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Drawing blood from a central venous catheter |
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STANDARDS:
* Management and care of central venous catheters (CVC) may only be undertaken by registered nurses accredited to give intravenous medication
* Procedure should be carried out under strict asepsis.
* To have a uniformed approach to drawing blood from a central venous catheter by trained nursing staff.
* The central venous catheter is not an ideal site for drawing blood samples but may be used in conditions where other access is not available.
* Caution is to be taken when aspirating blood samples from the CVC
not to haemolysis sample.
* Rapid withdrawal can create a vacuum which may damage/collapse catheter or blood vessel.
* Caution is to be taken not to contaminate blood sample with solution infusing through other ports.
* Proximal port on the CVC should be designated for drawing blood
and kept Heparinized for this reason.
OUTCOMES:
* The patient will experience no infection through contamination of the CVC during his/her stay at LBH.
* Blood samples drawn from the CVCs will not be contaminated
by other solutions being infused through other ports of the same CVC.
* No damage will occur to either the blood vessels or the CVC through excessive force while drawing blood.
EQUIPMENT:
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Equipment as for Heparinizing CVC
- Eye protection
- Apron
- Yellow Vacutainer shield
- Vacutainer luer lock
- Appropriate blood collection tubes.
PROCEDURES:
* Explain procedure to patient before starting.
* Aseptic preparation before starting procedure.
* Maintain proper barrier protection to protect nurse against possible blood contamination. Prepare dressing pack at patients bed side
* Place patient in supine position. Have patient turn head away from CVC site during procedure.
* Turn off infusion at least one minute before sampling.
* See Policy and Procedure for 'Heparin Lock for Central Venous Catheter Lines'
* After removing 5 mls of blood from CVC pigtail attached syringe and remove required
amount of blood for blood test. Draw off blood for electrolytes and full blood counts
before coagulation studies. If coagulation studies are the only tests required
it may be necessary to draw up to 10 mls of blood for discard before drawing sample
bloods.
* Re-heparinize CVC port following Policy and Procedure for 'Heparin Lock for Central Venous Catheter Lines'.
* Record date and time of procedure on flow chart.
* Note in patient's chart procedure carried out and any problems noted during procedure.
R
REF:
Arrow International, (12/ 94), Arrow Multi-Lumen Central Venous Catheter Care
, Catheter Maintenance, Blood Sampling, pg. 105-111.
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