Blood specimen from iv sites.

  1. Okay so yesterday ,a lady from the lab approached me to draw lab from a peripheral iv site that has been used for days,told her I can't that if it's a newly inserted iv I would,informed my charge nurse and house supervisor and they equally said no.So today ,my unit director asked me why I didn't get blood for lab and I told her the same thing I told d lab lady and she said No,it doesn't matter.So my question is,is it really a good practice to draw samples from an iv that has been in situ for days?
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    About omotee

    Joined: Jan '16; Posts: 32; Likes: 10

    31 Comments

  3. by   brownbook
    The blood is the same blood irregardless.

    Was there IV fluid running?

    Why couldn't the phlebotomist draw blood from another site? If there was a really good reason why it would be very difficult for the phlebotomist to access another site the request may be reasonable.

    If the patient has poor IV access it is reasonable to NOT want the phlebotomist to potentially ruin the only good IV the patient has. If the patient has such poor IV access perhaps they need a PICC or other type of IV access.

    Lots of things to consider. But bottom line the blood is not going to be different or affected because it's drawn from an IV that has been in place a few days.
  4. by   Been there,done that
    This would be covered under existing policy, the big question is why was a peripheral site left in for "days"?
  5. by   brownbook
    Quote from Been there,done that
    This would be covered under existing policy, the big question is why was a peripheral site left in for "days"?
    I can NEVER find old posts on Allnurses...but there was a fairly recent one about what's the longest time a patient has kept the same IV site. Shockingly the evidenced based answers were that the "old" change every three days policy seems to be unnecessary. They can stay in as long as they work and appear okay.

    Hopefully you are better at finding old posts than I am. It was very interesting.
  6. by   Triddin
    Our policy is to keep them in for as long as they work/ have no signs of infection/infiltration/ phlebitis based on the same evidence
  7. by   AnnieOaklyRN
    I agree if it's not a new line, then blood shouldn't be drawn off a PIV, UNLESS the patent is an extremely hard stick and the lab can't get the blood otherwise.

    Drawing off PIV increases infection risk, increase the risk that it will clot off, and more time then not the blood hemalizes anyway!

    Annie
  8. by   Been there,done that
    Quote from Triddin
    Our policy is to keep them in for as long as they work/ have no signs of infection/infiltration/ phlebitis based on the same evidence
    Excuse this oldy moldy. Back in the day... any peripheral site was changed in 72 hours. My thoughts still remain that the chance of infection is present, without obvious signs. Wonder if an infection control nurse could chime in.
  9. by   Wuzzie
    FTR: I only read the abstract but found it to be pretty comprehensive.


    Optimal timing for peripheral IV replacement?
  10. by   MunoRN
    Drawing labs from a peripheral IV, even if it wasn't just inserted, is actually the current recommended practice over drawing from a central line or PICC based on Infusion Nursing Society recommendations. Whether a facility decides to adopt that recommendation is up to them, but it's certainly not generally forbidden as a matter of practice recommendations.
  11. by   MunoRN
    Quote from Been there,done that
    Excuse this oldy moldy. Back in the day... any peripheral site was changed in 72 hours. My thoughts still remain that the chance of infection is present, without obvious signs. Wonder if an infection control nurse could chime in.
    There never was any evidence to support q72 hour changes, the change to IV site rotation based on assessment is because it reduces the risk of complications, since the majority of complications are associated with the insertion of the IV.
  12. by   iluvivt
    Several years ago INS came out with a white paper, backed by evidence ,stating there is no need for routine PIV site changes and site changes should be based on assessment.So if the IV site is good...keep using it! The white paper and its evidence is quite good.
  13. by   omotee
    Thank you,that was what I thought!
  14. by   PeakRN
    We have been drawing off of existing IVs in the ED and Peds for a long time, why it has taken the rest of the adult world so long to catch up is beyond me. There are certain tests that cannot be drawn off of existing IVs (tacro levels, cultures, et cetera), but beyond that there isn't a reason to keep poking the patient for routine testing when the IV draws.

    I would love to see some literature that shows that drawing a sample off of an IV either increases infection risk or failure rate of IVs. Most of the adult IVs we replace upstairs are clotted from the nurses being afraid to aggressively flush IVs rather than from infiltration and certainly not from draws (since our inpatient adults RNs refuse to draw off of IVs).

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