Question about PICC draws

[qbanmom]

I am a new nurse and just started working nights. Night RNs are responsible for am labs. I know that my preceptor told me to draw blood into a 10 or 12 mL syringe then transfer into a tube. I haven't seen anyone do it but have been told by several nurses that they dont use a vacutainer on the syring to transfer blood into the tubes but they use blunts. When I tried the other day, after I finished flushing and changing the cap, I put the needle into the tube and the blood wouldnt go in... I feel really dumb..did it clot or something? I had to draw again with a vacutainer and it worked though I have been told I should use a syringe due to the pressure and possibility of hemolysis. What did I do wrong.

[Asystole RN]

Keep in mind that Vacutainer is the brand name for an entire line of products from BD. Vacutainer products can range from the actual collection tubes to butterfly collection sets to transfer devices etc.

Now most likely, which is not uncommon, you simply had a bad tube that lost it's suction or had insufficient suction in the beginning. If you don't puncture the tube fast enough with a blunt the tube can lose suction that way too. Now if you pulled the blood, changing the needleless access device and flushed prior to transferring the blood it very well could have clotted.

Personally I like to draw, then connect a 10mL flush and flush. I then transfer the blood using a Vacutainer transfer device. Once the blood has been transferred into the sample tube I then follow that initial flush with a needleless access device change and an additional flush.

Try to get the blood into the sample tube as fast as possible to avoid clotting and possible hemolysis.

If the tube does not have suction it is probably best to discard and use another.

Asystole RN, CRNI, VA-BC

[brithoover]

Why don't you use a vacutainer to transfer blood to the tube? This is the easiest way I know of

[Anna Flaxis, BSN, RN]

I agree with Asystole, either you had a faulty tube that had lost its suction, or the blood had clotted. A blunt needle should work just fine. You should be able to tell if the blood is clotted in the syringe. If it doesn't appear clotted, try another tube. I agree with getting your blood tubed as quickly as possible. You definitely want to flush your line, at least with one flush syringe, but other things like hooking up IV fluids or giving meds should be done after you've tubed your blood.

[KelRN215, BSN, RN]

I am a new nurse and just started working nights. Night RNs are responsible for am labs. I know that my preceptor told me to draw blood into a 10 or 12 mL syringe then transfer into a tube. I haven't seen anyone do it but have been told by several nurses that they dont use a vacutainer on the syring to transfer blood into the tubes but they use blunts. When I tried the other day, after I finished flushing and changing the cap, I put the needle into the tube and the blood wouldnt go in... I feel really dumb..did it clot or something? I had to draw again with a vacutainer and it worked though I have been told I should use a syringe due to the pressure and possibility of hemolysis. What did I do wrong.

I have always done it the way your colleagues are doing it. I have never connected a transfer device directly to a PICC line.

I usually use a Vacutainer transfer device with the female Luer lock on it to connect to the syringe.

If I don't have one handy, I use an 18 ga needle; I never use a blunt-tip because they're hard to pop through the rubber membrane.

Needles can be used safely under the right circumstances but the Vacutainer transfer device is, by far, your best choice.