Admission labs from the cord blood

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Specializes in NICU, NICU air & ground transport.

Hi there,

We are looking to put in place a protocol for drawing our admission labs (usually CBC, CRP, blood culture) from the cord blood. I'm looking for how other places do it...

Does the OB nurse or NICU nurse draw it?

How soon after delivery does it have to be done?

Just swab with antiseptic first?

Best gauge needle to use?

Anything you have would be helpful. Thanks!!

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Specializes in NICU, PICU, educator.

We don't do this where I work, but you would have to clean it just the way you would drawing it from the baby I would assume.

I know now if we wanted blood from the cord our L/D would make us draw it and take it with us for labeling. And it would probably have to be done relatively soon so clots wouldn't form or it get sent to patho or the placenta fridge.

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Great video if this is something you're considering. I did a literature search on this same issue, and Dr. Carroll from Intermountain Health actually published the protocol they use in their facilities. If you send me a PM I can try and send it to you (it's a PDF).

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Specializes in NICU.

^ The video above is a great resource to use. I actually helped write the policy for my unit for doing cord blood admission labs. We just started implementing it. I also did an extensive literature review on the topic for school. I think whether the NICU nurse or L&D nurse draws the labs will be specific to your hospital and their policies. For us, the NICU nurse draws them. We aim to get the labs within 10 minutes of delivery of the placenta. We swab with chloraprep, that video uses betadine... Either is good. We always use a 20 gauge attached to a 10 ml syringe, and like the video said we insert with the bevel UP! Let me know if you have any other questions or would like information on some of the research.

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Specializes in Reproductive & Public Health.

Sometimes we will double clamp a good length of cord to allow for more....leisurely? collection of venous and/or arterial cord blood, if the situation warrants (maybe a depressed baby who you want gases on, but mom is hemorrhaging so no time for fussing with labs). The blood stays fresh for a surprisingly long length of time, although of course if you are doing anything other than routine cord blood collection, then you want those labs drawn up as soon as possible.,

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Specializes in NICU, NICU air & ground transport.

Yes I'd love the PDF... I just need to make a few more posts apparently in order to have the ability to PM. You need like 15 or something :-S Can you PM me? Thanks a million!

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Specializes in NICU, NICU air & ground transport.

Yeah I guess I never heard about drawing right off the placenta. I assumed the OB would cut us a good length of cord, and we'd draw it off...or make the OB nurses :-p I showed one of our neos the video, and he had a confused look and his face and said we should just draw from the cord. We only need 3ish mLs. Any thoughts on this?

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Specializes in NICU, NICU air & ground transport.

Also, what labs can and can't you get from the cord blood?

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Specializes in NICU, NICU air & ground transport.

micropreemienurse did you mean bevel DOWN like the video? Would you be willing to share your policy? Thanks guys!

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Frustrating...since I don't have 15 approved posts I can't send a message :(

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Specializes in NICU.

HI there, my hospital is looking into this topic. We would love other protocols or policies to review. Any help would be greatly appreciated!

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