I was recently asked at my facility to help clarify blood cutlure sampling. INS states not to waste any blood when drawing blood cultures for a central line but our dialysis unit is concerned that they normally waste the heparin that is dwelling in the line prior to obtaining their blood sample for cultures. Would we treat a dialysis catheter that same as any other central line? Does anyone have any direction to help us?
I worked on that SOP so very familiar with it and the supporting evidence. The only reason to use any CVAD for drawing blood cultures is to rule out the catheter as the cause of the BSI. If the catheter is not suspected, draw from a peripheral vein. If you draw from the catheter, you want to collect what is inside the lumen so that you harvest the planktonic bacteria from the biofilm. If you discard that, you could get a false negative results. This is the recommendation from the standards organization for clinical laboratories. So I would treat an HD cathetr the same as any other CVAD. Heparin is not going to skew the cultures.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn for your time and expertise.
Chelsea Gavere, RN