Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T

•Rapid serum tubes (RST) are less prone to hemolysis vs plasma separator tubes (PST).•Underfilling tubes is a major source of hemolysis from the emergency department.•False positive troponin results were observed in PST but not RST samples. Hemolysis in the emergency department (ED) can significantly delay results and appropriate action. We evaluated the main sources of hemolysis during sample collection, and to evaluate the use of rapid serum tubes (RST) as a transport hemolysis-mitigating measure for high-sensitivity troponin T (hs-cTnT) testing. We examined the effect of tube type, tube fill, types of sample draw and collection methods on hemolysis and hs-cTnT in samples (n = 158) from ED patients. We also compared hs-cTnT values in paired RST and plasma separate tube (PST) samples that were hemolysis-free. The primary source of hemolysis in samples collected in the ED was underfilling tubes. In both tube types, PST and RST, filled tubes showed a median reduction in hemolysis of 69.1 % (p