Specimen Required

NOTE:  Blood culture are to be collected from central lines, PICC or venous access ports only when ordered by the physician.  These are collected by the nursing staff only.  If collecting from an indwelling intravascular access device or port, another blood culture collected by venipuncture is recommended.

Site Preparation:

1. Perform hand hygiene and don gloves.  Inspect bottle for defects, such as cracks, contamination, bulging, or indented stoppers.

2. Remove the plastic flip cap and cleanse bottle cap puncture site with an alcohol pad for at least 10 seconds and allow to dry.

3. After selecting the venipuncture site, disinfect the site using chlorhexidine sponge, scrub venipuncture site with back and forth motion and friction for 30 seconds. Let dry completely.
Do not blot, fan, or wipe dry

For infants <2 months old, use the alcohol Frepp:

1.  With the sponge facing downward, crush the ampule and press against the skin until liquid is visible. 

2.  Completely wet the site with the alcohol using a back and forth scrubbing motion for 30 seconds. 

3.   Allow to completely dry for 30 seconds.  DO NOT blot, fan, or wipe dry.

4.  Next, crush and squeeze the iodine Sepp, being careful not to touch the ampule head.  Apply the tip of the Sepp to the venipuncture site and stargin at the center of the site, move outward in a concentric circles.

5.  Allow to completely dry for 30 seconds.  DO NOT blot, fan, or wipe dry

NOTE:  If site must be touched by phlebotomist after preparation, phlebotomist must cleanse gloved fingertip with chlorhexidine ampule/iodine Sepp

Collection of Blood

Venipuncture with Winged (Butterfly) Needle Set

1. Perform venipuncture using Winged (Butterfly) Needle Set with a male angel wing hub attached to butterfly.

2. Collect the first 4ml (2ml minimum) of blood in the sterile diversion tube from the clean collect kit (4mL red top tube)

3. Fill  anaerobic (purple) bottle first, then the aerobic (blue) bottle.. Allow each bottle to collect 8-10mL per bottle, using the graduated lines on the bottle to estimate the sample volume.

Do not overfill bottle.

NOTE:  Culture bottles are placed in a position below the patient's arm in an upright position.  This is to prevent any possible backflow of chemical additives from the bottles.

4. Proceed with filling other blood tube(s) as needed.

Venipuncture with Syringe and Needle

1.  Collect 3ml (pediatric) or 20ml (adult) in a syringe. 

2.  Activate the sharps safety device, remove the needle and discard in sharps container

3.  Attach a blood transfer device to the syringe and fill the culture bottles.  Fill the anaerobic bottle first (purple), then the aerobic bottle (blue).

NOTE:   If blood begins to clot before injection into bottle, it must be discarded and redrawn.

Drawn from Central Lines/Venous Access Ports (to be performed by nursing staff only)

1. Access lumen with sterile syringe or blunt VACUTAINER adaptor.

2. Fill discard/waste 10 mL tube or syringe.

3. Fill 20-mL syringe to fill blood culture bottle(s)/tube(s).

4. Using a female angel wing device, transfer 10 mL of blood to each culture bottle/tube.

5. Fill anaerobic (purple) bottle first (with no more than 10 mL of blood), then the aerobic (blue) bottle.

6. Mix contents of bottle(s)/tube(s) immediately by gentle inversion. If blood begins to clot before injection into bottle, it must be discarded and redrawn.

Pediatric bottles:

1. Submit 5 mL (minimum volume: 1 mL) of whole blood in a pediatric blood culture bottle (silver top).

2. Label bottle with patients name (first and last) or other unique identifier, patients hospital
identification number or Social Security number, date and time of draw, collectors initials or Meditech number, and test(s) being ordered.  Be sure to not cover the bottle barcode with any labels

3.  Forward promptly at ambient temperature.

Adults

1. Submit 10 mL (minimum volume: 8 mL) of whole blood in an aerobic (blue) blood culture bottle and 10 mL (minimum volume:8 mL) in anaerobic (purple) bottle.

2. Label bottle with patients name (first and last) or other unique identifier, patients hospital
identification number or Social Security number, date and time of draw, collectors initials or Meditech number, and test(s) being ordered.  Be sure to not cover the bottle barcode with any labels

3. Forward promptly at ambient temperature.

Bone Marrow

**To be collected by a physician.  A technologist familiar with blood culture collection will need to be at the bedside to handle the culturing of the bone marrow before it clots**

1.  Sterilize the lid of the bottles.  Inject the bone marrow from the syringe into each bottle

     -For fungal and/or AFB culture, add 1ml of bone marrow to one MYCO/LYTIC blood culture bottle. 

      -For aerobic culture, add remaining bone marrow to an aerobic adult blood culture bottle.

2. Label bottle with patients name (first and last) or other unique identifier, patients hospital
identification number or Social Security number, date and time of draw, collectors initials or Meditech number, and test(s) being ordered.  Be sure to not cover the bottle barcode with any labels

3. Forward promptly at ambient temperature.