One consequence of squeezing the puncture site during collection is which of the following?

• A. Hemolysis
• B. Hemoconcentration
• C. Lipemia
• D. Clot formation

Answer: (A)

When you apply squeezing pressure at the puncture site, the force can crush red blood cells as they are drawn from the microvasculature. This mechanical disruption is hemolysis. Hemolyzed samples release intracellular contents into the plasma or serum, which can severely distort many laboratory tests by causing spurious results or interference in analytical measurements. For example, potassium levels can appear falsely high and certain colorimetric assays can be skewed because of pigment released from red cells.

Other possibilities don’t fit this mechanism. Hemoconcentration is more related to prolonged tourniquet use or vigorous fist pumping, which concentrates formed elements and solutes rather than damaging cells. Lipemia stems from high lipid content in the blood and is not caused by squeezing. Clot formation is a function of coagulation and time since collection, not direct mechanical rupture of cells from squeezing.

To get reliable results, avoid squeezing the puncture site and use gentle, proper technique.