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 get a blood sample 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.
How do you take a blood culture from a central line?
Here’s how to do it:
- Pull to aspirate 6 ml of blood into the syringe using the same syringe.
- Repeat the aspiration and reinfusion at least three times.
- Remove and discard the used syringe and attach a new syringe to draw the sample for the lab.
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.
Can you take blood cultures from a peripheral line?
Blood culture specimens are frequently collected via peripheral intravenous catheters (PIVs); however, collecting cultures via PIVs rather than dedicated venipuncture may result in higher contamination rates due to the difficulty of adequately sterilizing a collection site when a catheter is present.
Why can’t you draw blood from a PICC line?
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.
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 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 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.
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.
What tube is used for blood cultures?
Isolater tube: 10 mL (adult) or 1.5 mL (pediatric) glass tube containing liquid for mycobacteria, fungus, or AFB blood cultures. Blue top tube with 3.2% sodium citrate: used for coagulation testing and other plasma or whole blood determinations.
What is the most important step in collecting blood cultures?
The most important part of the blood collection procedure is cleaning the venipuncture site.
Why does endocarditis require 3 blood cultures?
Draw 3 to 5 sets of blood cultures over 24 hours to diagnose subacute IE, which helps detect 92-98% of cases in patients who have not recently received antibiotics. In the case of acute IE, 3 sets over 30 minutes (with separate venipunctures) may be drawn to help document a continuous bacteremia.
Should blood cultures be drawn from central lines?
Blood cultures obtained via central venous catheters are more likely to be contaminated by organisms residing in the device itself or device components (i.e., tubing, end caps). b. Arterial lines should not be used for blood cultures.
How many sets of blood cultures are needed?
Most blood cultures should be ordered in three sets (each set containing a pair of aerobic and anaerobic bottles), each containing 10 mL of blood (a total of 60 mL). The following are key principles for blood culture success: 1) Sensitivity is determined by the total blood volume collected before antibiotics.