Central venous line, blood withdrawal

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Hello,

I'm writing know an assignment about Central venous line, blood withdrawal between discarding the wast specimen " the first 5 cc" or flush it back to the vein In ICU

i want the reasons, why we must not flush it back with a reference or a hospital policy

because i saw many answers told "discard it" with many reasons. But i want it with an evidence, there are no articles that give even a reasons. that's why i'm struggling xD

and thank u all

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Specializes in CICU, Telemetry.

Idk about articles, but here are the reasons I can think of off the top of my head.

1. Blood coagulating in the syringe before you complete your blood draw, and then you inject a 5cc blood clot into your patient and immediately kill them.

2. Keeping the pulled blood sterile.

In ICU if you're concerned about blood loss, draw from an arterial line and use a 'vamp'

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Why would you push it back it in? What is the rationale for pushing it back in? It's 5-10mL. I never push blood back in, for the reason listed above. It can coagulate.

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Thank u

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Why would you push it back it in? What is the rationale for pushing it back in? It's 5-10mL. I never push blood back in, for the reason listed above. It can coagulate.

i'm asking about the rationale for why the nurse swill discard it with an evidence

but thank u

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Rationale def - reasoning behind a decision ... you got two very good ones. Now if you need the scientific proof to prove your statement, it's called google and juried articles. Don't forget to use APA style to site your sources.

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Since it says RN on your title, you must be trying to get your BSN??? Is that why you're writing a research paper?

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Specializes in Critical Care.

It's actually very common to return the waste in the critical care setting, that's what a VAMP does. The main advantage to a VAMP is that the waste remains in a closed system during the process, although this can also be done using two syringes on a 3 way valve.

I would suggest you start with researching iatrogenic blood loss, something we don't always consider as much as we should in critical care.

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Specializes in Critical care.

Here are 22 'reasons' for either why we need to be mindful of iatrogenic anemia, catheter related blood stream infections, and more...oh my!

(Yes, the formatting stinks)

1. Tinmouth, A.T., L.A. McIntyre, and R.A. Fowler, Blood conservation strategies to reduce the needfor red blood cell transfusion in critically ill patients. CMAJ : Canadian Medical Association journal= journal de l'Association medicale canadienne, 2008. 178(1): p. 49-57.2. Vincent, J.L., et al., Anemia and blood transfusion in critically ill patients. JAMA, 2002. 288(12): p.1499-507.3. Barth, M.D., et al., Blood Conservation: What Is Current Blood Draw Practice? Journal of infusionnursing : the official publication of the Infusion Nurses Society, 2013. 36(5): p. 323-328.4. Smoller, B.R., M.S. Kruskall, and G.L. Horowitz, Reducing adult phlebotomy blood loss with theuse of pediatric-sized blood collection tubes. Am J Clin Pathol, 1989. 91(6): p. 701-3.5. Eyster, E. and J. Bernene, Nosocomial anemia. JAMA, 1973. 223(1): p. 73-4.6. Henry, M.L., W.L. Garner, and P.J. Fabri, Iatrogenic anemia. Am J Surg, 1986. 151(3): p. 362-3.7. Andrews, T., H. Waterman, and V. Hillier, Blood gas analysis: a study of blood loss in intensivecare. Journal of advanced nursing, 1999. 30(4): p. 851-7.8. O'Hare, D. and R.J. Chilvers, Arterial blood sampling practices in intensive care units in Englandand Wales. Anaesthesia, 2001. 56(6): p. 568-71.9. Low, L.L., G.R. Harrington, and D.P. Stoltzfus, The effect of arterial lines on blood-drawingpractices and costs in intensive care units. Chest, 1995. 108(1): p. 216-9.10. Yucha, C.B. and E. DeAngelo, The minimum discard volume: accurate analysis of peripheralhematocrit. J Intraven Nurs, 1996. 19(3): p. 141-6.11. Keller, C.A., Methods of drawing blood samples through central venous catheters in pediatricpatients undergoing bone marrow transplant: results of a national survey. Oncol Nurs Forum,1994. 21(5): p. 879-84.12. Holmes, K.R., Comparison of push-pull versus discard method from central venous catheters forblood testing. J Intraven Nurs, 1998. 21(5): p. 282-5.13. Walrath, J.M., et al., Stopcock: bacterial contamination in invasive monitoring systems. HeartLung, 1979. 8(1): p. 100-4.14. Shinozaki, T., et al., Bacterial contamination of arterial lines. A prospective study. JAMA, 1983.249(2): p. 223-5.15. Thorpe, S. and A.N. Thomas, The use of a blood conservation pressure transducer system incritically ill patients. Anaesthesia, 2000. 55(1): p. 27-31.16. Oto, J., et al., Comparison of bacterial contamination of blood conservation system and stopcocksystem arterial sampling lines used in critically ill patients. American journal of infection control,2012. 40(6): p. 530-4.17. Thavendiranathan, P., et al., Do blood tests cause anemia in hospitalized patients? The effect ofdiagnostic phlebotomy on hemoglobin and hematocrit levels. Journal of general internal medicine,2005. 20(6): p. 520-4.18. Salisbury, A.C., et al., Diagnostic blood loss from phlebotomy and hospital-acquired anemia duringacute myocardial infarction. Archives of internal medicine, 2011. 171(18): p. 1646-53.19. Chant, C., G. Wilson, and J.O. Friedrich, Anemia, transfusion, and phlebotomy practices incritically ill patients with prolonged ICU length of stay: a cohort study. Critical care, 2006. 10(5): p.R140.20. Lin, J.C., et al., Phlebotomy overdraw in the neonatal intensive care nursery. Pediatrics, 2000.106(2): p. E19.21. Peruzzi, W.T., et al., A clinical evaluation of a blood conservation device in medical intensive careunit patients. Critical care medicine, 1993. 21(4): p. 501-6.22. Page, C., A. Retter, and D. Wyncoll, Blood conservation devices in critical care: a narrative review.Annals of intensive care, 2013. 3(1): p. 14.

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