Microbiology 3

b.

Blood Culture along with other Specimen

1. Apply a tourniquet to the patient's arm and cleanse the site. (See Skin Preparation)
2. Mark the Bactec culture vial labels at the desired fill level. The aerobic bottle should always be filled first.

   

3. Peel apart the package and remove blood collection set
4. Thread the Luer end of tubing set into Vacutainer holder
5. Remove sheath-covering needle at the wings.

   
   
   

6. Perform venipuncture by holding wings as shown. DO NOT hold by grasping the yellow safety shield.
7. Push and hold the Vacutainer holder over the top of the vial to puncture the septum.
8. Collect blood in the aerobic bottle to the desired fill level on the vial. Inoculate the amount recommended on the bottle (8-10 cc for adults). The volume of the inoculum must never be less than 3.0 for the standard aerobic/F, standard anaerobic/F, aerobic plus, and anaerobic plus bottles. Pediatrics plus bottles will except 1-3 ml.
9. Monitor to ensure proper blood flow and fill level.
10. Remove the holder from the vial. Immediately push and hold the holder onto the anaerobic bottle.
11. Collect blood to the desired fill level on the second vial. Remove the holder from vial. Note: If more samples are required, additional tubes may be drawn at this time using the Vacutainer holder. See Blood Culture along with other blood tests section for the required order of tube collection.

    

12. Removal
    a. When the final vial or tube is filled, withdraw the needle by grasping the wings and gently pulling. DO NOT WITHDRAW BY HOLDING THE YELLOW SAFETY SHIELD. Cover the puncture site with a sterile gauze pad and apply pressure.

    

    b. Activate the safety shield. Grasp either wing with one hand and grip the yellow safety shield base with the other hand. Slide the wings back into the rear of the safety shield until a snap is felt to insure that the needle is retracted completely and locked in place.

    

13. Discard in the nearest sharps container according to regulations.
14. Remove tincture of iodine from the collection site using sterile alcohol swab.
15. Attach a Cerner accession label lengthwise (being careful not to completely cover the bottle barcode) to both blood culture bottles. These labels must include the patient's name, medical record number, room number, procedure ordered, collection date and time. The staff member who performed the venipuncture must also handwrite his/her initials, collection date and time, area of puncture site or if drawn from a central line on the patient's Cerner accession label. Dispose of any used materials in the appropriate containers and wash hands.
16. Send to the laboratory within one hour.

1. Tubes for sterile samples (blood cultures, blood fungal cultures, and blood AFB cultures)

2. Tubes without additives

3. Tubes for coagulation studies

4. Tubes with additives in the following order of draw

a. SST

b. Heparin

c. EDTA

d. Oxalate/Fluoride

3.

a. Obtain 1 Myco/F Lytic blood culture bottle from the microbiology lab (ext. 5820). One bottle may be used for both AFB cultures (which includes MAI) and fungus culture. The Myco/F Lytic bottle may not be used for routine bacterial culture.

b. The optimal amount of blood for the Myco/F Lytic bottle is 1 to 5 cc. The sensor on the bottom of the bottle should be white and there should be 2 inches of liquid media in the bottle. Do not use expired media.

d. Send to the laboratory within one hour.

a. Obtain 1 Myco/F Lytic blood culture bottle from the microbiology lab (ext. 5820). One bottle may be used for both AFB cultures (which includes MAI) and fungus culture. The Myco/F Lytic bottle may not be used for routine bacterial culture.

b. The optimal amount of blood for Myco/F lytic bottles is 1 to 5 cc. The sensor on the bottom of the bottle should be white and there should be 2 inches of liquid media in the bottle. Do not use expired media.

c. Follow the routine bacterial blood culture guidelines including the skin preparation procedures, vial preparation, and blood collection, labeling, and disposal.

d. Send to the laboratory within one hour.

a. Obtain 2 lavender top vacutainer tubes.

b. Follow the skin preparation procedure as for bacterial culture using the Medi-flex skin prep kit.

c. Draw 5 cc of blood into lavender top tube.

d. Attach Cerner accession label to the tube, sign with initials, collection date and time. In Powerchart under comments, always state the type of infection and/or virus suspected. This is a CAP requirement.

e. Send to the lab within one hour