Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system

Abstract

Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.

To disinfect or not to disinfect that is the question – Procedure when drawing blood for alcohol measurements in Denmark

“…For the last two regions, the approach to disinfection or not was more mixed. Our previous study found that standardization between laboratories was poor (order of draw) [ 4 ] Our current study shows that there is a mismatch between local practices and international scientific literature and guidelines. Perhaps now, with the Danish bachelor's degree for BLS being more rooted in research and science since 2013 [ 32 ], new generations of BLS that we educate may find it more natural to update local practices with the newest scientific literature.…”

“…Denmark does not have its own standardized national recommendations for the disinfection procedure when drawing blood for p-ethanol. We have previously shown that Danish laboratories typically develop their own local protocols and that national laboratory guidelines are not custom in our country [ 4 ]. If interlaboratory guidelines exist, they are regional based, as shown in this study.…”

“…In this study, our main focus was blood sampling of p-ethanol for clinical matters and not blood sampling for forensic/police matters. From our previous work [ 4 ] and updated via the search engine Google (California, USA), we systematically collected telephone numbers, and in April 2020, we rang all the laboratories and gathered oral consent from the responsible respondents and an email address for future correspondence. Each respondent was informed that participation was voluntary, anonymous, and confidential.…”

“…This autonomy may not be just a Danish phenomenon, as a study showed that only 63 % of European laboratories followed a national guideline regarding the handling and storage of blood samples for coagulation tests [ 3 ]. This autonomy may be a concern if locally developed protocols neither follow official guidelines nor the scientific evidence-based literature - as we previously observed for blood tube order of draw in Denmark [ 4 ].…”

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

“…The Seventh Edition of the Clinical and Laboratory Standard Institute (CLSI) suggested that the order of draw sequence should start with blood culture or sterile tubes, followed by plain or gel tubes and then tubes containing additives, namely, the heparin tubes, ethylenediaminetetraacetic acid (EDTA) tubes, and the glycolytic inhibitor or fluoride tubes [26]. The purpose is to reduce the carryover of additive contamination, which can lead to erroneous results [26,27]. EDTA contamination, for example, can cause spurious hyperkalemia and hypocalcemia secondary to the EDTA chelation effect [22,28].…”