Connecting for health.

Abstract

British Journal of General Practice, April 2008 time and distance, exacerbating the low temperature effect (unless heated transit vehicles are used). Provision of the phlebotomy service and appropriate sample transport may become an additional responsibility for those GPs who presently have these services provided by the hospital. Figure 1 shows the effect of outdoor ambient temperature and improving phlebotomy technique on the percentage of samples giving significant hyperkalaemia (5.8 mmol/L or higher). Changes to pathology services may be introduced insidiously and GPs need to be aware of proposals that will affect their practice. Automated sample analysis can be performed in bulk on large analysers, but phlebotomy and pre-analytical handling require skill and knowledge. If this is overlooked in planned changes, news of pathology modernisation may be heralded by an epidemic of pseudohyperkalaemia. Periodic assessments of the incidence of hyperkalaemia in GPs’ own practices can yield powerful information. If the incidence of moderate hyperkalaemia (5.8 mmol/L or higher) rises above 0.7% or >9% are above reference range, transport and phlebotomy arrangements should be reviewed.