Wednesday June 9, 2010
Collection of Lactic acid and Tourniquet - bedside tip

Monitoring of Lactic acid level is helpful in both identifying potentially serious ill patients as well as identifying in the ICU patients with high morbidity and mortality. Elevated lactate levels may be related to sampling error as a result of recent patient activity, tourniquet use, or delayed sample processing.

When a patient arrives to an ED or ICU and that patient is hypotensive (BP less than or equal to 90 systolic), the nursing staff often starts an IV and if possible draws the patient's initial blood tests off that first IV site. This initial work up by the nursing staff takes 15 -20 minutes before a physician may see the patient.

It is recommended to draw lactic acid without a tourniquet or immediately after applying the tourniquet. If the tourniquet is applied for an extended time, remove the tourniquet and let the blood circulate two minutes prior to retrying the draw. Collect specimen in gray top tube. Invert specimen container gently to mix. Transport on ice. Specimen must be delivered to Chemical Pathology Laboratory within 15 minutes of collection.