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PICU Nursing (Pediatric) /

Intravenous blood draws



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No. 10
from irisRN
Old Nov 15, 2007, 09:09 PM

Default Re: Intravenous blood draws
Most kids in our PICU have art lines...so this is usually not an issue.

If our kids come up from the ED, i know the nurses there will insert two PIVs, one for infusions the other for draws. in this case, they usually put in a 20g or 22g. Drawing from this PIV is usually short term...I've seen very abnormal results from blood taken off a PIV, so its definitely not ideal....it really depends on the situation.

If these kids are very, very ill (as they usually are if they come to us from the ED), their PIVs wont matter, they buy themselves an art line the moment they get up to the unit.
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No. 11
from Semele
Old Nov 16, 2007, 04:13 AM

Default Re: Intravenous blood draws
Originally Posted by irisRN View Post
Most kids in our PICU have art lines...so this is usually not an issue.

If our kids come up from the ED, i know the nurses there will insert two PIVs, one for infusions the other for draws. in this case, they usually put in a 20g or 22g. Drawing from this PIV is usually short term...I've seen very abnormal results from blood taken off a PIV, so its definitely not ideal....it really depends on the situation.

If these kids are very, very ill (as they usually are if they come to us from the ED), their PIVs wont matter, they buy themselves an art line the moment they get up to the unit.
I would never put in a 20g specificly for lab draws, knowing how short term it will be and the possibility of collapsing tiny, obviously needed veins.I will do art sticks or even finger/toe sticks to get the lab rather than using a piv. Plus if one nurse draws from the piv and the next sticks the kid..the parents get very confused about why we would choose to stick when the other nurse didn't.

What policies do you all have regarding drawing from lines? Our facility even requires a doctors order to draw from PICC lines. We do it frequently but only if said order is on the chart.
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No. 12
from xkimmie518x
Old May 24, 2008, 07:42 PM

Default Re: Intravenous blood draws
If the kid has a PIV, we'll try anything to get blood off of it.

Today I turned a kid upside down to get it off a scalp PIV. It was either that, or a tourniquet (but I couldn't figure out where to put it).
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No. 13
from gal220RN
Old May 27, 2008, 07:54 PM

Default Re: Intravenous blood draws
Hi there!

I have found, along with a lot of other posters, that it is very difficult to draw back from a PIV for labs, unless it is right at the time of insertion. I also have found if you have a 22or 20g PIV in an AC you might have a little more success, but it is minimal.

If you have a single PIV for your IVF, meds, blood, etc, I would MUCH rather have a butterfly stick for labs to get what you need. I wouldn't risk loosing your access.

Thank heaven for CVL's, PICC's and PAL's- the PICU RN's best friends!
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No. 14
from preemieRNkate
Old Jun 01, 2008, 09:09 PM

Default Re: Intravenous blood draws
Originally Posted by xkimmie518x View Post
If the kid has a PIV, we'll try anything to get blood off of it.

Today I turned a kid upside down to get it off a scalp PIV. It was either that, or a tourniquet (but I couldn't figure out where to put it).

For scalp IVs, we put the tourniquet lower on the head than the vein that we're aiming for. For example, if it's the vein that runs straight down the forehead, we'll stretch the tourniquet across the forehead (like by the eyebrows). We typically use fat rubber bands for tourniquets, wiped down with an antimicrobial wipe and then cut.

We rarely draw blood off a PIV in the NICU where I work (and when I say rarely I mean never). Sometimes we'll use a new PIV start to collect blood, but we let it drip into a microtainer off the angio before flushing it and hooking up fluids.
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