What are signs of specimen hemolysis and what steps minimize hemolysis during collection?

• A. Pink/red plasma; use 22–23 gauge, gentle inversion, avoid excessive suction, and not probing veins aggressively.
• B. Pink plasma only; use any gauge and vigorous suction.
• C. Dark plasma; use 23 gauge and rapid suction.
• D. Dark plasma; expose to air and refrigerate immediately.

Answer: (A)

Hemolysis shows up as pink to red plasma because hemoglobin has leaked from ruptured red blood cells. That pink/red tint is the key clue that the sample has been damaged during collection or handling.

To minimize hemolysis during collection, use a needle of about 22–23 gauge to reduce shear forces, perform venipuncture with a smooth, steady technique rather than probing aggressively, and avoid applying strong suction or overly forceful vacuum during collection. After drawing, invert the tube gently to mix additives instead of shaking, which can also damage cells. These steps collectively help preserve red blood cell integrity and keep the plasma color normal.