PROCEDURE: DRAWING BLOOD CULTURES | LHSC
Any order for blood cultures should include a MINIMUM of two complete sets of cultures, each drawn from a different draw (e.g., two different venipuncture sites). RNs have a medical directive to order cultures when indicated. Review indications for pan cultures for all new admissions.
Blood cultures drawn at the time of line insertion can be considered “venipunctures.” If the patient does not have intravascular lines, draw two sets of peripheral cultures from two separate draws. For multilumen central venous catheters, obtain blood culture from the distal lumen whenever possible. Select “Blood Culture” as shown below (no “s” on the end of the culture when entering).
Other specimens, such as bronchoscopy samples or CSF samples, can be done STAT (this will provide a gram stain report). CAB (Catheter Associated Bacteremia) assessment is not required if the catheter is being removed. Citrate may have antiseptic properties; a discard sample is required (e.g., for hemodialysis catheters).
How do you take a culture from a central line?
If a culture is being collected from a central venous catheter, disinfect the access port with a 2% chlorhexidine gluconate in 70% isopropyl alcohol impregnated swab, swab for 10 u2013 15 seconds, and allow to dry completely.
How do you draw blood for blood cultures?
- Locate the vein to be used.
- Remove FreppTM from the package.
- Place sponge on selected venipuncture site and depress once or twice to saturate sponge.
- Use a back and forth friction scrub for at least 30 seconds.
How do you take a blood culture from a PICC line?
If the PICC does not give a blood return, flush it with saline and ask the patient to move, take a deep breath, or cough while attempting to get a blood return.
Do you flush central line before drawing blood?
If you need to draw blood from a CVC for culturing, don’t flush it first; instead, draw a sample directly from the hub and inject it into a blood culture vial, discarding nothing.
How much blood do you waste when drawing from a port?
8. Remove 5ml (or the appropriate amount) of blood with an empty 10ml syringe and discard.
Which blood culture do you draw first?
Because the butterfly tubing may contain air, fill the blue (aerobic) blood culture bottle first, then the purple (anaerobic) bottle, as air entering the purple bottle will impede the growth of anaerobic organisms.
When do you culture a central line?
Dialysis lines should also be cultured within 15 minutes, but cultures must be drawn by a nurse who has been approved for CRRT or hemodialysis. For multilumen central venous catheters, obtain blood culture from distal lumen whenever possible.
Why do you draw blood cultures from 2 different sites?
To increase the likelihood of detecting bacteria or fungi if they are present in the blood, two blood samples are usually taken from different veins.
What is the most important step in collecting blood cultures?
The most important part of the blood collection procedure is cleaning the venipuncture site.
What is the best time to collect blood for blood culture?
When a bloodstream infection or sepsis is suspected, blood cultures should be obtained as soon as possible after the onset of clinical symptoms; ideally, before antimicrobial therapy is administered.
What happens if you don’t flush a PICC line?
Infection and catheter occlusion or rupture are risks associated with drawing blood specimens from a PICC if the PICC isn’t flushed properly afterward. However, for patients with severely compromised venous access, the PICC may be the only option for drawing blood specimens.
Why do PICC lines stop drawing blood?
Excessive force can cause a flexible PICC to collapse and obstruct blood flow. On a peripheral vein, you could be pulling the vein wall over the catheter lumen, as shown in this drawing. If slow and gentle doesn’t work, try a smaller syringe.
At what temperature do you take blood cultures?
Blood cultures should be taken on a patient with a clinical suspicion of bacteraemia or candidaemia (temperature >37.9C or other evidence of sepsis), during the investigation of a deep-seated infection such as infective endocarditis or discitis, and on the advice of the microbiologist/ infectious disease specialist.