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Sheila's picture
To waste or not to waste

We have a burning question that was brought to us by our ICU nurses regarding blood cultures drawn from CVCs.  The ICU position is that you waste, as usual, but for the reason of obtaining a "pure" blood sample for the culture.  One of our ID doctors says definitely waste, the other says not necessary.  Does it even matter?  Any thoughts?

Sheila, Austin,TX

If you are wanting a "pure

If you are wanting a "pure sample" for blood cultures you should be drawing a peripheral sample. The reason to draw blood cultures from a CVC is to see if the line test positive. So the idea would be to not waste, thus obtaining a mostly residual blood sample from within the catheter. Someone correct me if I am wrong as this is our policy.

Parrish Nored, RN

Daphne Broadhurst
Dr. Kites, a  U.K.

Dr. Kites, a  U.K. microbiologist investigating biofilm, addressed this at a recent ASPEN conference. He stated that the sample should not be be wasted so as to capture a more true microbial content of the lumen. As well (I'm not sure if it was he or Marcia Ryder who made this comment) that all lumens should be sampled, not just one.

Daphne Broadhurst, RN
Ottawa, Canada

Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada

I have not seen any evidence
I have not seen any evidence supporting either way. You are actually looking for what has colonized the catheter walls. The first sample could be contaminated with new bugs that were introduced recently. The second sample could be more populated with bugs from the biofilm. I am not sure that it really makes much difference either way. 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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