The Impact of Prehospital Blood Collection on Time to Laboratory Test Results and Emergency Department Length of Stay

Abstract

Introduction: The purpose of this prospective study was to determine the impact of obtaining blood specimens in the prehospital setting versus drawing specimens in-hospital. Variables examined were length of time from arrival to laboratory result availability; specimen quality; and emergency department length of stay. Methods: A total of 101 patients were enrolled in the study and assigned to either prehospital group (n = 58) or the in-hospital group (n = 43). Clinical laboratory personnel were blinded to the study groups. Results: Patients in the experimental group had door-to-results times for complete blood cell counts of 26 min shorter than the control group (p < .004). Doorto-results times for serum chemistry studies were 28 min faster than controls (p < .02). There was no significant difference between groups for hemolysis. Conclusions: Collecting samples in the prehospital setting significantly shortens time to results, is not associated with an increase in hemolysis, and may decrease overall emergency department lengths of stay. Key words: divert, door-to-laboratory results availability, length of stay, hemolysis, prehospital lab draw, throughput T HE GOAL of every emergency department (ED) is to see and treat patients in a timely manner. Patient and employee

The impact of prehospital blood sampling on the emergency department process of patients with chest pain: a pragmatic non-randomized controlled trial

“…[15,16] Waiting for laboratory results is frequently described as a cause for increased EDLOS and crowding. [13,17,18] In our study, the improvement in the efficiency of laboratory testing was reflected in a shorter EDLOS when adjusted for other factors. In our regression model concerning EDLOS, 26% of the variation was explained by prehospital blood draw, age, a second troponin draw, and a radiology request, suggesting that other, possibly important, contributors to EDLOS were not measured in this study.…”

“…A study analysing 101 patients demonstrated door-to-result times for serum chemistry studies in cases being 28 min faster than controls (P<0.02). [13] A 29-minute decrease in LOS was observed which did not reach statistical significance. In a study including 400 patients, the authors concluded that the practice of prehospital blood draws by EMS in the field should be supported, based on no differences in redraw rates and a non-significant decrease in median LOS.…”

“…Our findings concerning errors such as hemolysis, which did not differ between the groups, are congruent with the literature. [6,13] Prehospital blood draw is safe with no statistically significant differences in haemolysis and redraw rates and no increased risk of blood exposure incidents. [6] Additionally, the high preanalytical stability and validity support the practice of prehospital blood draw.…”