The Effect of Luer-Lock Adapter on Hemolysis Rates in the Emergency Department

Area of Science:

• Clinical Pathology
• Laboratory Medicine
• Preanalytical Errors

Background:

• Blood testing is vital in emergency departments (ED) for patient care.
• Hemolysis is a frequent preanalytical error, negatively impacting lab results, increasing costs, and requiring repeat blood draws.

Purpose of the Study:

• To compare hemolysis rates between Luer Lock adapters and standard intravenous injectors for ED blood samples.
• To assess the efficacy of Luer Lock adapters in high-pressure emergency settings, where hemolysis is a significant issue.

Main Methods:

• Prospective observational study at Ege University Hospital.
• Blood samples collected from 517 adult patients using both standard injector and Luer Lock methods.
• Hemolysis rates analyzed using McNemar test; statistical significance at P < 0.05.

Main Results:

• Overall hemolysis rate was 12.4%.
• Luer Lock adapters showed significantly higher hemolysis rates (12.4%) than the injector method (8.1%, P = 0.011).
• Elevated hemolysis was observed for LDH and potassium with Luer Lock adapters compared to the injector method (P < 0.001).

Conclusions:

• Luer Lock adapters were associated with increased blood sample hemolysis in the ED, contrary to prior research.
• Improving blood collection practices requires standardized procedures, staff training, and investigation into device-specific factors.