blood cultures

[Nurse_AV]

When a physician/practitioner orders blood cultures on a patient who has a central line and an arterial line, do you draw one set from the central and one from the art line? I ask because I am a new ICU nurse (have been a nurse for over 8 years total but just started in critical care a few weeks ago). I have worked in this hospital for over a year and I was taught before that only ONE specimen should come from central/PICC line and not both due to the high risk of contamination of the line. My preceptor disagrees and we drew cultures from a PICC and the second from the art line. Also, I was told not to flush/waste 10mL when doing blood cultures and just to aspirate blood immediately and use that as the specimen. Is this because the flush could wash away potential bloodborne contaminants? My preceptor has been great but she really wasn't sure on both of these questions. Thanks in advance for any help with this!

[IVRUS, BSN, RN]

When a physician/practitioner orders blood cultures on a patient who has a central line and an arterial line, do you draw one set from the central and one from the art line? I ask because I am a new ICU nurse (have been a nurse for over 8 years total but just started in critical care a few weeks ago). I have worked in this hospital for over a year and I was taught before that only ONE specimen should come from central/PICC line and not both due to the high risk of contamination of the line. My preceptor disagrees and we drew cultures from a PICC and the second from the art line. Also, I was told not to flush/waste 10mL when doing blood cultures and just to aspirate blood immediately and use that as the specimen. Is this because the flush could wash away potential bloodborne contaminants? My preceptor has been great but she really wasn't sure on both of these questions. Thanks in advance for any help with this!

Appropriate technique should incliude:

1. If you are not connecting your syringe directly to the female catheter's hub, and you are connecting and drawing through a needleless connector, make sure that the connector is changed BEFORE drawing your cullture.

2. Always remembver to cleanse the top of the Blood Culture bottle prior to injecting blood specimen.

3. Also, using a central line for blood culturing should only be done if it is suspected to be the source of the infection.

4. Do NOT discard the initial "waste", but rather this first draw should be your first specimen. (Don't you want the first draw with the most likely microbes to be part of the assessment?)

[blondy2061h, MSN, RN]

The prescriber specifies their desired site on our orders. We don't do many peripheral cultures at all.