| Topic |
Blood Culture Collection Guidelines |
| Pre Collection Notes |
• Specimen should be drawn PRIOR to antibiotic therapy, if possible.
• Always collect the blood cultures first to avoid contamination when the specimen is collected with other lab blood tests.
• Proper site preparation and aseptic collection techniques are essential for blood culture collection
• If the blood culture and other laboratory blood tests need to be collected at the same time, the blood culture should always be the first bottles/tube(s) collected to avoid contamination of the sample.
Pre Collection Notes |
| Blood Culture Collection Set |
| Blood Culture Set: |
Blue Cap BacT/Alert SA (aerobic) bottle |
| Collect one of each: |
Purple Cap BacT/Alert SN (anaerobic) bottle |
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| Recommended Collection for a Blood Culture |
Obtain two (2) separate sets of blood cultures 30 minutes apart from two (2) separate collection sites.
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| Collection Containers and Specimen Volumes |
Adults
Containers:
One (1) blue cap BacT/ALERT SA ™ (aerobic) bottle
One (1) purple cap BacT/ALERT SN ™ (anaerobic) bottle
Volume: Total 10-20 ml per venipuncture (split evenly between both bottles); Fill each bottle with 5-10 ml of blood; Note: do not overfill bottles with more than 10ml in each bottle
Children
Container:
One (1) yellow cap BacT/ALERT PF™ (aerobic) bottle; No anaerobic bottle necessary
Volume: Total 1-4 ml per venipuncture; Fill bottle with entire blood sample; Note: do not overfill bottle with more than 4ml of blood.
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| Physician Request for Antibiotic Removal |
Used for patients on antibiotics at the time blood cultures are ordered
Containers: One (1) Green cap BacT/ALERT FA™ (aerobic) bottle
One (1) Purple cap BacT/ALERT ™ SN (anaerobic) bottle
Volume: Fill each bottle with 5-10 ml of blood |
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Difficult Sticks and Low Volume Draws
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Adults
When the entire specimen collected is less than 6 ml of blood
Containers: One (1) blue cap BacT/ALERT SA ™ (aerobic) bottle only
Volume: Place the entire sample in the bottle.
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| Preparation of the Collection Bottles |
• Select appropriate BacT/ALERT bottles for the culture.
• Do not use bottles that are cracked, leaking, or expired. The bottom of bottle contains a sensor which should not be yellow.
• Remove the plastic flip top from each bottle.
• Wipe the stopper with an alcohol prep to disinfect.
• Mark the initial broth level with marker, to make sure no more than 10 ml blood is collected for adult bottles.
• No more than 4 ml for pediatric bottles
• Click Here to go to a diagram. |
| Patient Preparation |
Using Iodine or Providone
• Cleanse the venipuncture site with 70% alcohol for 30 seconds.
• Apply tincture of iodine or providone in a spiral pattern starting at the center and working to the edge of the venipuncture site.
• Let dry one (1) minute.
• Do not retouch the site after it has been cleaned.
Using Chloraprep
• Scrub the site using an up and down motion for 30 seconds.
• Allow to air dry approximately 30 seconds.
• Do not retouch the site after it has been cleaned.
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Specimen Collection
Butterfly Method
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1. Firmly tighten the luer adapter of the butterfly to the adapter cap.
2. Perform venipuncture. When needle is in the vein, secure with tape or hold in place.
3. Inoculate aerobic bottle first. While holding bottle straight up and down, press the adapter cap onto the bottle and hold in place.
4. Observe markings on side of bottle to determine when maximum fill has been reached.
5. Remove adapter from aerobic bottle and inoculate anaerobic bottle next.
6. Remove adapter from aerobic bottle and inoculate anaerobic bottle next.
7. When finished, remove the needle from the culture bottle or laboratory tube first and then from the patient’s arm.
8. Gently invert the bottles 2-3 times to prevent clotting.
9. Label bottle with patient’s information, date/time drawn and the initials of the person collecting the specimen.
10. If placing a label on the bottle, place it lengthwise on the bottle and DO NOT cover the bottom of the bottle or the bottle’s pull off barcode tab.
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Specimen Collection
Syringe Method
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1. Prepare the bottles needed as in butterfly method above.
2. Collect entire amount of blood needed in one (1) stick (ideally 20 cc for an adult, 4 cc for a child.)
3. Aseptically split the specimen evenly between the aerobic and anaerobic bottles. There is no need to change needles.
4. Let the bottles draw the specimen in with the bottles’ vacuum. DO NOT force the blood in, or spattering may result.
5. For children, place the entire specimen (1-4 ml) in one pediatric aerobic bottle.
6. Gently invert the bottles after inoculation to mix the bottles 2-3 times to prevent clotting.
7. Label bottle with patient’s information, date/time drawn and the initials of the person collecting the specimen.
8. If only a small amount of blood is obtained on an adult (less than or equal to 6ml), place the entire specimen in one blue aerobic bottle only.
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| Specimen Storage and transport |
• Always store blood culture specimens at room temperature.
• DO NOT REFRIGERATE!
• Transport blood culture specimens to the WakeMed Clinical Pathology laboratory promptly. |
| Collecting Acid Fast Bacilli (Mycobacteria) or Fungus |
Collect one (1) tube for Acid Fast Bacilli.
Collect one (1) tube for Fungus.
If both Acid Fast Bacilli and Fungus are ordered, collect two (2) full isolator tubes.
Container: Adult
1 - 10 ml Isolator™ tube, at least ¾ full
Storage Requirements: Room temperature
Transport Conditions: Deliver promptly to WakeMed Pathology Laboratory
Container: Child
1 – 1.5 ml Isolator™ tube, full
Storage Requirements: Room temperature
Transport Conditions: Deliver promptly to WakeMed Clinical Pathology Laboratory
Patient Preparation
• Cleanse the venipuncture site with 70% alcohol for 30 seconds.
• Apply tincture of iodine or providone iodine in concentric circles, working outward from the venipuncture site. How about: in a spiral pattern starting at the center and working to the edge of the venipuncture site.
• Let dry one (1) minute.
• Do not retouch the site after it has been cleaned
Collection Tube Preparation
• Disinfect stopper of Isolator™ tube with iodine.
• Do not allow iodine to pool on the stopper.
• Let dry completely for about one (1) minute.
• Do not touch the stopper once it has been cleaned.
Specimen Collection
Can be collected with multi sample needle and holder or with a syringe.
If the blood culture and other laboratory blood tests need to be collected at the same time, the blood culture should always be the first tube(s) collected to avoid contamination of the sample.
1. Collect the blood sample, allowing the tube to fill completely.
2. Note: During collection, do not permit contents of the tube to contract the yellow tube stopper in order to avoid the possibility of backflow of reagents from the tube with the possibility of adverse patient reaction.
3. Gently invert the bottles after inoculation to mix the bottles 2-3 times to prevent clotting. If the specimen is received clotted, it will be rejected for analysis.
4. Label bottle with patient’s information, date/time drawn and the initials of the person collecting the specimen.
5. Keep at room temperature.
6. Deliver to the WakeMed Pathology Laboratory.
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