Hemolysis Check
The second screening test which should be utilized is the Hemolysis Check.
Checking a patient for intravascular hemolysis is fairly simple: Take a freshly drawn (post-transfusion) blood sample from the patient, centrifuge it, and look at the color of the serum or plasma (red top or purple top; it really doesn't matter which. Just use your normal pretransfusion sample type). As little as 5 ml of hemolyzed blood can give a visible color change; making this test by far the earliest and best way to make the diagnosis of acute hemolysis.
A note of caution, however: While the hemolysis check is very sensitive, it may not always be specific. A sample drawn with a very small gauge needle (like a butterfly) or drawn from an IV line running a hypotonic solution, or any other problem leading to a hemolyzed sample can give you an identical appearance. Remember, this is still a screening test, and when a hemolyzed posttransfusion sample occurs, it should be evaluated in the context of all the other information available to you.
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