Drawing Labs from IV Line

Nurses General Nursing

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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?

Specializes in Oncology; medical specialty website.

We try to draw off a new start if possible; onc. pts. don't have many veins to work with so we try to save them sticks whenever possible. We did the same thing when I worked in the ED.

Specializes in Emergency.

theres no contamination if 5ml are wasted from PIV lines... I always draw from existing lines...

As an E.D. POC tech who has to draw 2nd & 3rd Biomarker samples oneself, I always use existing lines wherever possible (with proper waste, & flush). Sometimes it's not possible. Sometimes I have to ask the tech for that area to try to get a usable sample. Sometimes it's necessary to call Lab to ask for a Phlebotomist, for a 'difficult stick.' And, sometimes, that doesn't work, either.

i've seen a lot of hemolyzed samples from drawing off lines, but maybe the lines were already old.

Specializes in Emergency.

the trick to prevent hemolysis is not to draw with too much negative pressure. If its not drawing with a 10cc syringe, step it down to a 5, and if that doesnt work go down to the 3cc syringe... i rarely have problems drawing off existing lines.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Drawing off PIV line is common practice in many areas of the country. The key is to minimize the risk of hemolysis. I have found gently appling the tourniquet a good distance up the arm and not too tight. Prep the saline lock w alcohol and to use the adaptor and vacutainer just as if you were sticking the needle in the vein. If there is no return sometimes you can get a syringe and gently pull back but the risk of hemolysis increases. If all else fails you still need to do a needle stick but at least the patient knows you tried!

Specializes in ER/ICU/STICU.
the trick to prevent hemolysis is not to draw with too much negative pressure. If its not drawing with a 10cc syringe, step it down to a 5, and if that doesnt work go down to the 3cc syringe... i rarely have problems drawing off existing lines.

I agree. It can be done properly without hemolysis. I do it when ever possible, with the exception of blood cultures. Especially if the pt has a large bore IV such as an #18 or larger and the line is giving back a good blood return. If blood could never be drawn off of IV lines, then why would you be able to draw them from a central line? As long as you waste and do not use too much negative pressure then why not take it from an existing access?

Specializes in acute care med/surg, LTC, orthopedics.
I agree. It can be done properly without hemolysis. I do it when ever possible, with the exception of blood cultures. Especially if the pt has a large bore IV such as an #18 or larger and the line is giving back a good blood return. If blood could never be drawn off of IV lines, then why would you be able to draw them from a central line? As long as you waste and do not use too much negative pressure then why not take it from an existing access?

I've wondered about this myself. We are discouraged from putting a PIV into an ACF because this area is lab's territory, but if they could draw from there it would certainly be convenient, however this isn't done at my facility. Nurses do draw from PICCs but for some reason the lab techs aren't allowed - something I never quite understood, the nurse has to draw PICC blood herself. I'm having a hard time understanding why it needs to be so complicated.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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?

Just like PICC lines you have a waste. Because a PICC is a more invasive procedure some facilities do not allow non nursing personel to be interavtive with the lines. I have found this more common in LTC or the LTAC setting. In acute care settings some facilities have allowed lab, respiratory to access the various central lines for sample purposes ensuring that they have been given competency to do so! which is very helpful to the RN

Specializes in Med/Surg Nurse.

In my facility the RN's draw the labs from the PICC lines - I don't think it has to do with lab not being allowed to but more has to do with lab doesn't have to; lab see's it as if the RN can do then by gosh, they get to do it.

Specializes in acute care med/surg, LTC, orthopedics.
In my facility the RN's draw the labs from the PICC lines - I don't think it has to do with lab not being allowed to but more has to do with lab doesn't have to; lab see's it as if the RN can do then by gosh, they get to do it.

Actually on my ortho floor, the lab techs are physically not allowed. They will come to the RN, remind them pt has PICC and hand back the req. It's not out of laziness - it's just not in their scope, for whatever reason, which I don't understand either.

Specializes in Med/Surg.

Well, I have a simple reply: "It's against our policy." Ha.

In the ED, they will draw off a start only. We do not do that on the floor (I'm not sure why, honestly, but it is what it is).

Someone on this thread (sorry, can't remember who) asked why we can sample off central lines and not PIV's. Well, the end of those caths are in a much larger vessel than a PIV. It's apples and oranges.

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