CHI Health Laboratory 4955 F Street Omaha, NE 68117 Phone: 402-717-5227 Fax: 402-717-5252

BLOOD CULTURE

Determine the type of culture bottles to utilize, as indicated per physician's order. If necessary, discuss timing of cultures, sites, need for any special instructions with the physician.

Alegent Creighton Laboratory Culture tube guide

Optimal Age Group Bottle Distribution Difficult draw Volume Infant (Neonate -1 Bactec® Peds Plus 1-3 ml All into Peds bottle N/A yr old Child (1-5 yrs) Bactec® Peds Plus 1-5 ml All into Peds bottle N/A Bactec® Aerobic 8 ml into Aerobic bottle, the Child (6-8 yrs), < 8 ml, entire specimen and Anaerobic 10 ml remaining into the under 80 lbs in Aerobic Bottle bottles Anaerobic bottle 8 ml into Aerobic Adults > 8 yrs old Bactec® Aerobic bottle, the remaining 10 ml Aerobic bottle and children > 80 and Anaerobic 20 ml into Anaerobic bottle 10 ml Anaerobic bottle lbs bottles <8 ml entire specimen into Aerobic bottle

Bactec® Myco/F All ages 3-5 ml All into Fungal bottle 3 ml minimum bottle

BLOOD CULTURE BOTTLE STORAGE REQUIREMENTS:

The Bactec blood culture bottles are ready for use as received and require no reconstitution or dilution. Store vials upright, in a cool, dry place (2-25°C), out of direct light.

SPECIMEN COLLECTION:

1. Types of Blood Cultures available a. Routine blood culture b. blood culture c. Acid Fast blood culture d. CMV blood culture

2. Number and Timing - Most cases of bacteremia are detected by using 2 sets of blood cultures, collected separately. A single blood culture may miss intermittent bacteremia and make it difficult to

interpret findings. Blood cultures ordered when a patient is "spiking a temperature" are considered STAT and the first culture must be obtained within 10 minutes of the time ordered.

Alegent Creighton Health is now CHI Health.

3. Volume - The volume of blood is critical because the concentration of organisms in most cases of bacteremia is low.

4. Site selection - If multiple cultures are ordered, select a different site for each culture drawn. Avoid drawing blood through indwelling intravascular catheters unless blood cannot be obtained by or unless the diagnosis of catheter is suspected.

5. Procedure 1. Wash or sanitize hands before and after removing gloves.

2. Assemble necessary equipment for phlebotomy before preparation of patient's skin.

3. Apply tourniquet and identify the phlebotomy site

4. Cleansing the phlebotomy site using Chloraprep® One-Step Frepp a. apply solution to skin using a side to side motion (no concentric circles is necessary) for 15 seconds. b. Reverse the direction and clean up and down for 15 seconds. c. Allow to air dry for 30 seconds. d. Avoid touching the chosen phlebotomy site after cleansing,

5. Using a sterile syringe or butterfly, draw 20 ml of blood sample.

6. Place 10 ml of sample into the Anaerobic bottle first, then 10 ml into the Aerobic bottle.

Updated 1/23/15

Alegent Creighton Health is now CHI Health.