why no tylenol before blood cultures drawn?

allnurses Guide · Dec 31, 2004

Must admit, I have never heard of witholding tylenol before obtaining blood cultures, but practice here is often quite different to the States!
However, I had a quick look on the internet and every article I read, all said the same thing... no special preparation is required before blood cultures. One article stated that initiation of antibiotics should be withheld until blood cultures are drawn, reasons are pretty obvious. It may be that Tylenol is withheld initially, so that the doctor can get a full clinical picture, but once he has examined the patient and has an accurate temperature, I dont see why tylenol should be withheld before blood cultures are drawn
However, I think if subsequent antibiotics are deliberatley withheld in order that blood cultures are drawn, then the antibiotics levels could well fall below therapeutic levels, which is clearly not in the patients best interests
Withholding tylenol could well be one of those myths that are in all hospitals. It had a theory one time, but with advances in medicine, practice just hasn't caught up! Its a thought anyway.
Anyone know an Infection Control Nurse they could ask?

I think you may be right on with your thought that this could be one of those myths.

We need a snopes.com for med myths!!!!

steph

CritterLover, BSN, RN · Dec 31, 2004

i spent several years working in a level i trauma icu. we always did the cultures before the tylenol. never made sense to me, either. when i finally asked one of our fellows about it, she said that we wanted to get the culture sample when the bacteria were the most metabolically active, which was when the fever was the highest.

Katnip, RN · Dec 31, 2004

I've never withheld Tylenol for a culture. Heck, we will give Tylenol in triage before a doc even sees the patient if the fever is high enough.

SusanJean · Dec 31, 2004

Per the doc in my living room, it is not that big of deal...

OriginalWmn · Dec 31, 2004

The first facility I worked in held tylenol before cultures. HAven't seen this is any of the subsequent facilities I've worked in.

jaimemds · Dec 31, 2004

maybe tylenol reacts with the preservative in the vial, therefore affects hemolysis rendering the test inaccurate?

jeepgirl, LPN, NP · Dec 31, 2004

i have never heard of holding the tylenol before drawing BC. now, I have heard this for antibiotics.

at our facility, we take the kids temp immediately prior to drawing the culture. maybe if you give the anti-pyretic you are obscuring the "whole picture."

maybe the docs want to see what their temps are before getting cultures and starting treatment. just one piece of a big puzzle used to see if the kid is getting better or worse.

DutchgirlRN, ASN, RN · Jan 1, 2005

I've never heard of holding Tylenol until after cx are done--I don't understand how treating the fever would interfere with finding the source?

We have an infection specialist physician at work who is awesome. I probably won't see him until next Thursdsay but when I do I'll ask about the Tylenol. I think we all understand about the antibiotics and how they affect the BC's but I don't know about the Tylenol or ASA. I will find out.

DutchgirlRN, ASN, RN · Jan 1, 2005

TYLENOL IS NOT A ANTIBIOTIC

Gee Thanks, stbernardclub, I do realize that Tylenol IS NOT an antibiotic. That's pretty basic information even for a non-medical person. I didn't just fall off of a turnip truck. I said the antibiotics interfere with the growth.

purplemania, BSN, RN · Jan 1, 2005

if we suppress the temperature then we may be allowing germs to replicate without nowing what we are dealing with. Blood cultures are ordered when a fever is present. Masking the clinical presentation may delay appropriate treatment.

DutchgirlRN, ASN, RN · Jan 1, 2005

if we suppress the temperature then we may be allowing germs to replicate without nowing what we are dealing with. Blood cultures are ordered when a fever is present. Masking the clinical presentation may delay appropriate treatment.

Thanks, I think you've hit the nail on the head. That makes perfect sense. No fever, no blood cultures. The Tylenol or ASA would definately mask the clinical sx. Thanks !

crazyearrings · Jan 1, 2005

If you don't mind one more opinion on the topic:

I work peds hem/onc, and our practice is this. When a patient comes in with fever, we draw lab immediately and give the Tylenol almost simultaneously (most of our patients have lines, so we aren't waiting on phlebotomy). We only hold antibiotics until after cultures. Then we usually have an order for blood cultures daily for fevers. If it has been almost 24 hours since the last blood culture, we hold any more tylenol until the next fever. We don't want a doc to think a patient is afebrile and not needing blood cultures when really we are keeping the kid medicated every 4 hours. As far as antibiotics and blood cultures, our blood culture bottles have some special ingredient which is supposed to filter antibiotics out of the specimen. That is how we can draw daily blood cultures after starting antibiotics.