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Mastering the preanalytical phase

Small details, big impact: ensure reliable blood gas results with preanalytical excellence

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OPERATOR FIRST

12 common preanalytical errors and how to avoid them

Accurate blood gas results begin well before analysis—in the critical preanalytical phase. From patient ID to sample handling, every step plays a vital role.


Heparin-induced bias
Patient sample mix-up
Contamination by venous blood
Contamination by flush solution
Contamination by tissue fluid
Air contamination
Clotting
Cold exposure effect
Ongoing metabolic effect
Inhomogeneous sample
Hemolysis
Operator hazard
Heparin-induced bias
1/12

Choose the right collecting device

Choose a syringe or capillary tube containing dry electrolyte-balanced heparin to avoid heparin-induced bias.

How Radiometer products support you:

Wide choice of syringes and capillaries with dry electrolyte-balanced heparin.

Aspirating syringes

When collecting blood from an indwelling catheter, use a Radiometer aspirating syringe containing dry electrolyte-balanced heparin, which virtually eliminates heparin-induced bias.

Self-fill syringes

When collecting blood by arterial puncture, use a Radiometer self-fill syringe containing dry electrolyte-balanced heparin, which virtually eliminates heparin-induced bias.

Capillary tubes

When collecting a capillary blood sample, use the Radiometer capillary tube containing dry electrolyte-balanced heparin, which virtually eliminates heparin-induced bias.
Patient sample mix-up
2/12

Label properly

Reliably identify the patient, sample, and operator to minimize patient sample mix-up risk.

How Radiometer products support you:

Through simplifying your workflow, we’ll help you prioritize patient care, without compromising sample integrity.

1st Automatic

By scanning barcodes to link operator, patient, and sample IDs at the bedside, 1st Automatic helps reduce the risk of patient sample mix-ups. It’s the only solution that automates the entire process, from blood draw to test reporting.

ABL analyzer

Radiometer blood gas analyzers have a built-in barcode reader and seamlessly interchange data with AQURE FLEXLINK and LIS/HIS.

safePICO syringes

safePICO syringes are pre-barcoded to facilitate their scanning at the bedside and reduce the risk of patient sample mix-up.
Contamination by venous blood
3/12

Arterial puncture

Perform an arterial puncture, avoiding accidental venous puncture and contamination by venous blood.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

Self-fill syringes

Short-beveled needles increase the likelihood of the needle lying entirely within the arterial lumen. Low venous blood pressure can prevent the syringe from filling, or cause it to fill more slowly, in the event of an accidental venous puncture when using the self-fill syringe.
Contamination by flush solution
4/12

Vascular line sampling

Discard a sufficient amount of flush solution— significantly exceeding the dead space volume— when collecting a blood sample via a catheter, to avoid sample contamination.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

Aspirating syringes

It is essential to carefully follow the procedure for discarding the flush solution before collecting a blood sample from a vascular line.
Contamination by tissue fluid
5/12

Capillary sampling

When collecting a capillary blood sample, avoid milking and applying pressure to minimize contamination by tissue fluid.

How Radiometer products support you:

Simplify capillary blood collection with a precision capillary tube and a BG analyzer designed for small-volume samples, ensuring efficiency and accuracy with minimal blood required.

Capillary tubes

safeCLINITUBES 45, 55, 70, 85, 100, and 125 µL.

ABL90 FLEX PLUS

Up to 19 parameters from 65 µL sample, 17 parameters from 45 µL in MicroMode.

ABL800 FLEX

FLEXMODE starting from 35 µL sample volume.
Air contamination
6/12

Expelling air and sealing the sample

Expel air and seal the sample immediately after collecting to avoid air contamination

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

PICO syringes

When sealing the PICO syringe, use a tip cap with four air channels and a pin to reduce the risk of residual air at the tip.

safePICO syringes

Immediately after collection, seal the safePICO syringe with safeTIPCAP and expel the air.

safeCLINITUBES

Fill the capillary tube to its maximum fill volume, leaving no air inside. Use end caps to seal the sample.
Clotting
7/12

Blood sample anticoagulation

Mix the sample thoroughly to dissolve and distribute heparin in the blood to prevent clot formation. A proper concentration of heparin in blood samples is essential for adequate anticoagulation.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

safePICO syringes

safePICO Aspirator and safePICO A – 80 IU of dry electrolyte-balanced heparin, safePICO self-fill – 60 IU of dry electrolyte-balanced heparin. Mixing ball facilitates effective dissolution and distribution of heparin in the blood sample.

PICO syringes

PICO A - 80 IU of dry electrolyte-balanced heparin, PICO70 and safePICO70 - 60 IU of dry electrolyte-balanced heparin. Heparin on the fiber-based matrix in PICO syringes for dissolution and distribution of heparin in the blood sample.

Capillary tubes

safeCLINITUBES 45, 70, 100, and 125 µL – 70 IU/mL concentration of dry electrolyte-balanced heparin. safeCLINITUBES 55 and 85 µL – 240 IU/mL of dry, non-balanced sodium heparin for particularly challenging capillary samples. The mixing wire facilitates effective dissolution and distribution of heparin in the blood sample.
Cold exposure effect
8/12

Appropriate storage and transport conditions

Transport the sample collected in a plastic syringe or capillary tube at room temperature to avoid preanalytical errors from growing plastic’s permeability to gases and Na+-K+-ATPase inhibition.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

Point-of-care testing

Implementing point-of-care blood gas testing helps avoid the need to cool the sample by placing the blood gas analyzer closer to patient’s bedside.
Ongoing metabolic effect
9/12

Ensuring the shortest time to analysis

Mitigate the ongoing metabolism-related preanalytical error by measuring a sample immediately or as soon as possible, within 30 minutes from collection.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

Point-of-care testing

Implementing point-of-care blood gas testing helps keep the preanalytical phase short, by placing the blood gas analyzer closer to the patient’s bedside.

1st Automatic

1st Automatic can keep the sample age under control, flagging samples measured later than 30 minutes after collection.
Inhomogeneous sample
10/12

Mixing before analysis

Mix the sample thoroughly for a minimum of one minute immediately prior to analysis to restore homogeneity and avoid bias on ctHb.

How Radiometer products support you:

Radiometer’s solution provides automatic mixing, improving the quality of total hemoglobin results, reducing manual tasks, and optimizing workflow efficiency.

safePICO syringes

Each safePICO syringe features a mixing ball rotated by the magnetic field of the ABL analyzer's mixing unit, ensuring efficient automatic mixing in just 8 seconds.

ABL800 FLEX

The FLEXQ module of the ABL800 FLEX analyzer accommodates and scans up to three safePICO syringes, automatically mixes them, and ensures measurement without operator intervention.

ABL90 FLEX PLUS

ABL90 FLEX PLUS analyzer prepares a blood sample in a safePICO syringe for analysis by automatically mixing it in 8 seconds.
Hemolysis
11/12

Preventing factors leading to hemolysis

Avoid the factors that can cause hemolysis, creating positive bias on cK+: too vigorous mixing, aspiration with excessive vacuum or through a too narrow or kinking catheter (needle), accidental dropping of a sample, and contact with ice.

How Radiometer products support you:

Radiometer’s solution offers the tools to optimize quality in the preanalytical phase of blood gas testing.

Self-fill syringes

Self-fill syringes prevent excessive vacuum during blood collection, using the arterial blood pressure as the filling force.

safePICO syringes

Automatic mixing facilitated by the mixing ball in safePICO syringes does not cause hemolysis.

ABL analyzers

Automatic mixing of blood sample in safePICO syringes by ABL analyzers does not cause hemolysis.
Operator hazard
12/12

Ensuring operator safety

Ensure operator safety throughout the preanalytical phase by establishing a standardized policy and use of accessories supporting the mitigation of needlestick injuries, unwanted contact with patient blood, or transmission of bloodborne infection risk.

How Radiometer products support you:

Radiometer's solution is designed to maximize operator safety throughout the preanalytical phase of blood gas testing.

safePICO syringes

With safePICO syringes, you can securely seal the blood sample with safeTIPCAP immediately after collection, eliminating the need to remove it for air expulsion or measurement on the ABL analyzer. Combined with a needle-shield device that prevents needlestick injuries, this protects against unwanted contact with blood.

PICO syringes

PICO syringes incorporate safety features designed to protect the operator from needlestick injuries and unwanted contact with blood, including a rubber cube as a needle receptacle and a tip cap.

safeCLINITUBES

safeCLINITUBES are made of plastic, eliminating the risk of breakage and sharp edges to ensure operator safety.
QUIZ
QUIZ

Test your preanalytical knowledge

Related solutions from Radiometer

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Knowledge sources

How-to videos - guide to blood gas

Watch six educational videos to support you in understanding blood gas analysis.

Watch the videos

Patient blood management

Patient Blood Management is an evidence-based approach to optimizing the care of patients’ blood.

Learn more about PBM
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