PIV usage for lab draws - POLL

I always assumed my hospital did not allow blood draws from a peripheral except during initial venipunture; however, I went to the ED to retrieve a MICU alert and witnessed one of the nurses doing it - he used a 16 gauge, at least, but the line had clotted off by the time we got her to the MICU. We never did it in the ICU, M/S, L&D, OR, etc.

(Hospital with all ages).

Echoing DeLana, have only ever seen this done when an IV is initially placed. Otherwise not allowed. This was a tele unit.

In ICU, if the pt doesn't have an arterial line, PIVs are usually the go-to for lab draws. Many pts are very edematous/weepy and just have poor vasculature for a multitude of reasons ultimately making venipuncture especially difficult. We USED to draw labs from central lines but the hospital (not our unit) had an increase in CLABSI so this is no longer permitted without an order from the fellow or attending.

CRBSI risk is increased with hub manipulation. There are no studies comparing central line use with blood draws compared to without. So in a round about way if hubs are not scrubbed properly and changed a least every 7 days you can bet the risk of infection goes up!

If my patient doesn't have a line, I use a peripheral. I've read on here many places don't allow it, but we do. For all the labs I have to draw all the time, sticking somebody that many times a day could be torture for them if I have serial labs or different physicians ordering labs throughout the day.

Some of my patients can be very edematous and it's nearly impossible to do a stick on them. I'm using whatever I've got on them.

Technically you should not use your initial IV for blood draws. The biggest reason is they will clot off quickly if you don't take special care of them so you are going to have to start another sooner. I had a pt who refuse to have lab sticks and we could only get it from his IV. We did it but you should treat it as a CL and flush(depending on meds/IV receiving), as to not interfere with blood test. It still may not last as needed but what else can you do when they refuse..Even the big bosses have to give up on this one!

I don't see the option I agree with - labs can be drawn from a PIV in a pinch, but all infusions have to be stopped and I'd waste at least 5ccs.

I'd never say never - if you need labs right then, the patient is an impossible stick, and you have a peripheral that draws back - some information is better than none. It's not ideal, but if it's your only option you do what you have to do.

It's sort of policy (as in, we generally don't but can in a pinch) at my hospital to not draw off of PIVs but we work in the peds population and it would be great to not have to do q2h sodium levels by constantly sticking a patient. One of the groups in my residency cohort discussed drawing off of PIVs to avoid frequent needle sticks and they had a lot of great rationales and supporting evidence to implement this practice. BUT, we don't want to risk blowing a PIV and having to start a brand new one on a squirrely, anxious 3 yo. It's not ideal. I would love to draw off PIVs and sometimes I attempt it when a needle stick may be crossing a line (i.e. q2h sodium levels).

Labs are routinely drawn off PIVs in the two ERs I've worked in.

The LTC facility I used to work in would allow RN's to draw off of PICCs, but not so in the facility I'm currently at.

We do not ever draw from the PIV. I guess if it were a dire emergency.... If patient had a PICC, only nurses can draw labs from it other wise the lab team does it.

PICU Nurse,

We can use PIVs to draw our labs. We have to pause our meds/fluids, flush our line, draw a waste of at lease 3 cc's (could be more or less depending on the size of the patient) and then draw our labs. We usually return the waste that we draw off of our patients and then restart the meds or fluids. If the PIV is not in use we usually hep lock the IV after we drawn from it. I'm in North Carolina by the way.