Correct way to draw blood? - page 2
I will start off saying I am not trying to find fault with any nurse, but I and my sisters (Which are RNs as well) have never done this, so just trying to figure something out,lol Father has... Read More
Jan 13Is it an IV, or a midline that sometimes looks like a peripheral IV? We can draw blood from midlines, but you'd never know it was a midline unless you looked closely at the tubing. It would look like we were drawing out of a regular IV.
Jan 13When I worked floor/stepdown, we were allowed to draw labs off an IV start before we ran anything and usually after you inserted the catheter but before you connected the pigtail tubing. Alternatively, we were allowed to draw off a midline, PICC or CVC of any kind provided we'd been checked off on the accessing requirements. We had a lot of patients come to use from surg/trauma or neuro ICU and those usually had a temporary central line. Central lines or PICC lines made lab draws for mannitol or heparin administration so much easier. We really liked our PICCs and CVCs for things that were vesicants...not that you don't have to worry at all but there is a lower likelihood of issues there.
Being in the OR now, it's a little different. Almost all of my patients get either an arterial line or a central line (really big, treacherous cases get both). Anesthesia can draw labs off either. No additional stick required, though our patients wouldn't know the difference.
I will say, I was a patient in my facility's ED earlier this year. They drew my labs off my IV before they connected the 6" tubing section. If I recall, that's what our policy says.
Regarding hemolysis of drawing labs through a peripheral IV, I never considered that as the reason. I was always taught that you couldn't do it if the medication you're testing levels for was run through that line you couldn't use it because of the potential to draw back some of the medication perhaps still in the tubing. Also, most peripheral stick sets for venipuncture - butterfly devices, what have you, are 23g or 25g. Most IVs and IV tubings are a larger bore gauge than those devices. Is there something I'm missing here? Maybe it's been too long since I've been a floor nurse...
Jan 13Quote from FurBabyMomAs an ED RN, I do this all the time. What helps this happen is our phlebotomists from the lab usually show up in the patient's room at about the time I'm about to start a line. If I'm successful with the first stick (I usually am) then I do the draw for them right off the catheter and the patient doesn't need to be stuck another time....I was a patient in my facility's ED earlier this year. They drew my labs off my IV before they connected the 6" tubing section...
Jan 20Where I work, you can only take blood from IVs during the first 24 hours it has been placed. After that, you need to stick 'em.
As long as you're flushing the IV first, and then wasting the first lot, you should be getting an accurate reading.
Jan 22We use PIVs to draw labs if possible to avoid additional sticks on our patients. I work on a hematology oncology floor, so our patient population generally have poor veins, and are thrombocytopenic. Usual practice is to flush the line, then waste 5 ml's before obtaining the specimen. Potential exceptions are situations where a patient has a heparin gtt running, and we are drawing a PTT to monitor the infusion rate. Generally in that situation, I will do a peripheral stick from the opposite arm to ensure the specimen is correct. Also, we never draw blood cultures off a peripheral line. As with all things, know your policy/procedures as every hospital/institution is a bit different. Hope this helps!