Opinions on pausing drips before blood draw?

[IheartICUnursing]

Ok, so I know for the most part everyone agrees that you should pause any IV fluids or drips before drawing blood from a line. But do you typically only pause them if they are going into the same line, (i.e same line you're drawing from, just a different port), or do you also pause them if the are running into a totally different line?

What if you are drawing the blood from an art line? I am a new nurse, and my preceptor has had me redraw a lab because she noticed that I didnt have my drips paused. It just seems to me that if all these drips are infusing into a vein, by the time the blood circulates through the heart, lungs, and into the artery that I am drawing blood from that it would be a pretty accurate picture of the make-up of the blood anyways.

I feel the same about drawing blood from, say, the left arm when meds are infusing into the right arm.

I guess its good to be in the habit of pausing meds but I just don't feel its necessary all the time!

Opinions?

[umcRN, BSN, RN]

that really doesn't make much sense. I can understand pausing say TPN if thats the only line you have to draw from, but whether you pause it or not you will be turning the stopcocks in a way that the tpn wouldnt be infusing at the time of the draw, and you would be drawing a pretty good waste with it as well. As far as drawing from an a-line or separate line, really doesnt make sense, especially if your patient is on vital drips ie. vasopressors, sedation, etc

[Da_Milk_of_Amnesia, MSN]

A couple things I learned/ was taught..You should never draw off a port (on a TLC) that was used for TPN/Lipids. Nor should you draw off from the same arm that you have something infusing into.. If your drawing blood from a Triple lumen, I stop the drips quickly because I've had samples come out dilute n they needed to be re-drawn..I've seen this happen if ur infusing thru the medial and proximal ports and you draw off the distal port. If you are drawing from a A-line then you dont have to stop the drips obviously because there should never be anything infusing thru that, nor should it make a difference by the time any medication reaches the arterial side of the system. just make sure you waste enough so ur sample doesn't come back dilute n you're fine.

[ICUenthusiast]

Our policy is to stop all drips afaik. An ABG off the a. line, you don't need to stop. I'm not so sure about labs off the a. line itself though. Specific for heparin, we are supposed to draw off an opposite limb after having the drip off for x amt of time (Idr honestly) unless their veins are just awful.

Now I've had accidentally sent in a lab that I didn't stop all the drips before. One of the drips ran in D5W. My blood glucose was sky high lol... Even tho logically if I draw at a vein lower than where it's infusing there shouldn't be a difference in labs, I stop stuff just in case anyways...

[SummitRN, BSN, RN]

There's no logical reason having the drips on would skew results so long as you are NOT drawing from an immediately adjacent/downstream access/port. In fact, it is arguable that shutting off drips for several minutes could skew your results!

As with many things, I make one logical argument, and am then told "no this is how we are doing it" so I shut up and do what I'm told so long as it is not harmful. It doesn't hurt anything unless you are shutting off pressor or TPN or the like, which you shouldn't. I guess it wastes time and makes the pumps beep. I'd love to see evidence either way

[ckh23, BSN, RN]

I pause them if I'm drawing off the TLC just because it shouldn't take more than 60 seconds to draw off your waste and collect your labs, but leave them running when drawing off the art line.

[detroitdano]

If your hospital utilizes VAMP's, you can hook them into any line for blood draws.

http://www.edwards.com/products/pressuremonitoring/pages/vampsystem.aspx

I always throw 'em on triple lumens or ports. Hit pause on your pumps, draw your waste into the VAMP, get your labs then restart your pumps, then flush the line. There's no fumbling around of syringes full of wasted blood, etc. And if your patient is on pressors at a high dose your momentary pause to do it this way is really, really short.

[IheartICUnursing]

Yes, we do utilize VAMPs with every art line, but no one here has ever used it with a CVC. How convenient! I'm going to run it by our manager to make sure he's ok with that practice (although I see no reason why not) and then maybe we can implement that on our unit, it would be so convenient!

Thanks for the info!

[Biffbradford]

What 'drips' are we talking about? If you have the luxury of stopping life support drips to draw blood, then I don't think you really need them. Drips running + no art line = stick for labs!