Poor knowledge and faulty thinking regarding hemolysis and potassium elevation
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Robert C. Hawkins
Abstract
A questionnaire to assess knowledge of the expected elevation in serum K measurement with different grades of hemolysis was administered to medical technologists working in biochemistry laboratories, hospital physicians and nurses. The questions involved different grades of hemolysis (mild, 1.0, moderate, 2.5 and severe, 5.0g/L) and different final K measurements (2.9, 4.0, 5.2 and 8.2mmol/L). Subjects estimated the K concentration in a non-hemolyzed sample for each scenario. Adjustment values (difference between final hemolyzed K concentration and subject's response) were calculated. For the 132 respondees, the mean correct score was 1.7/12. Mean adjustment values were: mild, 0.43mmol/L (K 2.9), 0.55 (4.0), 0.88 (5.2) and 1.53 (8.2); moderate, 0.85 (2.9), 0.92 (4.0), 1.33 (5.2) and 2.50 (8.2); and severe, 0.93 (2.9), 1.48 (4.0), 1.96 (5.2), 2.96 (8.2). Correct adjustments were: mild, 0.28; moderate, 0.70; and severe, 1.40mmol/L. Healthcare staff overestimated the effect of hemolysis on potassium measurement and used an incorrect proportional adjustment approach to the problem. Such poor knowledge and faulty thinking could lead to diagnostic delays or misdiagnoses. There is potential for such faulty thinking in all areas of laboratory medicine, and laboratories should review their educational responsibilities and reporting practices in light of this.
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- Quality control for SELDI analysis
- Immunobead multiplex RT-PCR detection of carcinoembryonic genes expressing cells in the blood of colorectal cancer patients
- Optimization and evaluation of surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) with reversed-phase protein arrays for protein profiling
- Simultaneous determination of HIV antibodies, hepatitis C antibodies, and hepatitis B antigens in dried blood spots –a feasibility study using a multi-analyte immunoassay
- Hematopoietic cytokines in the sera of patients with pancreatic cancer
- Modulation of translation factor's gene expression by histone deacetylase inhibitors in breast cancer cells
- Whole genome amplification of buccal cell DNA: genotyping concordance before and after multiple displacement amplification
- Y-Chromosome short tandem repeat (STR) haplotypes in a Campania population sample
- TaqMan assays for genotyping of single nucleotide polymorphisms present at a disease susceptibility locus on chromosome 6
- The secretion of ibuprofen metabolites interferes with the capillary chromatography of urinary homovanillic acid and 4-hydroxy-3-methoxymandelic acid in neuroblastoma diagnosis
- Selective measurement of HCHO in urine using direct liquid-phase fluorimetric analysis
- A spectrophotometric micromethod for determining erythrocyte protoporphyrin-IX in whole blood or erythrocytes
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