What happens when there is prolonged application of tourniquet?
A prolonged tourniquet time may lead to blood pooling at the venipuncture site, a condition called hemoconcentration. Hemoconcentration can cause falsely elevated results for glucose, potassium, and protein-based analytes such as cholesterol.
What happens to pH level when application of tourniquet is prolonged?
Prolonged tourniquet times lead to a fall in tissue pH, an increase in capillary permeability, and a prolongation of clotting, all of which promote the development of a compartment syndrome.
Which of the following can result from extended application of a tourniquet?
Continuous application for longer than 2 hours can result in permanent nerve injury, muscle injury, vascular injury and skin necrosis.
What are four problems associated with tourniquet application?
Complications of tourniquet placement such as neuropraxia and nerve paralysis4 attributable to direct nerve pressure or ischemia,5 rhabdomyolysis,6 compartment syndrome,7 increased intravascular coagulation,8 and limb ischemia are well known.
Does lipemia affect potassium?
Background: Lipemia affects electrolyte concentration obtained by indirect ion selective electrode (ISE) method, samples for the major electrolytes i.e., sodium and potassium.
Does hemolysis affect potassium?
Of all routine blood tests plasma/serum potassium measurement is one of the most sensitive to the effect of hemolysis because red-cell potassium concentration is so much higher than that of plasma (approximately 20 times higher); hemolysis causes a spuriously high plasma potassium concentration.
Why is hemolysis a concern?
Hemolysis, involving the rupture of red blood cells (RBCs) and release of their contents into blood plasma, is a major issue of concern in clinical fields. Hemolysis in vitro can occur as a result of errors in clinical trials; in vivo, hemolysis can be caused by a variety of medical conditions.
What can causes hemolysis when drawing blood?
Hemolysis resulting from phlebotomy may be caused by incorrect needle size, improper tube mixing, incorrect filling of tubes, excessive suction, prolonged tourniquet, and difficult collection.
What does it mean if potassium is Hemolyzed?
Pseudohyperkalemia is the term applied to the clinical situation in which in vitro lysis of cellular contents leads to measurement of a high serum potassium level that does not reflect the true in vivo level.
Do Hemolyzed potassium specimens need to be repeated?
Conclusions: In the setting of hemolysis, GFR ≥ 60 mL/min in conjunction with a normal ECG is a reliable predictor of pseudohyperkalemia and may eliminate the need for repeat testing. In patients with a normal GFR who are otherwise deemed safe for discharge, our results indicate there is no need for repeat testing.
How do you prevent a Hemolyzed specimen?
Best Practices to Prevent Hemolysis
- Use the correct needle size for blood collection (20-22 gauge).
- Avoid using butterfly needles, unless specifically requested by patient.
- Warm up the venipuncture site to increase blood flow.
- Allow disinfectant on venipuncture site to dry completely.
What causes Pseudohypokalemia?
Pseudohypokalemia is a decrease in the amount of potassium that occurs due to excessive uptake of potassium by metabolically active cells in a blood sample after it has been drawn. It is a laboratory artifact that may occur when blood samples remain in warm conditions for several hours before processing.
What is the most common cause of hypokalemia?
Low potassium (hypokalemia) has many causes. The most common cause is excessive potassium loss in urine due to prescription medications that increase urination. Also known as water pills or diuretics, these types of medications are often prescribed for people who have high blood pressure or heart disease.
What are the signs and symptoms of hypokalemia?
Symptoms
- Weakness.
- Fatigue.
- Muscle cramps or twitching.
- Constipation.
- Arrhythmia (abnormal heart rhythms)