I read the 2024 INS standard that initial sample should be discarded when drawing blood culture via peripheral venipuncture (Page S141 -- G1, c). Not clear if the discard requirement applies only if diversion device is used.
We currently do not use diversion device, and wondering if we have to discard the first sample before collecting the actual culture (via peripheral venipuncture). And what's the rationale for it?
Thank you
Discard the initial 1.5 to 2 mL from a peripheral venipuncture. The diversion device does this automatically but you can do it manually if not using one of those devices. This discard will removed the skin plug that can sometimes happen with any venipuncture. Plus there is no way that any skin prep can render the skin sterile. There will always be skin flora left after the most effective skin antiseptic and technique. Discarding this initial sample reduces the contamination of the blood sent for culture.
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 for the clarification. Will change our practice accordingly.
HI Lynn
I was always taught previously to always collect the aerobic sample first and never to discard either from peripheral or central line. If we discard first, how does it work for the aerobic sample?
Thank you
New studies have shown that blood cultures are easily contaminated by skin and/or a skin plug from the needle. When you divert the first 1.5 to 2 mL immediately after the venipuncture, you greatly reduce the possibility of a false positive on the culture results. From a CVAD always send the first sample drawn and do not discard any because you want to capture what was inside the catheter lumen. See INS SOP on Blood Sampling.
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 :)