A Comparison of the Quality of Blood Specimens Drawn in the Field by EMS Versus Specimens Obtained in the Emergency Department

Introduction

Emergency Department (ED) acceptance of blood specimens drawn by Emergency Medical Services (EMS) staff is not a consistent standard of practice across hospitals. The literature does not address acceptance of pre-hospital phlebotomy specimens drawn by EMS staff. The purpose of this study was to compare specimen redraw rates and ED throughput times for specimens drawn by EMS versus ED staff.

Methods

Data was collected on 400 patients regarding phlebotomist type, intravenous (IV) site, IV angiocatheter size, number of IV attempts producing blood specimens, redraw reason, undue blood exposure to phlebotomist, diagnosis, and length of stay.

Results

In this study of 400 patients (EMS=200; ED=200), the redraw rate was higher for the ED group (11.5%) than the EMS group (9.5%). The primary reason for redraw in the EMS group was insufficient quantity (52.6%; ED=8.7%, p<.05). The primary reason for redraw in the ED group was hemolysis (52.2%; EMS=31.6%). Median ED throughput time was 17 minutes less for the EMS group (163 minutes) than for ED group (180 minutes). There were no incidences of undue blood exposure in either group.

Discussion

Based on no statistically significant differences between the two study groups in redraw rates, a decreased ED patient throughput time, and no undue blood exposure incidences, pre-hospital phlebotomy by EMS in the field and subsequent ED acceptance of samples is a standard of practice that can be implemented.

Key words: Blood specimen collection, Emergency Medical Services, Emergency department, Prehospital emergency care, Length of stay