Taking Blood Cultures by Syringe

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					                                                                      Wentworth Area Health Service

                                                       Taking Blood Cultures by Syringe

                 Taking Blood Cultures by Syringe
Desired Outcome
    •   Identification of the organisms causing bacteraemia and minimization of the
        contamination of blood cultures by skin flora

    •   To provide guidelines for taking blood cultures

    •   Registered nurses
    •   Medical officers

Indications and Relative contra-indications

    •   For the diagnosis of general bacteraemia, take 2 peripheral venous samples from
        different sites or at different times before antibiotics are started (or changed). If the
        patient is very ill, the two samples can be taken in quick succession before empiric
        antibiotics are given.
    •   If endocarditis is suspected, then a total of three peripheral samples should be
        taken before antibiotics are started.
    •   For suspected vascular line sepsis, take 2 peripheral samples and one line sample.
    •   Do not use peripheral venous or arterial cannulae for the peripheral samples.

In patients with no change in their clinical status and no growth from the first 2 samples,
there is usually no benefit in repeating the blood cultures even if fever persists. Likewise,
successive blood cultures during the first 72 hours of antibiotic therapy will not usually add
new diagnostic information.

Risks and Precautions

Risk                                                Precaution
Cross-infection from the patient’s blood            Standard precautions
Patient discomfort or pain
Haematoma at the puncture site                      Withdraw needle before compressing the
                                                                    Wentworth Area Health Service

                                                     Taking Blood Cultures by Syringe

   •   Tourniquet
   •   Dressing pack
   •   Chlorhexidine 0.5% in 70% alcohol
   •   20ml syringe
   •   21G needle
   •   sterile gloves
   •   1-2 aerobic blood culture bottles and one anaerobic bottle
   •   Pathology request form
   •   Biohazard specimen bag


                   Procedure                                      Rationale
Wash hands thoroughly
Explain procedure to the patient
Expose the patient’s skin site
Apply the tourniquet
Put on the sterile gloves
Clean the site with 0.5% chlorhexidine in 70%
alcohol- move swab outwards in a spiral
direction away from the puncture site
Allow to air-dry completely                       Maximum antisepsis occurs after the
                                                  solution has dried- about 30 seconds
Wipe the tops of the bottles with gauze
squares soaked in the chlorhexidine/alcohol
Use no-touch technique for the venepuncture       Minimize contamination
Draw at least 20mls from the site (but no more    The highest yield is obtained if blood
than 30mls)                                       volume is 20-30mls
Divide the blood between two or more bottles      Use the recommended inoculation
(no more than 10ml/bottle)                        volume for each bottle
Do not change needles between sampling            Minimize the risk of needlestick injuries,
and filling the 2 bottles                         changing needles does not reduce
                                                  contamination rates
Fill the blood culture bottles first if you are   Minimize contamination of the blood
taking blood for other samples
Mix the blood in the bottles (do not shake)
Label the bottles with your own name and the       Don’t put a sticky label on the bar code!
site and the time/date. Minimum patient
details required include full name, DOB, MRN.
Put clinical history on the request form
                                              Wentworth Area Health Service

                                    Taking Blood Cultures by Syringe

AUTHORISED BY    ICU Protocol Committee

COMMITTEE        ICU Protocol Committee

DATE REVISED     March 2004


REVIEW DATE      April 2007

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