Sports Medicine and Performance Testing Collections
Course Objectives
- Identify athlete-specific pre-analytical variables that influence draw safety and lab results, including time since last exercise, hydration status, supplement use, and time-of-day consistency, and relay those variables accurately during specimen intake.
- Apply stasis-reduction and vein-selection best practices for athletic patients by prioritizing vein palpation, anchoring mobile or firm veins, selecting a 20–22g needle when indicated, and limiting tourniquet time to ≤60 seconds to reduce hemolysis and vein collapse risk.
- Match specimens to appropriate handling requirements by protecting light-sensitive tubes during transport, placing lactate or other iced plasma tubes on ice immediately when required, and initiating expedited processing or a clinical pause when specimen stability or athlete symptoms present increased risk.
Course Content
Course Creator: Adriana Alley CMA
Total CE Hours: 1 Credit Hour
Pace Course #: 586-2413-25
Course Overview:
This article gives phlebotomists a practical guide to collecting and handling blood samples in sports medicine, where an athlete’s physiology, timing, and performance demands can affect results. It explains how training, hydration, hormones, and recent exercise can influence common sports panels and describes the important pre-collection questions, proper tube selection, and timing considerations needed for accurate testing. The article also addresses collection challenges that are unique to athletes, such as firm or dehydrated veins, and outlines key specimen-handling steps, including preventing hemolysis, protecting light-sensitive samples, and following chain-of-custody procedures. Finally, it emphasizes privacy, legal, and ethical responsibilities, particularly when working with minors, tactical personnel, or high-profile athletes whose results require extra care.
References:
This article gives phlebotomists a practical guide to collecting and handling blood samples in sports medicine, where an athlete’s physiology, timing, and performance demands can affect results. It explains how training, hydration, hormones, and recent exercise can influence common sports panels and describes the important pre-collection questions, proper tube selection, and timing considerations needed for accurate testing. The article also addresses collection challenges that are unique to athletes, such as firm or dehydrated veins, and outlines key specimen-handling steps, including preventing hemolysis, protecting light-sensitive samples, and following chain-of-custody procedures. Finally, it emphasizes privacy, legal, and ethical responsibilities, particularly when working with minors, tactical personnel, or high-profile athletes whose results require extra care.
References:
- Haller, N., et al. (2023). Blood-based biomarkers for managing workload in athletes: Considerations and recommendations for evidence-based use of established biomarkers. PMC10197055. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10197055/
- U.S. Department of Health & Human Services. (1996). Health Insurance Portability and Accountability Act of 1996 (HIPAA). https://www.hhs.gov/hipaa/index.html
- CLSI (2019). Order of Blood Draw Tubes and Additives. https://clsi.org/resources/insights/order-of-blood-draw-tubes-and-additives/
- Bayot, M. L., & Tadi, P. (2023). Laboratory Tube Collection. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK555991/
- Heaton, L. E., Davis, J. K., Rawson, E. S., & Braun, B. (2017). Biomarkers in sports and exercise: Monitoring health, performance, and recovery. PMC, National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640004/
- Nassis, G. P., & Geladas, N. D. (2015). Monitoring training load in athletes: Endocrine and immune responses. International Journal of Sport Physiology and Performance, 10(5), 601–610. https://journals.humankinetics.com/view/journals/ijspp/17/12/article-p1654.pdf
- Hackney, A. C., & Lane, A. R. (2023). Hormonal responses to physical activity: Implications for monitoring and performance. Biomolecules, 14(11), 1418. https://www.mdpi.com/2218-273X/14/11/1418
- Thomas, K. N., Akerman, A. P., Gibbons, T. D., Campbell, H. A., Cotter, J. D., & van Rij, A. M. (2023). The athlete’s vein: venous adaptations in the lower limbs of endurance athletes. American Journal of Physiology – Heart and Circulatory Physiology. https://pubmed.ncbi.nlm.nih.gov/37172076/
- Carraro, P., Zorzi, C., & Plebani, M. (2007). Causes of hemolysis in blood samples: Tourniquet time should be kept to a minimum. Clinical Chemistry and Laboratory Medicine, 45(8), 1061–1065. https://pubmed.ncbi.nlm.nih.gov/19389888/
- Lima-Oliveira, G., Lippi, G., Salvagno, G., Montagnana, M., Danese, E., & Guidi, G. C. (2013). The effective reduction of tourniquet application time after minor modification of the CLSI H03-A6 blood collection procedure. Biochemia Medica, 23(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900072/
- Arch Pathology & Laboratory Medicine Staff. (2018). Preanalytic factors associated with hemolysis in emergency department blood samples. Archives of Pathology & Laboratory Medicine, 142(2), 229–235. https://meridian.allenpress.com/aplm/article/142/2/229/65790/Preanalytic-Factors-Associated-With-Hemolysis-in
- Clinical Pathology Department. (2020). Prevention of hemolysis. In Chemical Pathology Handbook. Hospital UiTM. https://hospital.uitm.edu.my/images/departments/clinical/pathology/download/CES_Sept2020_CP.pdf
- Lippi, G., Salvagno, G., & Guidi, G. C. (2016). Key factors influencing the incidence of hemolysis: A critical appraisal of current evidence. Clinical Chemistry and Laboratory Medicine, 54(6), 937–944. https://pubmed.ncbi.nlm.nih.gov/28013559/
