Blood withdrawal from peripheral IV

allnurses Guide · Apr 25, 2017

We do it here at my hospital. No policy against it.

Other hospitals may not allow it.

simbaman · Apr 25, 2017

It works great. You check each IV for blood return each shift (q4h if you want to be fancy), why not steal 1 ml of blood for a quick cbc,bmp, or vbg? I would never use a PIV for blood cultures because you will get a false positive result. I would avoid for things like coagulant (lite blue top) or a blood type screen (pink top in most hospitals) because you need more blood for these type of tubes 2.7+mls and unless you have a fast blood return you will be sitting there a while drawing back blood. also don't draw vanc levels off a iv you just ran vanc through. I have yet to blow an IV pulling blood of them and as long as you use your brain the results are good. Many pts can avoid a central line with 1 or 2 well placed 20-18g IVs.

Okami_CCRN, BSN, RN · Apr 25, 2017

I occasionally dabble in IV therapy, and our current policy is that blood can be used for labs from a peripheral IV during placement only. In my experience more often than not people tend to blow their IV's when trying to get blood for a specimen or end up with some degree of hemolysis.

I try to avoid it when possible, but if a patient is a hard stick and their IV has great blood return why not?

Flatline, BSN, RN · Apr 25, 2017

This is what the Infusion Nurses Society Standards of Practice 2016 says on the matter;

D. Short peripheral catheters

1. Consider obtaining a blood sample from an

indwelling short peripheral catheter for pediatric

patients, adults with difficult venous access, presence

of bleeding disorders, and the need for

serial tests. Infusing solutions should be stopped

for at least 2 minutes prior to obtaining the

blood sample; waste 1 to 2 mL of blood before

obtaining the sample. 55-58 (IV)

2. Sampling of blood from indwelling short peripheral

catheters is reliable for many routine

blood tests, including coagulation studies.

Obtaining blood cultures from short peripheral

catheters at insertion or during the dwell is not

recommended. 29,59-61 (II)

3. Obtaining a blood sample during the insertion of

a short peripheral catheter is associated with

higher rates of hemolysis and spurious lab values,

regardless of whether the sample was drawn

directly from the catheter hub or from an

attached extension set. The effect of this process

on the outcome of the catheter is unknown. 4,11,14,24

(II)

4. Veins of the antecubital fossa produce the lowest

rates of hemolysis. However, short peripheral

catheters inserted for infusion into veins of the

antecubital fossa are not recommended due to

higher catheter complication rates in areas of

joint flexion (see Standard 27, Site Selection ). 24

(II)

5. Lengthy tourniquet time and difficult catheter

insertion can produce inaccurate lab values. 13,62

(IV)