Help with blood draws--please

[happy place]

I am embarrassed to ask this, but can you draw blood from a saline lock? Or do you need to draw directly from the vein? I've drawn blood many times from the vein, but sometimes my patients have saline locks and I wonder if you can draw blood from them. I know we can from a virgin port, but my patients only have saline locks on the floor. :idea:I am new and this seems like one of those questions that would really make me look dumb at work, so that is why I am asking here

[ChristineN, BSN, RN]

Depends on your facility. Look up your policy. I have worked some places where it is encouraged to draw from saline locks and other places where the nurse's wouldn't dream of it. Technically drawing from a saline lock can risk a diluted sample or a clotted sample. However, if my pt is a very hard stick, I will do it, especially if they have like an 18G or 16G, and just make sure I have like a 3cc discard to try to compensate for the risk of dilution.

[danh3190]

I know when we bring patients into the ER by ambulance they draw blood from our saline locks routinely.

However we are not allowed to draw blood from a saline lock on our floor although occasionally a physician orders blood drawn from the saline lock if there is no other access. Generally we don't have blood returns in our saline locks by the second day anyhow so it's a moot point.

[Caffeine_IV]

We do not do this on the floor. The phlebotomist does the blood draws and nurses draw from central lines.

In the ER (to my knowledge) patients usually have a set of blood cultures drawn from the fresh IV before the connector set is attached (since you have to have 2 sites..this saves a stick).

The only sites that will give me blood return a day or so later consistently are ones in the AC.

[SkiingCait, BSN, RN]

Where I work we can only draw off an IV as it's being placed, before the saline lock is connected. I would definitely suggest checking the policy where you work. Good luck!!

[nurse2033, MSN, RN]

If it's allowed just be sure to draw at least 7ml of blood and discard to reverse flush the lock with blood. This will mostly prevent dilution of the sample. Then of course flush with saline when done.

[happy place]

Thank you to everyone who replied! I am sure we have a policy about it somewhere- I will check on my next shift. Thank you!!

[MassED, BSN, RN]

yep, we draw off lines - discard at least 5 mls, then draw. No reason not too.. .unless you're obtaining blood cultures.

[wooh, BSN, RN]

Once it's been in a while, the catheter "softens" in the vein. In the ED, it's not such a problem because it's just been put in. But later, unless it's a big one, (and sometimes even then), you're at high risk of losing the IV site AND not getting the blood you need.