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Blood discard prior to drawing blood cultures
Our Community Venous Access Team is haveing a discussion about drawing blood culturres form central lines and if blood should be wasted prior to drawing the blood culture or not.  We know that the INS P&P states to not discard the first draw (pg 176).  Most of the nurses involved on this team are from different facilities in our area and have always drawn a waste before drawing the blood culture.  What is the reason for not discarding blood before drawing the blood culture and are there any articles out there that anyone could recommend for us to review either supporting or not supporting this practice?
In this reference you will

In this reference you will find what you are looking for:

Principles and procedures for blood cultures; approved guideline    Clinical and Laboratory Standards Institute      M47-A, Vol 27, No 17

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They state it is not necessary to discard the initial volume of blood/locking solution from the catheter. 

I have also heard Dr. Maki make this same statement in some of his presentations. 

You are trying to collect any planktonic cells from the biofilm inside the catheter lumen. Discarding the first draw could discard these cells that you are actually trying to retrieve. Any blood culture is only as good as the sample obtained and whether that particular sample has planktonic cells in it. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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