Re: Re: one study done on tube system and k

[Guest guest]

Ah but do they drink the sleep medicine and committ suicide. Alas I am killed!May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 24, 2012, at 12:31, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

As you say this is a controled study on one system. Each system results would have to be looked at in the same way. Some may have less effect on k then others. As long as the test tube is full. If test tube not full effect on K is higher.

Might be intersting to have study done on WRJ tube system. BTW at least part of the consistency of a courier system has been addressed.

From the WRJ VA site. We started the year by reintroducing our patients and staff to Romeo and t, a cute couple on wheels. Romeo and t are a pair of automated delivery robots or tugs as we call them in the hospital setting. The tugs navigate hallways, avoid obstacles, and remotely call elevators to deliver lab specimens from the Medical Center inpatient setting to the hospital laboratory for analysis.

> >

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> > Lab Medicinelabmed.ascpjournals.org

> > 1. doi: 10.1309/LMZNZ2Y1P3KRDQYL (2009) LabMedicine, 40, 728-731.

> > Changes of Serum Lactate Dehydrogenase and Potassium Levels Produced

> by

> > a Pneumatic Tube System

> > 1. Ming Cui

> >

> <http://labmed.ascpjournals.org/search?author1=Ming+Cui & sortspec=date & su\

> \

> > bmit=Submit> , PhD1

> > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,

> > 2. Rongrong Jing

> >

> <http://labmed.ascpjournals.org/search?author1=Rongrong+Jing & sortspec=da\

> \

> > te & submit=Submit> , PhD1

> > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> and

> > 3. Huimin Wang

> >

> <http://labmed.ascpjournals.org/search?author1=Huimin+Wang & sortspec=date\

> \

> > & submit=Submit> , PhD1

> > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,2

> > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-2>

> >

> > + <http://labmed.ascpjournals.org/content/40/12/728.full#> Author

> > Affiliations

> >

> > 1. 1Center of Laboratory Medicine, Affiliated Hospital of Nantong

> > University

> > 2. 2Public Health Institute of Nantong University, Nantong, Jiangsu

> > Province, People's Republic of China

> >

> > Next Section

> > <http://labmed.ascpjournals.org/content/40/12/728.full#sec-5> Abstract

> > Objective: Errors in laboratory measurements could be derived from

> many

> > pre-analytical factors. The aim of this study was to assess the

> > influence of the hospital's pneumatic tube system (PTS) on serum

> > lactate dehydrogenase (LDH) and potassium.

> >

> > Methods: Forty-five healthy blood donors were involved. We studied LDH

> > and potassium delivered to the laboratory by a PTS with different

> > carrier inserts and transport times. In addition, influences of the

> PTS

> > sending different types of specimens on LDH and potassium were

> > determined.

> >

> > Results: Blood specimens sent via PTS several times or without carrier

> > inserts had statistical changes in LDH; the potassium had a slightly

> > rising trend. Of the under-filled blood draw tubes or lithium heparin

> > tube specimens, changes were caused by the PTS, but there were no

> > effects on pure serum specimens.

> >

> > Conclusions: Many minor shakings derived from the transportation of

> the

> > PTS inevitably influenced LDH and potassium.

> >

> > Rapid sample delivery systems, usually pneumatic tube systems (PTSs),

> > have been installed in hospitals to transport blood specimens from the

> > phlebotomy site to the core laboratory and deliver patient reports to

> > clinicians. The use of such rapid sample delivery systems can

> > significantly reduce the turnaround times (TATs) of results, which

> > account for approximately 40% in the laboratory median TATs.1

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-1> However,

> > the forces applied on a blood specimen transported by a PTS include

> > sudden accelerations/decelerations, changes in air pressures, movement

> > of blood in the test tube, and vibrations. It should be noted that the

> > strong forces from the PTS can potentially affect some clinical

> > laboratory measurements, such as blood gas measurements,2

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-2>

> > spectrophotometric analysis of cerebrospinal fluid,3

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-3> routine

> > and novel hematology, and coagulation analyzations.4

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-4> In some

> > cases it will induce blood cell deterioration caused by rapid a

> > ccelerations and decelerations along its trajectory.5

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-5> Thus,

> > considering the blood specimen's quality, Sodi and colleagues

> > stressed that all laboratories should investigate their blood

> > specimen's susceptibility to hemolysis when transported through the

> > PTS.6 <http://labmed.ascpjournals.org/content/40/12/728.full#ref-6>

> >

> > The aim of this study was to evaluate the possible changes to the

> levels

> > of 2 sensitive indicators, lactate dehydrogenase (LDH) and potassium.

> > Both easily leak out of the blood cells in blood specimens when

> > transported through the PTS in our hospital.

> > Previous Section

> > <http://labmed.ascpjournals.org/content/40/12/728.full#abstract-1>

> Next

> > Section <http://labmed.ascpjournals.org/content/40/12/728.full#sec-13>

> > Materials and Methods Description of the PTS

> > The PTS (Sumetzberger, Vienna, Austria) installed in our hospital had

> 2

> > subsystems, 52 stations, a constant speed of 6 m/s, and the longest

> > route of 600 m. In our present study, the test specimens were

> > transported by the PTS from the phlebotomy site to the clinical

> > chemistry laboratory, which is approximately 90 m including 17

> vertical

> > and horizontal bends (800 mm radius) and 2 switches. The carriers have

> a

> > diameter of 160 mm and a length of 440 mm. Two kinds of carrier

> inserts

> > (sponge-rubber and plastic-bag) were used for protection during the

> > transportation in the PTS.

> > Specimens and Experimental Design

> > The study subjects consisted of 45 healthy blood donors (21 males and

> 24

> > females, mean age 29 years, range 22–35 years). All subjects gave

> > informed consent to participate in the study. The collection of venous

> > blood specimens was performed by a single venipuncture from the

> > antecubital vein by trained phlebotomists. Two kinds of Vacuette blood

> > collection tubes, 5 mL clot activator tubes and 4 mL lithium heparin

> > tubes, were used in this study.

> > Part 1: Effects of r Inserts and Transport Times

> > A total of 50 mL of blood from each donor was collected into 10

> Vacuette

> > clot activator tubes. Of the 10 specimens, No. 1 was hand carried from

> > the phlebotomy site to the clinical chemistry laboratory (mode H).

> > Numbers 2, 3, and 4 were protected with sponge-rubber inserts (mode S)

> > and transported by the PTS 1 time, 5 times, or 9 times, respectively.

> > Numbers 5, 6, and 7 were protected with plastic-bag inserts (mode P)

> and

> > sent via the PTS for the above times respectively. Numbers 8, 9, and

> 10

> > were transported with no inserts (mode N) by the PTS for the same

> times

> > respectively.

> > Part 2: Effects of Transportation of Under-filled Blood Specimens and

> > Anticoagulated Specimens

> > We obtained 10 mL of blood from each donor. The first 1 mL of blood

> was

> > drawn into a 5 mL Vacuette clot activator tube, and only 20% of the

> tube

> > capacity was filled. Another 5 mL Vacuette clot activator tube was

> > filled with 5 mL of blood, and a 4 mL Vacuette lithium-heparin tube

> was

> > simultaneously filled with 4 mL of blood. Then all 3 specimens were

> > transported by the PTS 5 times with sponge-rubber inserts.

> > Part 3: Effects of Transportation of Serum

> > The amount of 7 mL of blood from each donor was drawn into 2 Vacuette

> > clot activator tubes and allowed to clot for 30 minutes. Pooled sera

> > from the 2 tubes were aliquotted into 3 Vacuette tubes after

> > centrifugation. One of them was hand carried for 1 time; the others

> were

> > transported by the PTS for 1 time or 9 times, respectively.

> >

> > In each part of the study, a standardized procedure was followed to

> > eliminate certain variables: all measurements of each part were tested

> > in the same run; all blood specimens were routinely centrifuged for 10

> > minutes at 2,500 × g; hand carrying was always done by the same

> > person.

> > Sample Analysis

> > Lactate dehydrogenase activity was measured on the Hitachi 7600

> > instrument (Hitachi, Tokyo, Japan) with an IFCC-recommended method. An

> > ISE method was used for measuring potassium levels. The calibration

> was

> > processed with Randox calibrators (Randox Laboratories, Crumlin,

> United

> > Kingdom) in accordan

[Guest guest]

I have been trying to get state weights and measures to certify as accurate dr office's Bp devices. ESP since they have removed the simple cheap and long lasting and easy to calibrate mercury devices. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 24, 2012, at 13:25, <jclark24p@...> wrote:

Maybe the medical profession should implement a certification process

and require the system be recertified every so many years like they do

gas pumps and scales (If that test is as important as that gallon of

gas!) Maybe Obamacare will take care of it once he teaches them to take

proper BP - could save a lot of money and lives if he did that, IMHO!

> > >

> > > [Publisher Logo]

> > >

<http://www.ascpjournals.org/tslogin?url=http%3A%2F%2Fwww.ascp.org%2F>

> > > [LabMedicine] <http://labmed.ascpjournals.org/>

> > > Skip to main page content

> > >

<http://labmed.ascpjournals.org/content/40/12/728.full#content-block>

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> > > <http://labmed.ascpjournals.org/content/40/12/728.full#>

> > > *

> > > Lab Medicinelabmed.ascpjournals.org

> > > 1. doi: 10.1309/LMZNZ2Y1P3KRDQYL (2009) LabMedicine, 40, 728-731.

> > > Changes of Serum Lactate Dehydrogenase and Potassium Levels

Produced

> > by

> > > a Pneumatic Tube System

> > > 1. Ming Cui

> > >

> >

<http://labmed.ascpjournals.org/search?author1=Ming+Cui & sortspec=date & su\

\

> > \

> > > bmit=Submit> , PhD1

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,

> > > 2. Rongrong Jing

> > >

> >

<http://labmed.ascpjournals.org/search?author1=Rongrong+Jing & sortspec=da\

\

> > \

> > > te & submit=Submit> , PhD1

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> and

> > > 3. Huimin Wang

> > >

> >

<http://labmed.ascpjournals.org/search?author1=Huimin+Wang & sortspec=date\

\

> > \

> > > & submit=Submit> , PhD1

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,2

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-2>

> > >

> > > + <http://labmed.ascpjournals.org/content/40/12/728.full#> Author

> > > Affiliations

> > >

> > > 1. 1Center of Laboratory Medicine, Affiliated Hospital of Nantong

> > > University

> > > 2. 2Public Health Institute of Nantong University, Nantong,

Jiangsu

> > > Province, People's Republic of China

> > >

> > > Next Section

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#sec-5>

Abstract

> > > Objective: Errors in laboratory measurements could be derived from

> > many

> > > pre-analytical factors. The aim of this study was to assess the

> > > influence of the hospital's pneumatic tube system (PTS) on serum

> > > lactate dehydrogenase (LDH) and potassium.

> > >

> > > Methods: Forty-five healthy blood donors were involved. We studied

LDH

> > > and potassium delivered to the laboratory by a PTS with different

> > > carrier inserts and transport times. In addition, influences of

the

> > PTS

> > > sending different types of specimens on LDH and potassium were

> > > determined.

> > >

> > > Results: Blood specimens sent via PTS several times or without

carrier

> > > inserts had statistical changes in LDH; the potassium had a

slightly

> > > rising trend. Of the under-filled blood draw tubes or lithium

heparin

> > > tube specimens, changes were caused by the PTS, but there were no

> > > effects on pure serum specimens.

> > >

> > > Conclusions: Many minor shakings derived from the transportation

of

> > the

> > > PTS inevitably influenced LDH and potassium.

> > >

> > > Rapid sample delivery systems, usually pneumatic tube systems

(PTSs),

> > > have been installed in hospitals to transport blood specimens from

the

> > > phlebotomy site to the core laboratory and deliver patient reports

to

> > > clinicians. The use of such rapid sample delivery systems can

> > > significantly reduce the turnaround times (TATs) of results, which

> > > account for approximately 40% in the laboratory median TATs.1

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-1>

However,

> > > the forces applied on a blood specimen transported by a PTS

include

> > > sudden accelerations/decelerations, changes in air pressures,

movement

> > > of blood in the test tube, and vibrations. It should be noted that

the

> > > strong forces from the PTS can potentially affect some clinical

> > > laboratory measurements, such as blood gas measurements,2

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-2>

> > > spectrophotometric analysis of cerebrospinal fluid,3

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-3>

routine

> > > and novel hematology, and coagulation analyzations.4

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-4> In

some

> > > cases it will induce blood cell deterioration caused by rapid a

> > > ccelerations and decelerations along its trajectory.5

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-5>

Thus,

> > > considering the blood specimen's quality, Sodi and colleagues

> > > stressed that all laboratories should investigate their blood

> > > specimen's susceptibility to hemolysis when transported through

the

> > > PTS.6

<http://labmed.ascpjournals.org/content/40/12/728.full#ref-6>

> > >

> > > The aim of this study was to evaluate the possible changes to the

> > levels

> > > of 2 sensitive indicators, lactate dehydrogenase (LDH) and

potassium.

> > > Both easily leak out of the blood cells in blood specimens when

> > > transported through the PTS in our hospital.

> > > Previous Section

> > > <http://labmed.ascpjournals.org/content/40/12/728.full#abstract-1>

> > Next

> > > Section

<http://labmed.ascpjournals.org/content/40/12/728.full#sec-13>

> > > Materials and Methods Description of the PTS

> > > The PTS (Sumetzberger, Vienna, Austria) installed in our hospital

had

> > 2

> > > subsystems, 52 stations, a constant speed of 6 m/s, and the

longest

> > > route of 600 m. In our present study, the test specimens were

> > > transported by the PTS from the phlebotomy site to the clinical

> > > chemistry laboratory, which is approximately 90 m including 17

> > vertical

> > > and horizontal bends (800 mm radius) and 2 switches. The carriers

have

> > a

> > > diameter of 160 mm and a length of 440 mm. Two kinds of carrier

> > inserts

> > > (sponge-rubber and plastic-bag) were used for protection during

the

> > > transportation in the PTS.

> > > Specimens and Experimental Design

> > > The study subjects consisted of 45 healthy blood donors (21 males

and

> > 24

> > > females, mean age 29 years, range 22–35 years). All subjects

gave

> > > informed consent to participate in the study. The collection of

venous

> > > blood specimens was performed by a single venipuncture from the

> > > antecubital vein by trained phlebotomists. Two kinds of Vacuette

blood

> > > collection tubes, 5 mL clot activator tubes and 4 mL lithium

heparin

> > > tubes, were used in this study.

> > > Part 1: Effects of r Inserts and Transport Times

> > > A total of 50 mL of blood from each donor was collected into 10

> > Vacuette

> > > clot activator tubes. Of the 10 specimens, No. 1 was hand carried

from

> > > the phlebotomy site to the clinical chemistry laboratory (mode H).

> > > Numbers 2, 3, and 4 were protected with sponge-rubber inserts

(mode S)

> > > and transported by the PTS 1 time, 5 times, or 9 times,

respectively.

> > > Numbers 5, 6, and 7 were protected with plastic-bag inserts (mode

P)

> > and

> > > sent via the PTS for the above times respectively. Numbers 8, 9,

and

> > 10

> > > were transported with no inserts (mode N) by the PTS for the same

> > times

> > > respectively.

> > > Part 2: Effects of Transportation of Under-filled Blood Specimens

and

> > > Anticoagulated Specimens

> > > We obtained 10 mL of blood

[Guest guest]

Your are right but without an accuate device all else fails. I think we must educate the consumer to the problem until we mandated proper training of all who take BP. ASH does not seem to be too interested in the issue nor the AHA. They are worried about liability if they certify someone and Then they do it wrong will ASH and AHA be liable? Seem not to worry about this for CPR as there is liability legislation preventing this for CPR. But not sure about this. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 24, 2012, at 20:49, <jclark24p@...> wrote:

Why? If the people using the device are not going to use it correctly what difference does it make. You as a FASH and HTN professional should be working on that! IMHO!

> > > > >

> > > > > [Publisher Logo]

> > > > >

> > <http://www.ascpjournals.org/tslogin?url=http%3A%2F%2Fwww.ascp.org%2F>

> > > > > [LabMedicine] <http://labmed.ascpjournals.org/>

> > > > > Skip to main page content

> > > > >

> > <http://labmed.ascpjournals.org/content/40/12/728.full#content-block>

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> > > > > * HOME <http://labmed.ascpjournals.org/>

> > > > > * CURRENT ISSUE <http://labmed.ascpjournals.org/content/current>

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> > > > > Advanced » <http://labmed.ascpjournals.org/search> User Name

> > > > > Password Sign In

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#>

> > > > > *

> > > > > Lab Medicinelabmed.ascpjournals.org

> > > > > 1. doi: 10.1309/LMZNZ2Y1P3KRDQYL (2009) LabMedicine, 40, 728-731.

> > > > > Changes of Serum Lactate Dehydrogenase and Potassium Levels

> > Produced

> > > > by

> > > > > a Pneumatic Tube System

> > > > > 1. Ming Cui

> > > > >

> > > >

> > <http://labmed.ascpjournals.org/search?author1=Ming+Cui & sortspec=date & su\

> > \

> > > > \

> > > > > bmit=Submit> , PhD1

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,

> > > > > 2. Rongrong Jing

> > > > >

> > > >

> > <http://labmed.ascpjournals.org/search?author1=Rongrong+Jing & sortspec=da\

> > \

> > > > \

> > > > > te & submit=Submit> , PhD1

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> and

> > > > > 3. Huimin Wang

> > > > >

> > > >

> > <http://labmed.ascpjournals.org/search?author1=Huimin+Wang & sortspec=date\

> > \

> > > > \

> > > > > & submit=Submit> , PhD1

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-1> ,2

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#aff-2>

> > > > >

> > > > > + <http://labmed.ascpjournals.org/content/40/12/728.full#> Author

> > > > > Affiliations

> > > > >

> > > > > 1. 1Center of Laboratory Medicine, Affiliated Hospital of Nantong

> > > > > University

> > > > > 2. 2Public Health Institute of Nantong University, Nantong,

> > Jiangsu

> > > > > Province, People's Republic of China

> > > > >

> > > > > Next Section

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#sec-5>

> > Abstract

> > > > > Objective: Errors in laboratory measurements could be derived from

> > > > many

> > > > > pre-analytical factors. The aim of this study was to assess the

> > > > > influence of the hospital's pneumatic tube system (PTS) on serum

> > > > > lactate dehydrogenase (LDH) and potassium.

> > > > >

> > > > > Methods: Forty-five healthy blood donors were involved. We studied

> > LDH

> > > > > and potassium delivered to the laboratory by a PTS with different

> > > > > carrier inserts and transport times. In addition, influences of

> > the

> > > > PTS

> > > > > sending different types of specimens on LDH and potassium were

> > > > > determined.

> > > > >

> > > > > Results: Blood specimens sent via PTS several times or without

> > carrier

> > > > > inserts had statistical changes in LDH; the potassium had a

> > slightly

> > > > > rising trend. Of the under-filled blood draw tubes or lithium

> > heparin

> > > > > tube specimens, changes were caused by the PTS, but there were no

> > > > > effects on pure serum specimens.

> > > > >

> > > > > Conclusions: Many minor shakings derived from the transportation

> > of

> > > > the

> > > > > PTS inevitably influenced LDH and potassium.

> > > > >

> > > > > Rapid sample delivery systems, usually pneumatic tube systems

> > (PTSs),

> > > > > have been installed in hospitals to transport blood specimens from

> > the

> > > > > phlebotomy site to the core laboratory and deliver patient reports

> > to

> > > > > clinicians. The use of such rapid sample delivery systems can

> > > > > significantly reduce the turnaround times (TATs) of results, which

> > > > > account for approximately 40% in the laboratory median TATs.1

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-1>

> > However,

> > > > > the forces applied on a blood specimen transported by a PTS

> > include

> > > > > sudden accelerations/decelerations, changes in air pressures,

> > movement

> > > > > of blood in the test tube, and vibrations. It should be noted that

> > the

> > > > > strong forces from the PTS can potentially affect some clinical

> > > > > laboratory measurements, such as blood gas measurements,2

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-2>

> > > > > spectrophotometric analysis of cerebrospinal fluid,3

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-3>

> > routine

> > > > > and novel hematology, and coagulation analyzations.4

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-4> In

> > some

> > > > > cases it will induce blood cell deterioration caused by rapid a

> > > > > ccelerations and decelerations along its trajectory.5

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-5>

> > Thus,

> > > > > considering the blood specimen's quality, Sodi and colleagues

> > > > > stressed that all laboratories should investigate their blood

> > > > > specimen's susceptibility to hemolysis when transported through

> > the

> > > > > PTS.6

> > <http://labmed.ascpjournals.org/content/40/12/728.full#ref-6>

> > > > >

> > > > > The aim of this study was to evaluate the possible changes to the

> > > > levels

> > > > > of 2 sensitive indicators, lactate dehydrogenase (LDH) and

> > potassium.

> > > > > Both easily leak out of the blood cells in blood specimens when

> > > > > transported through the PTS in our hospital.

> > > > > Previous Section

> > > > > <http://labmed.ascpjournals.org/content/40/12/728.full#abstract-1>

> > > > Next

> > &