Kathy Kokotis
Bard Access Systems Â
Question of the day:
If one suspects a CR-BSI and one has a multi-lumen catheter would not one draw a blood c/s from each lumen and label the c/s samples as one lumen may be infected and the other two not infected?
I have looked for an article to substantiate that. Hadaway where are you
Kokotis
I have never seen a study that looked at the culture results from multiple lumens. I makes sense to think that a sample from only one of 2 or 3 lumens could easily result in missing an infected catheter, but don't recall any articles that discuss this.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
We've discussed this with ID and IC at our facility, and are in agreement although we currently haven't changed our practice and also don't have data. I remember reading other conjectures that this might be a good idea, but don't remember where I read it. If I find it and it's useful, I'll post.
Because such a large volume of blood would be drawn to get cultures if one bottle were drawn from each lumen, from a triple lumen catheter for example, would it make more sense to use a separate sterile syringe to draw a partial sample from each lumen and put all in one bottle? Or would it be useful to know exactly which lumen the positive culture came from? or the contaminant came from?
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Very good questions, but don't know if the IC experts have considered this yet. If one lumen is positive, then pulling or treating is indicated. If one lumen is positive, I would tend to think that treating all lumens would be necessary if pulling the catheter is not an option. But again, I don't know of any evidence about this.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Kathy Kokotis
Bard Access Systems
The reason I brought this up is Jackson in Miami draws from each lumen and labels each culture with the lumen and it just made so much sense to me and I realized that this is not the common or documented practice in the industry nor do we discuss it but it makes sense
kathy
Kathy Kokotis
Bard Access Systems