Do you draw a waste tube before a blood culture when it’s from a line?

  1. There should be a waste of at least whatever they flush for any indwelling lines (PICC, Port, etc), 10ml minimum. Saline contamination or dilution isn't a concern for strictly blood cultures, you can draw periph sets above a saline drip. Heparin, whether flush or drip, can have a suppressing effect on some bacteria, so that should be avoided for both.

  2. At my hospital we don’t allow blood cultures to be drawn from a line, just because drawing from a line increases contamination risk ever so slightly

  3. We use it solely to see if the line is infected. They have to draw a line and a peripheral venipuncture within an hour of each other and then we do a calculation based on how long it took the bottles to come off of the instrument as positive.

  4. Yes you don’t want the saline or heparin lock diluting/contaminating the sample. You should waste about 10mLs of fluid/blood before drawing a sample

  5. another big thing i havnt seen is skin plugs. waste tubs get rid of any skin that might have been grabbed by the needle. we have also started using steripaths. which seem to have helped reduce our rates. we are typically below 1% though.

  6. Our policy explicitly allows us to use the waste for the culture. We’re culturing the line, so it doesn’t matter if the liquid that’s carrying the bacteria that we eventually grow was blood or some other fluid. Of course, I wouldn’t send a culture if that fluid is an antibiotic, but anything else is good to go!

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