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Drawing Lab Samples from Hickman Lines

Nurses   (11,057 Views 13 Comments)
by rnewmanjunkie rnewmanjunkie (New Member) New Member

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Our hospital is trying to solve a dilemma. We use a syringe to draw lab samples from a Hickman line then attach a needle and transfer the blood to the vacutainer tubes. We have an increase in clotted samples and it was discovered that some of the nurses are drawing the sample, laying the syringe to the side, flushing the line then attaching the needle and transferring the sample to the tubes. Is there a better way to collect these samples? Does anyone use a device to draw blood straight from the line and into the tube? We are trying to find a way to bypass the syringe/transfer step. Thanks!!!!!!!

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6,487 Posts; 21,375 Profile Views

Yes, a vacutainer transfer device that labs use. The little yellow plastic tube with the needle inside of that. If there's a needle on the outside it can be removed and the 'tainer luer locked to the end of the line. Put your blood tube inside the plastic yellow thing and push it onto the needle and voila!

The other option is to transfer it to tubes as soon as it's drawn. The line is not going to clot off right away.

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Myxel67 specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

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We used a yellow plastic device that accessed the catheter--I believe it was a leur-lock screw on.. Then the blood tubes are pushed down into the device and onto a needle that punctures the tube top. Vacuum draws in blood. I always used these when I worked in CCU. Many of the nurses weren't accustomed to them so did not use the.

I can't remember the brand, but it our Pyxxis it was a catheter blood collection adapter.

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Myxel67 specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

463 Posts; 5,375 Profile Views

We used a yellow plastic device that accessed the catheter--I believe it was a leur-lock screw on.. Then the blood tubes are pushed down into the device and onto a needle that punctures the tube top. Vacuum draws in blood. I always used these when I worked in CCU. Many of the nurses weren't accustomed to them so did not use the.

I can't remember the brand, but it our Pyxxis it was a catheter blood collection adapter.

http://www.vanishpoint.com/Simple4.aspx?PageID=137

If link works--it looks like the big blue thing on far right, but instead of needle, there was a leur-lock to connect to CVC port. There was a short needle inside the adapter that pierced the vaccutainer tube when you pushed it down into the adapter.

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Myxel67 specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

463 Posts; 5,375 Profile Views

computer has hiccups again--sorry

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6,487 Posts; 21,375 Profile Views

I think we got the message, Myxel!! :rotfl:

That's the same thing I'm talking about, I think it's made by B-D

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brent_25 is a RN and specializes in Med/Surg, IV therapy, Emerg, Peds.

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HI all - I agree with all of the responses thus far - I just wanted to add that I am aware of 2 different 'systems' for this - the yellow vacutainer and the needle is usually a 2 piece system - where you would add the needle to the vacutainer by screwing it in - then removing the cap and luer locking one end into the cap on your Hickman (this is assuming that you have some sort of positive pressure cap with a luer lock end on it). But - an even better system that I am used to using is a one piece vacutainer (with the needle already inserted) that works great - of course anytime we add a needle to anything - we are increasing the chance of a needle stick injury..so this device eliminates the chance of this..They also make a 'syringe transfer' vacutainer that eliminates the need for a needle all together - it allows you to manually draw off the blood into a syringe - and then luer lock the syringe onto a 'female' ended vacutainer directly - and insert your vials into the vacutainer - no needle! Again - this assumes that you have some sort of cap on the end of your Hickman that allows you to luer directly onto the cap..I'm not 100% sure of the company that manufactures these vacutainers - I think it's BD.

Hope that helps!

Brent

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Altra is a BSN, RN and specializes in Emergency & Trauma/Adult ICU.

6,255 Posts; 40,286 Profile Views

I agree w/what's been posted so far - it will get the job done. But our hospital policy does not allow the use of vacutainers w/PICC lines. When we draw from a PICC, we use a syringe 10mL or larger - anything smaller, including the vacutainers, exerts too much pressure on the line ... or so we're told.

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Myxel67 specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

463 Posts; 5,375 Profile Views

I think we got the message, Myxel!! :rotfl:

That's the same thing I'm talking about, I think it's made by B-D

I didn't see your post until now--I'm just a slower typist or write longer notes!. Just came back online.

MYX

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brent_25 is a RN and specializes in Med/Surg, IV therapy, Emerg, Peds.

20 Posts; 1,330 Profile Views

My 2 cents again..at my hospital (every institution has different policy of course) I work on the IV team and we do all the blood draws from lines - we draw from all lines - groshong ended or open ended (we use Bard lines) - and Bard states that it is ok to draw blood from all lines (groshong included) - this includes percutaneous, PICC's, Hickmans, IVAD's etc..and we have had no problems using vactainers on our PICC's. It is recommended that with groshong style lines, or lines that have a valved cap (positive pressure cap) that you flush with at least 20-30cc NS post blood draw to clear the valve of blood.

Brent.

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