What do I do with a blood gas specimen that has no patient identification on the syringe?

Handling an Unlabeled Blood Gas Specimen

You must reject the unlabeled blood gas syringe and request a new properly labeled specimen to ensure patient safety and prevent potentially fatal errors.

Why Specimen Identification is Critical

Proper specimen identification is fundamental to patient safety. An unlabeled blood gas specimen poses significant risks:

1. Patient misidentification: Without proper labeling, results may be attributed to the wrong patient, leading to incorrect treatment decisions 1.

2. Treatment errors: Incorrect arterial blood gas (ABG) interpretation can lead to inappropriate respiratory support, oxygen therapy, or medication administration that could result in increased morbidity and mortality 1.

3. Regulatory and guideline requirements: Multiple guidelines explicitly state that all specimens must be labeled with unique patient identifiers 2.

Proper Handling Protocol for Unlabeled Specimens

When you encounter an unlabeled blood gas syringe:

1. Immediate rejection: The specimen must be rejected and a new properly identified sample requested 2.

2. Documentation: Document the incident according to your institution's protocols 2.

3. Communication: Inform the person who collected the specimen about the rejection and the need for proper labeling 2.

4. No exceptions: Even in emergency situations, patient identification is critical. The risks of misattribution outweigh the delay in obtaining a new sample 2, 1.

Proper Specimen Labeling Requirements

All blood specimens must include:

• Unique patient identifier
• Date of collection
• Time of collection
• Collector's identification 2

Importance in Blood Gas Analysis

ABG analysis is particularly sensitive to proper handling because:

• Results directly impact critical care decisions about ventilation and acid-base management 1
• Specimens have limited stability (typically 30-60 minutes at room temperature) 3
• Preanalytical errors can significantly affect results 3, 4

Preventing Future Incidents

To prevent recurrence of unlabeled specimens:

• Implement point-of-care labeling procedures
• Use pre-printed labels or barcode systems
• Conduct regular training on proper specimen handling
• Consider implementing closed arterial line sampling systems 2
• Ensure independent double-checking of specimens before processing 2

Special Considerations

• Different syringe types can affect blood gas results 5, making proper identification even more critical
• Smaller volume syringes (1mL vs 3mL) can reduce iatrogenic blood loss while maintaining specimen integrity 6
• Proper heparin concentration and mixing are essential for accurate results 4

Remember that patient safety must always take precedence over convenience or expediency. The potential harm from misidentified specimens far outweighs the inconvenience of collecting a new, properly labeled sample.