Intravenous blood draws

What kind of information are you looking for aleanth?? We draw blood from PIVs here...I'm just wondering what it is you are needing to know.

vamedic4

I would like to know what size IV you use and the procedure for drawing off the IV's i have found half the time I am unable to get blood return

I don't often have much luck drawing from an established PIV either. The ones I have the best luck with are the 20's, but of course they'd be in bigger kids, and usually have other options. Thank the lord for art lines, PICCs and CVCs!

In the NICU (I'm responding here bc sometimes you have babies in PICU) we never withdraw once an IV is in, but on initial insertion of a 24g (all we use) if we need blood we'll let the backflow drip out and fill the microtainers, or sometimes put a small needle on a syringe and aspirate the backflow from the, um, wider part of the... you know, the cone-shaped bit behind the catheter? But we never directly draw off a PIV. FWIW, a variation on that trick can work with a pokey P-Art line - stick a 23g needle in the port on the T-connector (or wherever you would normally draw your bloods from), attach another needle to a syringe, and aspirate up the drips. Sometimes you can use an art line for an extra shift or two that way.

The only time I attempt to draw off a PIV is if the pt has an 18 or 20 gauge in, however if they are a difficult stick, I leave it alone and only have my IV fluids and meds going through. Art lines, PICCS and CVLs are the best places to draw. SOmetimes if the pt is going to be in the PICU for a while I will ask for a CVL or Art line to be placed

Drawing blood off small (24 gauge) catheters can be done, but it's tricky. And you have to weigh the benefits and risks.

Do we need this blood bad enough to risk losing the IV?? Is it going to be difficult to establish other access if we ruin this IV by drawing blood from it??

If you HAVE to do it, flush it with some saline first. Then tie a tourniquet above the IV site as you would if you were starting an IV. Get yourself a 5 cc syringe and a needleless catheter (the larger the hole the better) or a 23 gauge needle. Draw off at least 2-3 cc of waste and get rid of it. Then get a fresh syringe and needleless device or needle and draw off only as much as you need to do your testing. Don't forget to flush the IV again with saline and heparin per your institution's policy.

You occasionally have to manipulate the IV site while drawing blood, so this procedure is DEFINITELY not adviseable on patients who's IVs are "iffy" at best, or if you are one breath away from breaking open a crash cart on them.

vamedic4

I am in the float pool. We draw from any PIV that will. Depending on the situation I may attempt to draw from a 24g but those are risky. We use mostly 22g and it just depends some nights when I am doing IVT they all draw, some nights none of them do! It saves a lots of tears, pokes and time!

I will only draw from the initial stick, like others have said. There is usually a good reason for the iv and it needs to be maintained over lab draws. Besides a heel stick or finger stick can get most of what is needed.