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Qualitative Analysis

Qualitative Analysis

For solutions containing mixtures of different cations, the identity of each cation can be determined by qualitative analysis. This technique involves a series of selective precipitations with different chemical reagents, each reaction producing a characteristic precipitate for a specific group of cations. Metal ions within a group are further separated by varying the pH, heating the mixture to redissolve a precipitate, or adding other reagents to form complex ions.
For instance, group IV...

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An In Vitro Hemodynamic Loop Model to Investigate the Hemocytocompatibility and Host Cell Activation of Vascular Medical Devices

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Do hemolyzed potassium specimens need to be repeated?

Boris Khodorkovsky¹, Bartholomew Cambria¹, Martin Lesser²

¹Department of Emergency Medicine, Staten Island University Hospital, Staten Island, New York.

The Journal of Emergency Medicine

|June 17, 2014

Summary

This summary is machine-generated.

Elevated potassium levels due to hemolysis in patients with normal kidney function and a normal ECG often do not require repeat testing. This finding can help emergency departments avoid unnecessary repeat tests and reduce patient length of stay.

Keywords:

emergency department testing hyperkalemia laboratory pseudohyperkalemia resource utilization

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Area of Science:

Emergency Medicine
Clinical Pathology
Nephrology

Background:

Hyperkalemia with hemolysis is common in emergency departments.
Elevated potassium levels are often rechecked to rule out true hyperkalemia.
This can lead to increased testing and longer hospital stays.

Purpose of the Study:

To determine if repeat potassium testing is necessary for patients with hemolyzed potassium, normal renal function, and a normal ECG.
To reduce unnecessary repeat testing and length of stay in the emergency department.

Main Methods:

Prospective enrollment of adult patients in the ED from July 2011 to February 2012.
Patients with hemolyzed potassium ≥ 5.5 mEq/dL had repeat potassium levels and ECGs.
Incidence of true hyperkalemia was measured in this cohort.

Main Results:

45 patients were enrolled; median age 52 years, 49% female.
In patients with hyperkalemia and GFR ≥ 60, the negative predictive value for true hyperkalemia was 97.8%.
In patients with hyperkalemia, GFR ≥ 60, and normal ECG, the negative predictive value was 100%.

Conclusions:

Normal GFR (≥ 60 mL/min) and a normal ECG reliably predict pseudohyperkalemia in cases of hemolysis.
Repeat testing is likely unnecessary for patients with normal GFR and a normal ECG.
This approach can potentially reduce repeat testing and emergency department length of stay.