How to order blood culture?

AgentBeast, BSN, RN · Jan 7, 2012

Sounds to me like there should be 6 draws? Two from 2 different sites NOW, two from two different sites in 5 minutes from the first draw, and two from two different sites in 10 minutes from the first draw. Unless there is some facility policy that says blood cultures should be done in x fashion I don't see the problem.

That Guy, BSN, RN, EMT-B · Jan 7, 2012

Yeah that order makes me scratch my head too. I write it: Blood cultures from 2 different peripheral sites stat. Unless they want one from a central line I would write it different. But they way it is written now makes it sound like Scott said, that you want them drawn a total of 6 times

GM2RN · Jan 7, 2012

It's been my experience that docs aren't always aware of the correct procedure for things like this, or at least they are unaware of the procedure wherever they are being ordered from. Cultures can be drawn at different times depending on hospital policy, and sometimes it's like pulling teeth to get the lab to deviate from their standard process.

In your position, I would have just drawn them myself once I realized that the phleb wasn't getting it.

vanburbian · Jan 7, 2012

our default order reads similar- BC X 2 q 10 minutes. We all "know" what it means is 2 sets of blood cultures, a set is obviously 2 bottles (aerobic/anaerobic) and the time frame is 10 minutes, so one set now, and one in 10 minutes. The order reads BC x 2, not 3, 4 or more, so I see this as the limiting factor- 2 sets- no more.

Not the most intuitive way to order it, IMO, but hey, I just work there...

netglow, ASN, RN · Jan 7, 2012

6? I'm thinking 4 draws. Cultures like you do in the ER are two sites. So asking for cultures, drawn twice (NOW, and in 5 min.)

glencovediva · Jan 7, 2012

The doctor gave an order for a blood culture,stat, q5 min x 10 min, two different sites. When lab tech saw the order she told me it didn't make any sense to her... So i explained and She still couldn't get it.. She told me that the way they do it is different... It's supposed to be q15 minutes according to her and that blood cultures couldn't be ordered stat because it's a send-out lab work... I told her for the nth time that the stat refers to the blood being drawn STAT and not the actual result of the culture.... It was sooooo frustrating! Are there any other ways a blood culture should be written? Thanks for the help!

As a former Lab Supervisor, you should consult the laboratory procedure manual for you facility on the proper collection. The phlebotomist is a laboratory employee that works under the pathologist's license, and she has to follow laboratory policy and procedure.

LilMissAlwaysCurious · Jan 8, 2012

That's my understanding of how the Md wants it and she just couldn't get it... She just didn't wanna listen from what i can tell... Tsk, tsk...

LilMissAlwaysCurious · Jan 8, 2012

@glencovediva: so, What the doctor ordered is incorrect and i should call her back @0500 to tell her that blood culture should be ordered per hospital policy?

Double-Helix, BSN, RN · Jan 8, 2012

A little off topic here: We only do one set of blood cultures (one site little kids, two big kids) as our policy. What's the rationale for doing four draws (two sets) 5-10 minutes apart?

vanburbian · Jan 8, 2012

A little off topic here: We only do one set of blood cultures (one site little kids, two big kids) as our policy. What's the rationale for doing four draws (two sets) 5-10 minutes apart?

I take a "set" to mean 2 bottles, not 2 sites. It is called a "set" because it is both aerobic and anaerobic, i.e. 2 bottles, from each site.

Why 10 minutes apart, no clue. In reality, in ER, they are often closer to 20 or 30 minutes apart, dependent on how sick the person is and how much staff is in the room.

On kids, yeah- we do one set, and use the mini single bottle with the yellow cap.

Babs0512 · Jan 8, 2012

I agree, I've always drawn an aerobic and anerobic culture - each from a different site. That is a "set", and I haven't been scolded for it in the 17 years I worked in the hospital.