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Blood draw from same side as IV Fluids infusing

Does anyone have a protocol or reference indicating the acceptable timeframe that IV Fluids need to be stopped prior to drawing labs from same arm?  This would also be for drawing labs from CVC w/IVF's infusing.  Our hospital lab has a policy stating that IV fluids/medication drips need to be stopped for 10 minutes prior to lab draw with I feel is old practice as well as not always possible with certain drips.  Our IVT practice is to stop all fluids/clamp lines for 1-2 minutes, draw 5 to 10 ml waste, draw labs, flush line manually with 10-20 ml saline, & resume IVF.  I need some backing to support our current IVT practice.

No studies have defined these

No studies have defined these time limits. A sample should never be drawn from a site above an infusion on the same extremity. It can be drawn distal to the IV site but not proximal to the IV site. I have never seen a study showing your 10 minutes time frame. So always draw from a distal site or the opposite extremity. Addtionally the 1 minute recommendation for stopping infusions through a CVC comes from the catheter manufacturers, but I am not aware of any studies on this issue. The discard volume should be no more than 3 times the internal volume of the system. Nosocomial blood loss and iatrogenic anemia is related to frequently drawing sample of a CVC with this wasting method. There is the mixing method for drawing samples however the reinfusion method should never be used. The mixing method calls for flushing the line with 10 mL saline, leaving this syringe attached, withdrawing 6-8 mL of blood, then pushing it back into the catheter. Repeat this withdrawal X 4 total without disconnecting the syringe. After the last time, detach the syringe, attach a new syringe and obtain the sample, transfer to the vacuum tubes using a needleless transfer device. No blood is wasted. Reinfusion method is where you inject the sample from the original syringe, the sample that is usually discarded. Blood clots have been found in these samples and the risk of infection is present so this is not recommended. Lynn

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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