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11/13/24, 7\:19 PM Guide | Blood culture collection

Blood culture collection

Table of contents
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Gather and prepare equipment

1. Clean a procedure tray with an antiseptic wipe.
2. Collect the relevant equipment\:
Apron
Non-sterile gloves
Tourniquet (single-use)
Blood sampling device with blood culture bottle adapter (e.g. winged blood collection set)
Blood culture bottles x 2 (anaerobic and aerobic)\:
Sharps container
Cleaning swab x 3 (2% chlorhexidine in 70% isopropyl alcohol)
Sterile gauze
Sterile plaster
Tape
Laboratory forms, labels and transportation bag
3. Remove unnecessary packaging and assemble equipment maintaining aseptic non-touch technique (ANTT) prior to placing
in the procedure tray\:
Attach the needle to the barrel (some blood collection systems come pre-assembled).
Remove the caps from the blood culture bottles and clean the top of each with a separate cleaning swab (2% chlorhexidine
in 70% isopropyl alcohol), allowing to dry before proceeding with bottle inoculation.
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Don gloves (optional at this stage)

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Brie
i n v o l v e s i n s e r t i n g a s m a l l n e e d l e i n t o y o u r v e i n . Y o u m a y b r i e
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Gain consent to proceed with blood culture collection.
Check if the patient has any allergies (e.g. latex).
Adequately expose the patient's arms for the procedure.
Position the patient so that they are sitting comfortably. If a bed is available, the patient can lay down for the procedure (this is
sometimes preferable, particularly if the patient is prone to vasovagal syncope).
Ask the patient if they have any pain before continuing with the clinical procedure.

Choosing an arm

1. Choose an arm to perform venepuncture on\:
You should ask the patient if they have a preference.
Pre-existing medical conditions may prevent particular limbs from being used (e.g. arterio-venous
stroke a
Do not perform venepuncture on an arm that has an intravenous infusion in progress as this may interfere with the sample.
2. Place a pillow under the relevant arm.

Choosing a vein

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1. Inspect the patient's arm for an appropriate venepuncture site\:
The median cubital vein in the antecubital fossa is commonly used for venepuncture.
Areas of broken, bruised or erythematous skin should be avoided.
Areas in which two veins join should be avoided where possible, as valves are often present.
2. Position the patient's arm in a comfortable extended position that provides adequate access to the planned venepuncture
site.
3. Apply the tourniquet approximately 4-5
4. Palpate the vein you have identi
Tapping the vein and asking the patient to repeatedly clench their
An ideal vein feels 'springy'
. A vein that feels hard is likely sclerosed, thrombosed or phlebitic (in
avoided.
5. Once you have identi
more than 1-2 minutes at a time.
6. Don an apron (if not already wearing one) and wash your hands again using alcohol gel and the World Health Organisation's
hand hygiene technique shown in our guide.
7. Don gloves.
8. Thoroughly clean the planned venepuncture site\:
Use 2% chlorhexidine in 70% isopropyl alcohol to disinfect the patient's skin and allow to dry.
If the patient's skin is visibly soiled use soap and water to clean the site.
Once the skin has been disinfected you should not touch the site again (even with gloves on).
Apply a tourniquet

Insertion of the needle

1. Re-apply the tourniquet if removed previously.
2. Unsheathe the needle.
3. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site.
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4. Warn the patient that they will experience a sharp scratch.
5. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. You should see
the needle's chamber and feel a sudden decrease in resistance as the needle enters the vein.
6. Advance the needle a further 1-2 mm into the vein after
7. Lower and anchor the needle to the patient's skin using the wings of the butter
8. Use your other hand to attach the aerobic blood culture bottle to the adapter, piercing the blood culture septum and
allowing the bottle to
9. Remove the aerobic bottle and then attach the anaerobic bottle, also
anchor the needle to the skin as you remove the

10. Release the tourniquet.
11. Withdraw the needle and then apply gentle pressure to the site with some gauze or cotton wool.
12. Ask the patient to hold the gauze or cotton wool in place whilst you dispose of the needle into a sharps container.
13. Apply a dressing to the patient's arm (e.g. cotton wool, gauze, plaster).
14. Discard the used equipment into the appropriate clinical waste bin.
Insert the needle and observe for

To complete the procedure...

Explain to the patient that the procedure is now complete and that they should seek review if the venepuncture site becomes
painful or in
Thank the patient for their time.
Document the patient's details on the blood sample bottles at the bedside (using either pre-printed or handwritten labels).
Dispose of PPE appropriately and wash your hands.
Send the blood samples to the lab for analysis in an appropriate plastic leak-proof bag with the completed laboratory request
form.
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Document the details of the procedure in the patient's notes\:
Reason for sample
Time and date of sample
Site the sample was obtained from
Your name, signature and contact details
Wash hands again

Reviewer

Graham Bone
Senior Clinical Lecturer in Medical Education

References

1. Taking blood cultures. A summary of best practices. UK Government Web Archive. Published in 2011. Available from\: [LINK].
2. WHO guidelines on drawing blood\: best practices in phlebotomy. Published in 2010. Available from\: [LINK].
3. WHO Guidelines on Hand Hygiene in Healthcare\: a Summary. Published in 2009. Available from\: [LINK].
Source\: geekymedics.com
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