Drawing Labs from IV Line

[abundantjoy07, RN]

Q: What's the easiest way to explain to a patient that you cannot draw blood from their IV line? Usually these lines don't give back blood and trying is futile. I generally explain that a smaller gage IV is placed and pulling back on the line causes the vein to collapse from the pressure, thus no blood return. But this is like talking in tongues. Any easier explanations?

[retiredlady]

You can say that it will clot off and you will have to be stuck with another needle to restart it and maybe more than once and then you will have to be restuck for the lab and sometimes the lab is not correct. Usually this works because they don't like to be stuck several times.

[JStollRN]

I'd probably talk about fibrin tails.

[bill4745, RN]

You can also mention that the blood sample can be contaminated by meds and/or fluid that was infused into the IV.

[littlemammanurse, BSN, RN]

You can also tell them that you don't want to blow their vein, I have seen it happen!

[GHGoonette, BSN, RN]

Blood samples cannot be taken from an IV line because the results will not be accurate.

Explain that it is in her best interest for her doctor to get accurate results so that he can treat her appropriately.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I think the biggest problem with this is that blood is drawn from IV lines on occasion and people don't understand why it can't be done again. I work ER and will often try to draw from a new line,..less than an hour old, after that I explain that once the line has been in awhile it often won't give blood without blowing the vein,..hence another stick.

[Fribblet]

I've drawn blood from IV lines since I've been a nurse. Rarely have I had any problems.

[gonzo1, ASN, RN]

I too draw blood from IV lines, and see many nurses do it. I look forward to seeing the replies to this. Maybe I need to stop this practice.

[ChristaRN]

In my job with the pediatric population we do try to draw from existing IV lines whenever possible. These's little ones are tough sticks for size of vein, amount of veins you can find and also it's difficult to hit a moving target! We find on my unit that when running IV fluids are stopped about 5 minutes before, a good flush is given and an adequate waste is taken we get reliable results. This is a daily practice in all of our pediatric and PICU units. Of course, as IVs get old or in smaller gauge IVs or with IVs in the smallest veins there are times it just doesn't work. 8/10 I am able to successfully draw off of a 22 gauge or larger -24s are also possible in the right conditions. Parents are usually quite understanding when we explain why it sometimes won't work and appreciate us trying first. Now back in my adult nursing years I never drew off of IVs.

[OttawaRPN]

I too draw blood from IV lines, and see many nurses do it. I look forward to seeing the replies to this. Maybe I need to stop this practice.

I have never in my whole 5 years of practice done this, or seen it done, for the very reason Bill and Goonette replied: potential contamination of blood sample.

Anyone know of best practice on this?

[MassED, BSN, RN]

in the ER, we draw off lines - we waste, then draw. Not blood cultures, though. If it doesn't work, then we draw the old fashioned way, but if we can get blood off and not ruin the line, we get it.