probably a dumb question about PIVs and drawing blood...

*canoehead* · Sep 23, 2005, 03:32 PM

I would draw from a peripheral IV if the blood flowed easily. Unfortunately I find that after the line has been in for a few hours I am less likely to be able to get a non hemolyzed sample unless it's a big line in a huge vein, so usually it's easier on the patient and the lab to just use a fresh site. Need to also consider that every time you mess with that site you could lose the IV, so I won't even try to draw if the patient doesn't have great veins.

nursepotter05 · Sep 26, 2005, 10:46 PM

Originally Posted by hrtprncss

hello i'm not a Peds or a PICU RN so I guess this might sound dumb to those that are....But with a running IVF, it's allowed to draw blood samples from the same site as where the peripheral IVF is running? I always thought that there's higher chance of hemolysis among other things that's why we're told not to draw blood from existing peripheral IV's...I mean I do work with alot of 18 or 16 g PIV's with IVF's, r u telling me I've wasted my time sometimes having to stand there with a butterfly looking for the last vein of a hard stick patient when I could have just as easily drawn it from the PIV? I mean yes during insertion I can draw prelim labs but after that I've always thought it was vein sticks...I'm just wondering

Having worked in both Peds ED and Adult Med Surg, I found the adult floor did not allow us to draw labs from an PIV because they said it caused the IV to go bad sooner. In Peds Emergency where I work now, we draw the labs from the PIV if we can get them to draw even if we are infusing fluids. The reasoning is that it is such a huge, dramatic deal for the child to be stuck in the first place, we will not do additional sticks if we can help it! Of course if the IV won't draw, we have to butterfly stick, but we avoid it at all costs of we can help it!!

P.TALLEY · Sep 27, 2005, 09:58 PM

Originally Posted by hrtprncss

Interesting, something new to learn from everyday I suppose, since I work in an environment where patient's almost always have CVC or an Aline, I guess all the years I've worked in the ICU setting, I've never seen one ICU nurse draw blood from a PIV with a mintenance IV going, nor from a hep lock...Personally I would frown if I see someone do this, but mainly because probably of lack of knowledge from the standard of practice that's used in different places in the hospital. Now my question is, for the other ER nurses out there....Is this done in your ER? And for the floor nurses and ICU nurses....Are these done in your unit? What's the thinking behind doing this as oppose to having nurses stick patients then if the patient has a hep lock with a large gauge for drawing labs...Keeping in mind that there is backflow from that heplock....I'm sorry did I just learn to be a good phlebotomist out of a myth? ALL responses would be appreciated.

I AM A 9 YEAR LPN THAT IS ABOUT TO GRADUATE FROM A RN PROGRAM. I WORK ON A PED FLOOR HERE AND I CAN TELL YOU THAT MY BOSS WOULD RAIN HELLFIRE ONTO MY HEAD IF I TRIED TO DRAW A LAB FROM AN EXISTING PIV. IT WOULD NOT MATTER TO HER IF IT WAS BEING USED OR NOT. OUR POLICY IS THAT ONCE FLUIDS ARE ATTACHED TO THE CATHALON THAT IS IT FOR GETTING BLOOD OUT. WE DO TRY TO GET PRELIM LABS WHEN THE IV IS FIRST STARTED BUT AFTER THAT WE HAVE TO STICK OR LAB DOES. SOME OF THESE KIDS ARE HARD STICKS BUT GETTING BLOOD IS EASIER THAN STARTING AN IV SO IF YOU MESS UP YOUR IV THEN WHAT HAVE YOU GAINED EXCEPT CAUSING THE CHILD TO HAVE ANOTHER STICK OR MORE THAN ONE. I FOR ONE WOULDN'T DO IT AND WOULDN'T WANT IT DONE TO MY CHILD.

Ladybug45RN · Oct 12, 2005, 08:27 PM