Blood draw from IVs?

texas2007, BSN, RN · Sep 10, 2008

I know your question was aimed at an adult population, but in NICU we sometimes have no other option to obtain labs than a venous stick. I have never heard of any of these kind of labs coming back hemolyzed...it is always our heelsticks that do so sometimes we will get a followup central K with the venous stick!!!

allnurses Guide · Sep 10, 2008

I've only seen one study, and it was a small one saying there was increased hemolysis with IV draws. (JEN). They also said more studies needed to be done. Did your facility do its own study, and say what percentage is happening, or is someone jumping on the bandwagon of "new evidence based" work?

mmutk, BSN, RN, EMT-I · Sep 10, 2008

I see no problem drawing labs from an IV stick, if the site was prepared properly I also see no problem getting blood cultures x 1 from that stick.

RN1982 · Sep 10, 2008

If my patient has a 18 or 20 gauge angiocath and it draws blood back fine, I use it. I don't see the point in sticking the patient again. I've never had any problems like abnormal test results with it. I flush draw back 5ccs to waste and draw my labs.

vamedic4, EMT-P · Sep 10, 2008

Of all the people who currently DO draw blood from IVs...
Can anyone send me info supporting this practice? Our ED is going to be going from that back to starting IV with 1 (or more) stick, and drawing blood with a separate stick. I have worked in the ED both here and in another far larger hospital for approx 1.5 yrs and have *NEVER* had a specimen from lab have to be redrawn due to it being hemolyzed. Maybe just my luck, but they are saying that hemolyzed specimen are why we are going back to separate sticks... and the only evidence-based practice findings that they can find support the idea that drawing blood from IVs causes hemolysis and inaccurate labs. I agree it happens on occasion but I think it happens from butterfly/needle stick blood draws as well... just can't find documentation to support.
Thanks in advance!!!
-A

Good luck finding studies or info regarding this practice. I have drawn what I needed from IVs to keep from having to stick a second time. It's counterproductive in pediatrics, and anywhere else we're using an "extra" vein that may be needed at another time for IV access.

We routinely draw blood from even the smallest of IVs - 24 gauges, without problems in most cases. In my experience, it's a matter of doing it right that is a problem for many.

As long as you draw back a waste from your IV site to rid your sample of unwanted saline or heparin, your labs will correllate nicely with any venipuncture. That much I know.

ruralnurs · Sep 10, 2008

In my ED we all also draw from the IV if possible. It is even on our standing order for Chest Pain. If you find any evidence based info please come back and post here, I would love to see it too......

SDS_RN, RN · Sep 10, 2008

We also will draw lab if we are starting an IV, if the labs have been ordered. I did however have one time where we only got a small amt of blood back and it hemolyzed, that's the only time I've had it happen thus far. It's always best for the pt if we can save them a poke.

ninisasa85 · Sep 10, 2008

Hey,

Interesting question....however from my instituition, we are not allowed to take it from the IV sites...high incidence of heamolysis. But if come across sucj EBP journals please forward to me.

Thanks.

Larry77, RN · Sep 10, 2008

I work at a few different facilities and one of them has a policy "banning" blood draws from IV starts unless it is a code or trauma situation. I think it's silly and still draw the blood and have had no c/o hemolysis at all.

I hate when management sees a problem and instead of giving people a little education on technique they just fix it by writing a policy "banning" a practice that is very effective if done right.

bullseye · Sep 10, 2008

I would like to see what evidence base research did your facility used to arrived at such ancient policy. When you find the research please share it with me. Bullseye:banghead:

klcrn1987 · Sep 10, 2008

In the ER where I work we draw blood from an IV that we JUST start...if it's an existing IV started by the Medics or if any meds/fluids have run through it...we do a separate stick. So far no problems that I know of.....