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Blood to measure the level of bloodalcohol will be taken usually by tapping veins. Sometimes vessels are brought with blood diluted by other solvents. It is possible to determine bloodalcohol levels also in these cases.
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For the correct procedure of vein puncture--to collect blood specimens--it is necessary to keep strictly the rules of securing the safety of patient, the one who collects the specimen and also the specimen. The preparation of the patient for the vein puncture, the using of the correct method and vein, the appropriate time of doing this procedure, the using of the sufficient quantity of blood for every blood examination are included to the main elements for the success of the purpose of vein puncture. Another important element for the success of the above procedure is the comfortable and appropriate position of the patient, which gives the blood taker comfort in his work and keeps the patient free from undesirable events. The steps taken after this procedure can help: (a) keeping the vein in a good condition, (b) preventing undesirable events in the point of vein puncture, (c) sending the blood specimen safely to the laboratory, (d) safe disposal of the material used in the procedure. Undesirable events during the vein puncture should be faced immediately. In the newborn children blood specimen is collected from the finger with a different procedure. Also in isolated or mentally ill patients and those under radiation treatment the procedure is different. Those who collect and handle the blood specimens, nurses or laboratory technicians, do face important problems. For the prevention of harmful events special rules must be kept.
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This study was carried out to define the consequences of collecting blood specimens during the forenoon instead of using fasting specimens collected early in the morning. Extensive laboratory data were obtained from specimens collected from fasting participants at 0800, after breakfast at 0930, and again at 1100. The subjects were inpatients in medical and surgical wards (n = 51; 13 women and 38 men; ages, 32-87 years) and subjectively healthy volunteers corresponding to outpatients (n = 51; 31 women and 20 men; ages, 18-63 years). The coefficient of variation (CV, %) of the patient results was compared with the analytical CV. The observed CVs of the subjects' results far exceeded the analytical CV (%), the average being 3.5-fold and up to 14-fold for some analytes. In individual results the observed change often exceeded the medically derived clinical critical difference. Laboratory data should always be interpreted in the context in which they were obtained. Clinical decisions should be based on objective data (observations) more than on experience and educated guesses. Different medical specialities and different clinical situations may require different kinds of procedures.
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This document has been prepared by an ICSH Task Force as a proposed ICSH Standard for Blood Specimen Collection for Reference Values. The procedures described are a model for standardization of blood specimen collection either for people confined to bed, or for those who are ambulant; they are intended for obtaining reference values using the principles described in the ICSH paper on the Theory of Reference Values (Clin. lab. Haemat. 3, 369-373, 1981). The document is based on recommendations by the Committee on Reference Values of the Scandinavian Society for Clinical Chemistry and Clinical Physiology as published in Scand. J. clin. lab. Invest. (35, Suppl. 144, 39-43, 1975); it has been prepared in collaboration with the Panel on the Theory of Reference Values of the Scientific Committee of the International Federation of Clinical Chemistry (IFCC). The responsible authorities of ICSH and IFCC have proposed that it should be the basis for joint recommendations by both organizations.