Who Draws blood from a-lines??

[bran1101]

i have a question for all intensive care nurses. we are having a debate at the hospital i work at about who can draw blood from an arterial line. in our cardiac intensive care unit, they have in the past allowed the patient care techs to draw blood from a-lines. in the other adult icu's we feel that this is definately wrong and not even covered in the scope of practice of a pct. we have written to our state board of nursing to ask but are awaiting a reply. so i just wanted to get everyone else's opinion on this matter.

thanks!!

[BULLYDAWGRN, RN]

Well, what would be the difference between drawing off a central line? All they have to do is wipe and pull back right???

its alittle more than just wiping and pulling back. that sort of rationalization is why we dont allow unlicened personnel to mess with hemmodynamic lines,ports and configurations.

[hidesert]

dealing with art lines is a nursing responsibility in our unit, there are plenty other things that techs do that keep their plates full besides having to draw art line samples.

I am kind of with you and GIRLvsRN on this one. I would not want a tech drawing from my art line either, and where I work it is only RNs and RTs.

[kimmie518]

its alittle more than just wiping and pulling back. that sort of rationalization is why we dont allow unlicened personnel to mess with hemmodynamic lines,ports and configurations.

That's exactly my point. There IS more than just wiping and pulling back...

[I_See_You_RN]

That's exactly my point. There IS more than just wiping and pulling back...

It IS a little more,.. and that is why they COULD be trained a LITTLE more. Its not rocket science and you don't need a degree to learn how to do it. Just like PCA's can be excellently trained to do phlebotomy (Some PCA's I know of can get peripheral samples a hell of a lot better than some nurses with 25+ yrs experience) I feel like they COULD be trained to draw off of A-lines safely.

As for lines clotting... flush till lines are visibly clear... anything else would be careless. However, there are other reasons why I DON'T think techs SHOULD be drawing off of lines but that has nothing to do with their intelligeance or ability to be trained. Sorta like how nurses cannot get written consent,.. not because their idiots,.. not because they don't understand the procedure, but because there are BETTER reasons why the DOCTOR should be getting consent himself.

My hospital does NOT have techs drawing off lines and I ask why would you NEED a tech to be drawing your labs anyway? In emergency situations or after vent changes you should be hovering around your patient so you should be there to do that anway. And for routine labs.. at some point (hopefully several points) of time during your shift you should be flushing your lines, making sure that they draw back, checking for signs of infection, changing dressings, repositioning hands to get a good wave etc... so the nurse should have plenty of opportunity to draw her own labs anywayz. If you say that you don't have time then you are just slacking and need to learn better time management because that means that you are clearly neglecting other tasks as well.

[Cardiolyte]

woooo, R.N.'s only..

[Reno1978, BSN, RN]

RN's and RT's only.

[CC-RN-EMTP]

We allow our tech's to draw off our A-lines and central lines when they are equipped with the VAMP system. All of our tech's receive training and are re-certified annually on their use. We have had no problems with this. The only samples they are drawing are for glucose checks. It is a real time saver when you have a pt. on an insulin infusion protocol requiring freq. BS checks.

CC

[NtannRN]

Only RN's or Resp. for A-lines, Only RN's for Central lines and only RN's from our IV team for Picc lines. And in extreme cases where there is absolutely no access other than a Vas Cath, The resident (MD) will draw off that. We have fantastic techs, and we have one that if she can't get blood from the stone than no one can but please don't touch my lines.

[HyperTension]

dealing with art lines is a nursing responsibility in our unit, there are plenty other things that techs do that keep their plates full besides having to draw art line samples.

Absolutly... As their primary RN, I am ultimately responsible and accountable for events that happen to the patient. By no means do I desire this next statement to be negative / degrading.... Techs do not have a need to be accessing arterial lines (granted I'm a bit more open to those with the VAMP, but still my premise stands).

If something goes wrong, it falls onto the nurse. A critical patient whose art line has clotted off / gone bad while on multiple pressors / lab draws can really make for a rather interesting time. I'm not keen on a line that has not been capped properly and the patient has now bleed all over the place, or the pressure bag that was replaced and nobody bleed the air.....

Don't get me wrong, a good tech / secretary will completely make your evening, but like anything in medicine there is a limit.

[clarkheart]

RN's only--I am ultimately responsible for that line-not a tech. Where I work only RN's can get blood samples from art and central lines. This makes sense to me--I have the experience to troubleshoot that line not a tech.

[Cinqly, BSN, RN]

It may not be rocket science, but it IS nursing responsibility. You are responsible for the patient and those taking care of that patient. Training or not, A-lines, central lines and all other manner of invasive monitoring require more than just simple technical skills. Our hospital allows RN's to do it, period. I will continue to monitor my own. If anyone else does something, well, I document.

p.s. Forgive me for re-iterating the previous posters... :-)

[Bella RN, BSN, MSN]

RN's and RT's only at my facility. I believe as someone mentioned above that it is out of a tech's scope of practice. Only licensed personnel with training should deal with the art lines.