Hypoxia and hypoxemia describe states of oxygen deficiency: hypoxia is deficiency in oxygenation at tissue or cellular level whilst hypoxemia is a suboptimal normal partial pressure of oxygen. Hypoxia and hypoxemia are interrelated, as untreated hypoxemia will ultimately result in hypoxia.  It should also be noted...

Ever since the landmark document “To err is human” [1] was released, patient safety has been the paramount objective in US hospitals. “Patient safety” became the catch phrase and focus for all activities; a trend that was rapidly taken up by the rest of the world’s hospitals. Suddenly a new catch phrase – “lean” – ...

Hospital do Coração (HCor) in São Paolo, Brazil is a hospital for cardiac patients, many of whom are children and newborns. Cardiac patients are closely monitored with respect to acid base and blood gases, and even the newborns have several arterial and venous blood samples drawn daily. Dr Alberto Duarte from the...

Reprinted with permission from British Journal of Nursing, 2004, Vol 13, No 9.  Arterial puncture is the most common method used to obtain a sample for the measurement of arterial blood gases (ABGs) and is essential to guide the prescription of long-term oxygen therapy (LTOT) in patients with chronic hypoxic lung...

As point-of-care testing (POCT) continues to expand in the hospital environment, the desire of physicians to participate in the performance of testing may increase. This article discusses the required competencies for a physician who wishes to be involved in laboratory testing and some practical considerations for...

Clinical initiatives to maintain blood glucose (BG) within a more normal range have emerged over the last decade as a growing trend in clinical management of patients in acute care settings. This trend has grown due to the increased focus of research in glycemic control (GC) and results indicating that GC is...

The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating glomerular filtration rate (GFR) and prepared recommendations to standardize and improve creatinine measurement. The NKDEP recommends using the estimating equation...

Lack of homogeneity of a blood sample can lead to incorrect results. In this paper, the quality requirements of a sample prior to mixing, the type of samples, sample collection devices and tools and mechanics of mixing will be highlighted. Issues related to the mixing of samples intended for hematological and blood...

Iatrogenic phlebotomy loss resulting from the intensive clinical monitoring in the weeks immediately following birth remains the primary cause of neonatal anemia and the need for red-blood-cell (RBC) transfusion. Reducing RBC transfusion needs in the neonatal intensive care unit (NICU) requires new approaches for...

Capillary blood sampling via a heel lance is the most common procedure performed in hospitalized neonates. Adequate training and supervision of the personnel performing the procedure is necessary to prevent/minimize inadequate sampling volumes, false laboratory results and complications such as pain. Efforts should be ...