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Patients should not be made to tightly clench their fists during phlebotomy procedures because it can cause misleadingly high blood potassium readings, according to a study.
What will be the effect of fist clenching on the levels of potassium in the blood?
During phlebotomy by venipuncture, fist clenching has commonly been used by the phlebotomists to make veins more prominent. The practice can cause potassium to increase locally so that the serum potassium is increased by as much as 1.6 mmol/L.
What can falsely increase potassium levels in capillary puncture?
Regarding samples held in separator tubes that already have been centrifuged, repeat centrifugation is a known cause of falsely elevated potassium. 3 During centrifugation, the gel layer in the tube compresses to allow serum or plasma to pass through.
How much is the increase in the potassium level if the fist is repeatedly pumped during venipuncture?
The discrepancies in serum and plasma potassium levels measured at various times in the patient resulted from the methods of phlebotomy used. Both repeated fist clenching and isometric handgrip increased the plasma potassium level by as much as 1.6 mmol per liter in the venous effluent from the contracting arm.
What can cause a false high potassium reading?
Falsely Elevated K (Pseudohyperkalemia) Pseudohyperkalemia from in vitro hemolysis is the most common cause of falsely elevated potassium, and it is most often caused by pressure gradients created during draws, often with a syringe or from an indwelling catheter.
Should you clench your fist during blood draw?
Patients should not be made to tightly clench their fists during phlebotomy procedures because it can cause misleadingly high blood potassium readings, according to a study.
Why is pumping of the fist before venipuncture inappropriate for blood collection?
They suggest that variation in analytes due to fist clenching are probably attributable to muscle contraction, hemolysis or both, and recommend that fist clenching before and during venipuncture be avoided.
Can blood draw cause high potassium?
Often a report of high blood potassium isn’t true hyperkalemia. Instead, it may be caused by the rupture of blood cells in the blood sample during or shortly after the blood draw. The ruptured cells leak their potassium into the sample.
Can high potassium be a lab error?
Errors in potassium measurement can cause pseudohyperkalemia, where serum potassium is falsely elevated. Usually, these are recognized either by the laboratory or the clinician. However, the same factors that cause pseudohyperkalemia can mask hypokalemia by pushing measured values into the reference interval.
How do you flush excess potassium?
This may include: Water pills (diuretics) help rid your body of extra potassium. They work by making your kidney create more urine. Potassium is normally removed through urine. Potassium binders often come in the form of a powder. They are mixed with a small amount of water and taken with food.
What is clenched fist syndrome?
Background. The Clenched Fist Syndrome (CFS) is a type of a psychiatric disorder, in which the patients show flexion finger contractures. Although no organic etiology can be identified, the syndrome in most cases presents with pain and paradoxical stiffness.
Does clenching fist raise blood pressure?
No systematic effect (lower or higher blood pressure) from making a fist was observed, but individual effects were often marked, as evidenced by the median absolute differences (regardless of ‘+’ or ‘-‘ sign) between the duplicate readings: 5 (range 0-31) versus 3 (0-18) mmHg for systolic blood pressure, and 4 (0-22).
What happens if blood is drawn too quickly?
Unsafe phlebotomy can cause adverse effects for patients; such effects are rare, but range from pain or bruising at the site of puncture, to fainting, nerve damage and haematoma.
Can drinking a lot of water lower potassium?
Excessive water consumption may lead to depletion of potassium, which is an essential nutrient. This may cause symptoms like leg pain, irritation, chest pain, et al. 6. It may also cause too much urination; when you drink lots of water at once, you tend to urinate frequently.
What are signs that your potassium is high?
What are the symptoms of hyperkalemia (high potassium)? Abdominal (belly) pain and diarrhea. Chest pain. Heart palpitations or arrhythmia (irregular, fast or fluttering heartbeat). Muscle weakness or numbness in limbs. Nausea and vomiting.
What is the main cause of high potassium?
The most common cause of high potassium is kidney disease. Other causes of high potassium include: Dehydration. Some medicines.
Does warming the site before performing a skin puncture increase the blood flow?
Skin puncture blood is a mixture of undetermined proportions of blood from arterioles, venules, capillaries, and interstitial and intracellular fluids. The arterial portion can be increased by warming the site prior to collection. This increases the blood flow as much as sevenfold.
Why is it hard for me to make a fist?
Tendons are the structures that connect the muscles to the bones. When your tendons are injured, performing certain actions such as making a fist can be difficult. We’ve previously looked at problems bending the thumb and problems bending the fingers, and tendon injuries came up a lot in these cases.
When performing a capillary puncture you should?
Hold the finger in an upward position and lance the palm-side surface of the finger with proper-size lancet (adult/child). Press firmly on the finger when making the puncture. Doing so will help you to obtain the amount of blood you need. Cap the Microtainer® and gently invert it 10 times to prevent clots from forming.
Why does blood stop flowing during a blood draw?
IF BLOOD STOPS FLOWING INTO THE TUBE: The vein may have collapsed; resecure the tourniquet to increase venous filling. If this is not successful, remove the needle, take care of the puncture site, and redraw. The needle may have pulled out of the vein when switching tubes.
What causes slow blood flow during blood test?
Conditions that slow blood flow or make blood thicker, such as congestive heart failure and certain tumors. Damaged valves in a vein. Damaged veins from an injury or infection. Genetic disorders that make your blood more likely to clot.
Why is hand pumping during blood collection for clinical chemistry tests is prohibited?
A closed hand causes the veins to become more prominent and easier to enter. Avoid pumping of the fist and a “tight” fist these may cause hemoconcentration of the blood.
Can Hemolyzed blood cause high 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.
Which drugs cause high potassium?
Which medications can raise potassium levels? ARBs (angiotensin II receptor blockers). ACE (angiotensin converting enzyme) inhibitors. Spironolactone. NSAIDs (non-steroidal anti-inflammatory drugs). Cyclosporine and tacrolimus. Heparin. Propranolol and labetalol.
