Copyright 2002 by Delmar, a division of Thomson Learning, Inc. All rights reserved.

EQUIPMENT
Povidone-iodine wipes
Alcohol wipes
10 cc syringes (4)
Heparin (10 u/cc)
Normal saline flush
Gloves, nonsterile
Povidone-iodine swabs or sticks (culture)
Mask (culture)
Gloves, sterile (culture)
GENERAL GUIDELINES FOR SPECIMEN
COLLECTION
1. Check physicians order. Ensures appropriate specimen
obtained from the correct child.
2. Check child for allergies to any materials used, e.g.,
povidone-iodine.
3. Prepare child and family. Enhances cooperation/partici-
pation; reduces anxiety/fear.
NOTE: Have an assistant hold/comfort the child as nec-
essary and in accordance with agency policy.
4. Gather equipment. Promotes organization and effi-
ciency.
5. Wash hands. Don gloves. Reduces transmission of
microorganisms.
PROCEDURE
1. Steps 15 of General Guidelines.
2. Position child as necessary to complete procedure.
3. Select lumen for blood withdrawal when child has mul-
tilumen catheter.
a. Preferable to select largest lumen.
b. Avoid using lumen where total parenteral nutrition
(TPN) currently infusing if possible.
c. Check for medication/serum sample interactions.
4. Turn off all infusions; clamp other infusions with multi-
lumen catheters. Avoids dilution or contamination of
specimen with infusion solution.
5. Put on nonsterile gloves. Protects from contact with
blood-borne organisms; reduces transmission of
microorganisms.
6. Prep end of injection port as specified by agency policy.
One method is to wipe off injection port with three (3)
povidone-iodine wipes; allow to dry. Wipe with alcohol
wipes. Reduces transmission of microorganisms.
Povidone-iodine must dry to be effective. Using alcohol
removes povidone-iodine, which could be introduced
into the central line.
NOTE: Agency policy may require removal of injection
port when drawing blood for culture. When this is
required, a new injection cap is placed after blood sam-
ple is obtained. When drawing blood for culture wear
sterile gloves. Put gloves on after cleansing injection
port to maintain sterility of gloves.
7. Wipe injection port with alcohol wipe. Prevents povidone-
iodine from being introduced into the central line.
8. Attach syringe with saline flush to injection port. Flush
with 510 cc, enough to equal two to three times the
intraluminal volume of the catheter. Clears the tubing of
all infusion solution.
NOTE: Small amounts are used with neonates.
9. Attach empty syringe to catheter. Withdraw blood equal
to two to three times the intraluminal volume of the
catheter. Clears the catheter and prevents contamination
of the blood sample with infusion solution.
NOTE: Policy regarding return of withdrawn blood
varies from agency to agency. Discard or return in
accordance with agency policy. If blood to be returned,
it must be drawn into a syringe that contains heparin,
generally 1 cc of heparin (10 u/cc).
10. Attach empty syringe onto injection port and withdraw
volume of blood needed for ordered lab tests.
11. Discard or return blood per agency policy. Discard in
appropriate container. Maintains body fluid precautions.
12. Attach syringe and flush with normal saline. Clears
blood from catheter and prevents clotting in or blockage
of catheter.
13. Resume previous infusion(s) or heparin/saline flush per
agency policy.
14. Place blood into appropriate containers.
15. Label containers and place specimen in appropriate bag
or container along with laboratory requisition slips.
Ensures specimen is properly identified and appropriate
test is performed.
16. Remove gloves. Wash hands. Reduces transmission of
microorganisms.
DOCUMENTATION
1. Time, source/site, specimen sent to lab (specify for what
test).
2. Record results of any test performed on the unit.
28
SKILL 8
SKILL 8
Blood Draw from a Central Venous Catheter