Blood Culture Sample Collection
Normally bacteria-free, blood is susceptible to infection through infusion lines as well as from thrombophlebitis, infected shunts, or bacterial endocarditis resulting from prosthetic heart valve replacements. Bacteria may also invade the vascular system from local tissue infections through the lymphatic system and the thoracic duct.
Blood cultures are performed to detect bacterial invasion (bacteremia) and the systemic spread of such an infection (septicemia) through the bloodstream. In this procedure, a venous blood sample is collected by venipuncture at the patient’s bedside and then transferred into two bottles, one containing an anaerobic medium and the other, an aerobic medium. The bottles are incubated, encouraging any organisms present in the sample to grow in the media. Blood cultures allow identification of about 67% of pathogens within 24 hours and up to 90% within 72 hours. Two or three sets of blood culture samples should be drawn over a period of 24 hours.
Equipment
Tourniquet ▪ gloves ▪ alcohol pad ▪ chlorhexidine swabs ▪ 20-mL syringe for an adult; 10-mL syringe for a child (1 syringe for each set of cultures) ▪ three or four 20G 1½″ needles ▪ two or three blood culture bottles (50-mL bottles for adults; 20-mL bottles for infants and children) with sodium polyethanol sulfonate added (one aerobic bottle containing a suitable medium, such as Trypticase Soy Broth with 10% carbon dioxide atmosphere; one anaerobic bottle with prereduced medium; and, possibly, one hyperosmotic bottle with 10% sucrose medium) ▪ laboratory request form ▪ laboratory biohazard transport bag ▪ 2″ × 2″ sterile gauze pads ▪ small adhesive bandages ▪ labels.
Preparation of Equipment
Check the expiration dates on the culture bottles and replace outdated bottles.
Implementation
Verify the doctor’s order.
Gather the appropriate equipment.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
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