• Percutaneous or peripheral vein (non-catheter) blood samples are the best source of contamination free cultures.
  • Use catheter (arterial line, central line, etc) blood culture samples only when there is no other option or for evaluation of line sepsis.
  • For evaluation of new fever: two sets (ie, 4 bottles) from two different sites are required: either two percutaneous sites, or one catheter drawn and one percutaneous draw (one percutaneous required if catheter used as other site.)
  • Use aseptic technique at all stages of draw.
Procedures Rationale/Comments
  • At least two sets needed to evaluate a new fever, if a blood stream infection is a possibility.
  • If 1 set is catheter-drawn, draw at least one set from a peripheral vein
  • 5-10 cc of blood in each culture bottle for adults

Assemble supplies:
bottles, tourniquet, syringe(s), butterfly needles, alcohol swabs, gauze pads, band aid(s), vacuum transfer device
  • A 'set" is two culture bottles: aerobic and anaerobic.
  • One set may be drawn from one site/access and, one or two syringes full of blood
  • Catheter-drawn cultures result in a significantly higher rate of false positives 

This blood volume in sample optimises the sensitivity of this test.
Clean Hands Before Drawing Cultures
- Use alcohol hand gel (allow to air dry)		 Hand hygiene is proven to reduce spread of infection and blood culture contamination.
Prepping skin : Peripheral Cultures
  • Select site of venipuncture: cleanse with soap and water if unusually dirty.
  • Wear non-sterile examination Gloves
  • Apply tourniquet, if necessary
  • Cleanse venipuncture site with 70% alcohol :-
  • Use circular gentle but firm strokes from inside to outside for a diameter of 2-3 inches centered on site.
  • Repeat twice (total of 3 circular preps)
  • Allow air Drying (20 seconds)
  • Reduce chance of false positives by reducing potential for sample to contact organisms on patient skin, central lines, or transferred from operator.
  • Do not blow or fan to speed drying of site,. can contaminate the cleansed area. Air drying can occur while culture bottles are being prepared.
  • Allows time for alcohol to act and avoids stinging from alcohol at site
Prepare Culture Bottles
  • Flip off plastic lid.
  • Cleanse each rubber top with 70% alcohol swab
  • Leave the alcohol swab on top of each bottle until ready to inoculate

 

Ensure sterile access to culture medium
Drawing/Transfer of Peripheral Site Blood Cultures (Recommended)
  • Apply tourniquet, if not already applied.
    Avoid contamination of prepped area with gloves or tourniquet.
  • After cleansing site: Cleanse gloved finger thoroughly with alcohol if it is necessary to touch venipuncture site
  • Use a safety needle - either regular straight or butterfly to draw blood into syringe
  • Perform Phlebotomy: release tourniquet and withdraw needle.
    Apply pressure to site and bandage.
  • Remove old needle without using fingers and place directly into a designated sharps bin which has a device for needle removal.
  • Transfer blood from syringe to blood culture bottles using a new sterile needle attached to sample syringe.
  

 

  • Safety needle reduces needlestick risk
  • Reduce needlestick risk
  • Reduce chance of transfer of contaminating organisms from needle or butterfly into culture bottles by re m ov i n g: may reduce false positives by half from this precaution alone.
  • Reduce chance of transfer of organisms from gloved finger to clean site

 
Label blood culture bottles and send to lab using standard protocol for specimen submittal.

Assure right patient, right test