High potassium and fist clinching

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A year-old male patient called our laboratory to complain about an increased potassium result of 6. However, the ED laboratory obtained a potassium result of 4. He questioned the high potassium result obtained from our laboratory, which caused him distress and an unnecessary ED visit.

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Even though the root word phleb refers to a vein, the term phlebotomy has evolved to include taking blood from veins venipuncturearteries arterial puncture and capillaries capillary or skin puncture. Phlebotomy can refer to drawing blood to perform laboratory testing or for collecting a unit of blood from a donor. Phlebotomists are those healthcare professionals whose responsibility it is to draw blood samples from patients or units of blood from donors.

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A potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte. Electrolytes are electrically charged minerals in your body that help control muscle and nerve activity, maintain fluid levels, and perform other important functions.

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Minhtri K. Pseudohyperkalaemia is a clinical condition in which there is an artifactual elevation of the serum potassium level due to in vitro release of potassium from blood cells [ 1 — 3 ]. Pseudohyperkalaemia has been reported in clinical settings such as in vitro haemolysis due to mechanical trauma during venipuncture, severe thrombocytosis and leukocytosis, and familial pseudohyperkalaemia [ 4 — 13 ].

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The first thing I would recommend is that you have the blood test repeated. Randy Horwitz, M. For example, clenching and relaxing your fist frequently while your blood is being drawn can elevate potassium.

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British Broadcasting Corporation Home. People who take blood have been warned not to get the patient to tightly clench their fist during the procedure. UK researchers who examinedblood test results found clenching then relaxing the fist could raise potassium levels, potentially confusing results. Raised potassium levels can indicate kidney or heart problems, the Annals of Clinical Biochemistry study said.

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Patient information : See related handout on potassiumwritten by the authors of this article. Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia.

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It is commonplace for clinical staff tasked with blood sample collection to ask patients to make a fist before venipuncture; it reportedly helps by making veins more visible. Patients may also be asked to maintain a clenched fist during the procedure. The results of this small study, which now challenge this practice, suggest that fist clenching immediately before and during venipuncture is a source of preanalytical error for a number of routine clinical chemistry tests. Sixteen healthy adult volunteers were recruited for study.


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