Confused about blood drawing from a hand that has an IV line?

Updated | Posted

drawing-blood-from-hand-with-iv-affect-accuracy.jpg.65e43f90aadbc8e24db4e1ea5a57facb.jpg

Hello to you all, since English is not my native language I will try to express myself as good as possible. 

In the Paramedic School, I was taught to never draw blood from a hand that has an IV fluid running because this can affect the accuracy of the blood test results, cause blood that is drawn from a vein that has an intravenous line may be diluted by the IV fluid. 

My question is how does this make sense?? 

In fact, IV fluids enter the whole blood circulation, meaning the hand that contains the IV line, the other hand and the whole body in general. 

Is it gonna make a difference if I draw blood from the other hand? Doesn't it contain the same blood (and the IV fluids) as the other hand?! 

I hope you understood what I asked and please excuse any possible grammar mistakes. 

Rose_Queen, BSN, MSN, RN

Specializes in OR, Nursing Professional Development. Has 17 years experience. 5 Articles; 11,204 Posts

It's because the hand where the IV line is will have a higher concentration of the IV solution. The IV is in a smaller vessel with less flow. It will reach the larger vessels and be further diluted. So no, the blood in the hand without the IV is not the same as the hand with the IV.

Lunah, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 14 years experience. 33 Articles; 13,714 Posts

I once watched someone draw from a vein above a running IV site, and that blood was incredibly diluted! As it turns out, they were drawing from the same vein that the IV was in below. Those samples had to be discarded. Drawing from below a running IV may be okay, if that is the only option. But otherwise it really is best to draw from the other side. 

Good luck in your studies! 

Hannahbanana, BSN, MSN

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB. Has 52 years experience. 1,187 Posts

On 5/29/2021 at 11:24 AM, Demareseitipota said:

I was taught to never draw blood from a hand that has an IV fluid running because this can affect the accuracy of the blood test results, cause blood that is drawn from a vein that has an intravenous line may be diluted by the IV fluid. 

 My question is how is this make sense?? 

Sorry about the drawing quality. The IV fluid enters the bloodstream and mixes with the blood IN THAT VEIN. Yes, it does go throughout the body, but in that vein it’s at its highest concentration. If you sample blood from that vein between the IV and the upper arm (in this picture) you’ll get a diluted blood sample. Draw below the IV, that is, in the hand or wrist (in this example), if you have to, it won’t be diluted there. Better to go to the other arm, though. 

If the IV is running in the hand, you have to go to the other arm fir an undiluted sample. 
Hope this helps.

362AC0A0-CB11-4CC3-80D1-FA60E0C0C10B.jpeg

0.9%NormalSarah, ADN, RN

Specializes in ICU. Has 3 years experience. 242 Posts

If you don’t have a lot of good veins, you can always stop the IV running for about 2 minutes and get an undiluted sample. I do this all the time, and sometimes I have a great PIV that works well and have something running through it. I just stop it running, wait 2 minutes or so, flush it, draw a waste, and then sample through the line, then reconnect my fluids or whatever was running. Or you could simply stop the fluid for 2 minutes and draw on that arm or hand, then restart after your draw.

Caveat: I would NEVER do this if what was running was unsafe to stop or flush into the IV, such as sedation, pressors, etc. 

jnikjoseph

jnikjoseph, ADN, RN

Specializes in New Grad RN. Has 1 years experience. 53 Posts

Once my PCA drew labs on a patient that had D5NS with 20mEq of potassium running in one arm and insulin drip running in the other. I was pretty sure I had stopped the fluids so they could do the lab, but it was apparent I hadn't when the lab called to ask about my patients glucose that was over 1000 and potassium that was 7.something. Drawing from an arm with an IV running definitely makes a difference. 

Nurse DeAnne

Nurse DeAnne, BSN, RN

Has 35 years experience. 26 Posts

This is one of the best threads I have read on here. Thank you all for your input.  I love the drawing! 

On 6/4/2021 at 4:26 PM, 0.9%NormalSarah said:

If you don’t have a lot of good veins, you can always stop the IV running for about 2 minutes and get an undiluted sample. I do this all the time, and sometimes I have a great PIV that works well and have something running through it. I just stop it running, wait 2 minutes or so, flush it, draw a waste, and then sample through the line, then reconnect my fluids or whatever was running. Or you could simply stop the fluid for 2 minutes and draw on that arm or hand, then restart after your draw.

Caveat: I would NEVER do this if what was running was unsafe to stop or flush into the IV, such as sedation, pressors, etc. 

Hi Sarah!

For Peripheral IV, would you get an empty syringe and fill it to 10 ml for lab draw?

 

0.9%NormalSarah, ADN, RN

Specializes in ICU. Has 3 years experience. 242 Posts

On 7/28/2021 at 9:43 PM, Nursingstudent012 said:

Hi Sarah!

For Peripheral IV, would you get an empty syringe and fill it to 10 ml for lab draw?

 

I would waste about 3 - 5 mL out of the IV first, then grab a syringe and fill it with the amount needed. Or, if you have a particularly juicy IV, I’d waste and then connect a vacutainer directly to the clave adaptor/IV port and then connect the tubes to the vacutainer and let them fill themselves. Then flush your IV and you’re done.

eileendg1989

eileendg1989, RN

Specializes in Emergency Room. Has 7 years experience. 18 Posts

You Have to flush, draw back  3 to 5 mls (depending on age of patient) , waste the draw, then draw again for the test, and flush and cap.