Frequent Blood Draw Question

offlabel · Oct 2, 2018

Hi All,
I am a former pediatric/neonatal nurse who is now working as a nurse clinical research coordinator. I am trying to help a professor put together a research study in which he wants to get frequent blood samples (healthy adult volunteers). We are talking samples which are 5 minutes apart up to an hour apart (total of 12 samples needed over 8 hours). Our hospital's policy is not to obtain blood samples from an IV, but I know it can be done (this research would be under research, so I could bypass the hospital's policy). My question is: do any of you do that and how successful are you? There will not be anything running through the IV--I would have to figure out when to flush it, so as not to mess with the blood sample. Does this sound like a crazy plan?!
Any advice would be appreciated. Thanks!

Healthy, non-fasted volunteers could just get an 18 ga catheter in a large forearm vein. If it were me, I'd just put short extention tubing onto it with a single stopcock. I'd use a BP cuff for venous occlusion, waste a few cc's, draw my sample, let the cuff down, flush with NS and done. If you're fast enough, you could just re-inject your waste back into the patient to mitigate blood losses. But if they're healthy, they'll tolerate it without any trouble at all.

Policies against sampling off of an IV are to avoid contamination of samples with the IV solution, which you won't have running, so it's moot.

IVRUS, BSN, RN · Oct 8, 2018

Healthy, non-fasted volunteers could just get an 18 ga catheter in a large forearm vein. If it were me, I'd just put short extention tubing onto it with a single stopcock. I'd use a BP cuff for venous occlusion, waste a few cc's, draw my sample, let the cuff down, flush with NS and done. If you're fast enough, you could just re-inject your waste back into the patient to mitigate blood losses. But if they're healthy, they'll tolerate it without any trouble at all.
Policies against sampling off of an IV are to avoid contamination of samples with the IV solution, which you won't have running, so it's moot.

NEVER REINFUSE waste blood. The only time that can be done is when one is performing the MIXING method of blood withdraw.

I do agree, however, with 1 cc waste from the IV catheter and then draw lab(s). Always perform a good mechanical scrub on that needleless connector before accessing it and flush with a good 10cc, or more s/p draw.

offlabel · Oct 8, 2018

NEVER REINFUSE waste blood. The only time that can be done is when one is performing the MIXING method of blood withdraw.
I do agree, however, with 1 cc waste from the IV catheter and then draw lab(s). Always perform a good mechanical scrub on that needleless connector before accessing it and flush with a good 10cc, or more s/p draw.

NEVER? Why not?

CowboyMedic, DNP, APRN, CRNA · Oct 9, 2018

We draw off of our IV's and Central Lines in the unit all the time. Stop all infusions, flush with 10 mL NS, draw 10 mL of waste, and then flush with another 10 mL NS. Also make sure the hub is clean when drawing.

MunoRN, RN · Oct 9, 2018

NEVER REINFUSE waste blood. The only time that can be done is when one is performing the MIXING method of blood withdraw.
I do agree, however, with 1 cc waste from the IV catheter and then draw lab(s). Always perform a good mechanical scrub on that needleless connector before accessing it and flush with a good 10cc, or more s/p draw.

There's no reason, other than quazi-voodoo based myth, not to reinfuse the waste.

adventure_rn, MSN, NP · Oct 10, 2018

Lol, in PICU we almost always give back waste; otherwise, we'd bleed the kids dry.

That said, we try to use a closed system if possible (i.e. drawing waste into a syringe that's attached to a stop cock, then giving it back without ever opening the waste syringe to air. That said, we will draw back as usual into a syringe and give that waste back if necessary (assuming that we keep the tip of the syringe sterile).