specimen has been hemolyzed, then this is an indication that the red blood cells in that sample were destroyed in some way. The destruction of the red blood cells will release hemoglobin and this renders the sample useless.
When a hemolyzed blood test is the result, most doctors will order another blood draw so that the test can be accurately completed. Not all test results are affected by hemoglobin, however, so if you did get your results back and it was noted that the blood test was hemolyzed, then there is nothing to worry about at all.
What Leads To a Blood Test Becoming Hemolyzed?
Most of the time, a hemolyzed blood test occurs because of a provider not following best practices while taking the blood draw. The most common reason for this test result is the presence of too great a vacuum in the vein when the needle is inserted. This causes the red blood cells to be drawn to the opening too quickly.
Here are some of the other common reasons for a blood test result to come back in this way.
1. The wrong needle is used.
If the red blood cells are forced through an opening that is too small for them, then the result will be their destruction. This, in turn, causes the hemoglobin to be released.
2. The wrong tube is used.
Having a tube that is too large for the sample being drawn can also cause this problem. This is due to the added vacuum capacity that the large space can create during the blood draw. Having a tube that is too small can also cause this problem because the red blood cells become too compressed.
3. The draw happens too slowly.
If the technician draws the blood in too slowly, this may also cause a hemolyzed test result.
4. The blood sample is shaken.
Just the simple act of vigorously shaking the blood sample is enough to cause the destruction of the red blood cells that it contains.
Laboratory procedures may also cause a hemolyzed blood test. This tends to happen when a anticoagulated blood sample is run through a centrifuge.
Sometimes Patient Actions Can Also Cause a Hemolyzed Sample
How the blood draw occurs has a direct impact on whether or not the blood sample will become hemolyzed. If a patient has their fist clenched for too long, then there is a slight risk for the blood draw to be compromised. This may also occur if the tourniquet is held in place for too long. A best practice is to have the tourniquet on for no longer than a minute and to only clench a fist when necessary to facilitate obtaining the sample.
How blood samples are transported to the laboratory can also affect the test results that are obtained. If the blood sample gets too hot or too cold, the red blood cell membranes may become unsustainable and rupture, ruining the sample.
How the blood sample is processed may also cause it to become hemolyzed. When applicator sticks are used improperly to dislodge fibrin while testing, the end result may be the accidental rupture of the red blood cells it contains. Having too long of a contact with the plasma or serum used for testing may also cause the membranes to rupture. Even processing the sample too quickly has been known to cause a hemolyzed result.
What Are the Options That Are Available?
The most common reaction to a hemolyzed blood test result is to take another blood sample. A different location may be chosen and the technician taking the sample may try using a different needle gauge to lessen the risks of a second occurrence.
When all of the blood collection assemblies are not properly fitted and frothing occurs, there will be an increased risk of experiencing a hemolyzed blood test. A greater focus on the timing of activators and other materials used with the test will also be in place.
From the patient perspective, there is really just one thing to do: relax as best as possible. Make sure the arm isn’t tense and rigid and avoid flinching when the needle is inserted.
A hemolyzed blood test does not mean there is something wrong with a patient. It just means that there was a problem involved at one point in the testing chain and this causes the membranes of the red blood cells to be destroyed. You may wish, however, to discuss with your health provider about who will be responsible for payment of the second blood draw.