TOURNIQUET APPLICATION TIME DURING PHLEBOTOMY AFFECTS BIOCHEMICAL TESTING

Introduction: Venous blood sampling is usually performed using a tourniquet to help locate and dene peripheral veins to achieve successful and safe venepuncture. In developing countries like India, there is lack of understanding about good laboratory practices and inadequate training to phlebotomists, compelling them to make errors during phlebotomy. The improper venous accesses or prolonged venous stasis created by tourniquet application will result in collection of unsuitable blood sample. Methods: The present study was conducted at one of the tertiary care hospital at State Capital to nd out the effect of tourniquet application time on 17 common biochemical analytes in 20 fasting healthy adult volunteers. Sequential venepunctures were performed by a single expert phlebotomist either without venous stasis or following the application of standardized external pressure of 60 mm Hg using a sphygmomanometer for 1, 3 and 6 minutes. Biochemical parameters were analyzed on Fully Automated Analyzer Olympus AU 680 by using standard protocol of commercially available kits. Results: ALT concentration was signicantly high in samples collected after application of external pressure for 3min (P<0.05) and 6min (P<0.01); Alkaline phosphatase, LDH, Creatine kinase, Total Cholesterol, Triglyceride, Total Protein, Albumin and Calcium concentrations were signicantly high in samples collected after application of external pressure for 6min (P<0.05) as compared to samples collected without venous stasis. There were no signicant alterations in rest biochemical analytes concentrations (Glucose, Urea, Creatinine, AST, Uric Acid, Phosphorus, Sodium, and Potassium) even after 6 min venous stasis. Conclusion: Venous stasis from tourniquet placement during venepuncture should be minimized, as it accounts for spurious and signicant variations for several biochemical analytes.