Collection Instructions

Specimen Type: Whole blood or bone marrow
Container(s): BACTEC MycoF Vial (preferred) or Green top (Sodium Heparin) or Green top (Lithium Heparin)

Preferred Volume to Collect: 5 mL

Minimum Volume to Collect: 3 mL

Collection Instructions:

• Disinfect the bottles or tubes using CHG swab stick. Remove plastic seal from the bottle and soak the rubber lid, allow to air dry.
• Prepare the patient’s venipuncture site by opening the
  • CHG One-Step Frepp applicator
    • Hold the applicator in a downward position.
    • Do not touch the sponge.
    • Pinch once to break the ampule. You should hear a pop.
    • Saturate the sponge with CHG by gently pressing it against the treatment area.
    • Vigorously scrub back and forth the treatment area for 30 seconds.
  • CHG Triple Swab sticks
    • Open packet and use one swab stick to prep bottle by saturating the bottle/tube top.
    • Use a second swab stick to prep the patient’s arm by vigorously scrubbing back and forth for 30 seconds.
    • The third swab stick can be used to prep the patient if a second set of cultures has been ordered
  • Children 2 months old or less: Betadine applicator.
    • Hold the applicator in a downward position
    • Do not touch the tip.
    • Pinch once to break the ampule. You should hear a pop.
    • Start in center of intended puncture site and make concentric circles.
    • Do not go back toward starting point.
• Allow to air dry
• Apply the tourniquet 3 to 4 inches above the puncture site for no longer than 1 minute. The use of a tourniquet is not always appropriate in drawing children.
• Perform venipuncture - following order of draw
• Remove tourniquet
• Place clean gauze over the puncture site and apply direct pressure
• Gently invert bottles 8-10 times to prevent clotting
• Label the bottles at the bed-side (or with patient): patient information, date and time collected, source is required information. Also write totalvolume per each bottle on the label or bottle. Place label vertically at the top of the bottle, leaving bottle's bar code visible.
• Bandage the patient's venipucture site

Number and timing of blood draw:

Most cases of bacteremia are detected by collecting 2 or 3 sets from different sites (veins). No more than 3 sets of blood cultures in a 24-hour period should be drawn as it yields little additional information.

Conversely, a single blood culture may miss bacteremia and may make it difficult to interpret the clinical significance of certain organisms.

General Pediatrics: A single blood culture is collected unless sub-acute bacterial endocarditis is suspected.

Notify Microbiology in suspected cases of:

1.  Brucella
2. Mycobacterial (AFB)
3. Histoplasma or other fungal or unusual organism is suspected.

Do not obtain specimens from the line for routine blood cultures. Cultures obtained through a line draw can be misleading in making a diagnosis. An Infectious Disease consult may be useful if a line related sepsis is suspected; ideally, use line draws only to detect the presence of colonization of a line.

Note: Clearing a line before obtaining a sample will not eliminate all the bacteria within that line; therefore, a physician’s order should be obtained to draw one set of blood cultures peripherally to help determine if the infection is true bacteremia versus a line contamination.