Dangerous Creatures in Hospital

A patient presents to hospital with an acute, non-specific condition. The doctor decides to take bloods, among which an FBC and U&E. The Little Medical Student gets the job of drawing the bloods.

A few hours later a lab technician calls in a flat spin. The patient’s Potassium is dangerously high. The doctors immediately commence potassium-lowering therapy.

However, a short while later the patient deteriorates. By some miracle, the patient survives when it is noted on a follow-up specimen that the patient’s Potassium is now dangerously low. Yet the therapy given would not have been able to lower Potassium so drastically.

What happened?

We started pathology today. This is an EDTA tube, which is what we use for a full blood count. EDTA prevents clotting by binding calcium. The purple tubes we use, though, also have added potassium.

When the Little (Inexperienced) Med Student drew blood, he/she accidentally allowed the vacuum purple top tube to guzzle all the blood. Not wanting to poke another hole in the sick patient, Med Student unscrewed the purple top tube and poured some blood into the yellow top tube (SST: Serum Separator Tube), which is used to test U&E, such as Potassium. And because the EDTA tube contained Potassium, the blood now has a false high potassium.

This apparently happens regularly. To be honest, the thought had never occurred to me before.

See, Medical Students can be dangerous creatures…

5 thoughts on “Dangerous Creatures in Hospital

  1. Yes we’re dangerous creatures. Even in O.R I’ve seen girls toppling over the instruments table and standing too close to the scrubbed ‘handsome’ surgeons while they operate. In this anecdotal evidence, someone should have overseen him/her though, nothing beats experience.

    1. Thanks for visiting! 🙂
      Medical Students in South Africa aren’t really supervised when drawing bloods because our hospitals are understaffed as it is… but this is a good example in favour of such supervision.

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