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New dialysis nurse - blood collection question

Nurses   (333 Views | 9 Replies)

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With dialysis patients, when drawing blood, do you draw from the venous or the arterial line? 

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If it’s for routine lab orders, you should not be using the dialysis lines for samples. It’s a huge unnecessary infection risk to access these lines and should only be used for labs in an emergency situation or if blood cultures from line are desired.

Strictly answering venous vs arterial - unless it’s a blood gas, either source isn’t highly important. Labs can be run from either. Maybe you’re talking about drawing from circuit? Or? 

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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37 minutes ago, Gingeriffic said:

If it’s for routine lab orders, you should not be using the dialysis lines for samples. It’s a huge unnecessary infection risk to access these lines and should only be used for labs in an emergency situation or if blood cultures from line are desired.

Strictly answering venous vs arterial - unless it’s a blood gas, either source isn’t highly important. Labs can be run from either. Maybe you’re talking about drawing from circuit? Or? 

These days it's not unusual for dialysis patients to have strict 'no peripheral stick' orders, with the existing line being the preferred source, although generally when already accessed for a dialysis run.

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I haven’t encountered this, so thanks for sharing. It’s useful to know what is going on elsewhere.
 

Just to clarify - in these situations (I’m mostly interested in accessing the line for labs if it’s not directly prior to or after a run), what other factors take part? Any precedence given to tunneled vs non-tunneled? Are only dialysis-trained RNs able to access the line for samples? Or is the room nurse able to? 

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7 hours ago, Gingeriffic said:

If it’s for routine lab orders, you should not be using the dialysis lines for samples. It’s a huge unnecessary infection risk to access these lines and should only be used for labs in an emergency situation or if blood cultures from line are desired.

Strictly answering venous vs arterial - unless it’s a blood gas, either source isn’t highly important. Labs can be run from either. Maybe you’re talking about drawing from circuit? Or? 

I work in a dialysis center. We do routine lab collections. Before hooking the patient to the machine, we insert a venous and an arterial line. I’m just curious as to which line I’m supposed to be drawing from. 

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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Look at your company policy. Fresenius is from arterial unless otherwise specified. I have yet to see a lab drawn from the venous access

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9 hours ago, Gingeriffic said:

 

Strictly answering venous vs arterial - unless it’s a blood gas, either source isn’t highly important. Labs can be run from either. Maybe you’re talking about drawing from circuit? Or? 

Dialysis ports are called 'venous' and 'arterial' by dialysis techs and nurses, but in reality both lumens are actually venous. At least for TDCs and Quinton caths. I have no particular experience accessing AV fistulas.

I'm not a dialysis nurse, but I don't think there's any significant difference in drawing from one port versus the other if dialysis is not currently running. 

Of course, you're right about infection risk. 

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2 hours ago, Cowboyardee said:

Dialysis ports are called 'venous' and 'arterial' by dialysis techs and nurses, but in reality both lumens are actually venous. At least for TDCs and Quinton caths. I have no particular experience accessing AV fistulas.

I'm not a dialysis nurse, but I don't think there's any significant difference in drawing from one port versus the other if dialysis is not currently running. 

Of course, you're right about infection risk. 

I’m speaking on patients that have fistulas or grafts, not ports. 

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3 hours ago, Hoosier_RN said:

Look at your company policy. Fresenius is from arterial unless otherwise specified. I have yet to see a lab drawn from the venous access

My company policy doesn’t specify. That’s why I’m confused. We draw from the arterial line on a cvc. Would it be the same for a fistula and graft?   

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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I would ask your direct supervisor or educator if you can't find it in your P& P. I can only answer for the company I work for and don't want to steer you wrong

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