Blood culture

Preparation

• Use a checklist to see if you have all materials needed for the procedure
• Ask the patient’s name, and check if this is the same name as the name on the laboratory request form
• Write the following information on the blood culture bottle – or prepare 2 labels: if you add labels to the bottle make sure to leave a window for visual inspection in the laboratory and do not cover expiry date and weight of the bottle)

• Blood culture bottle information
• Patient’s name
• Age or date of birth
• Sex
• Hospital-number if available
• Date and time of blood collection
• Specify whether the sample is taken from a peripheral vein, a catheter, or a central line
• Inform the patient about the procedure

• Clean your hands with 70% isopropyl alcohol hand rub before touching the patient – if no alcohol hand rub available wash and dry hands before touching the patient
• Position the patient and select a puncture site on the arm
• Apply the tourniquet (10 cm above the puncture site) and ask the patient to make a fist

Antisepsis of skin

• Clean the patient’s skin at the puncture site with 70% isopropyl alcohol wipe, start from the site you will puncture and make circles to the outside
• Wait 1 minute to allow the alcohol to dry
• Take compress and put poviodine-iodine 10%: wipe the puncture site, start from the site you will puncture and make circles to the outside (After this do not touch the puncture site anymore for the rest of the procedure)
• Allow the poviodine-iodine to act for 2 minutes until dry, you can do the 3 next steps in the meantime
• Remove caps from the 2 blood culture bottles – the bottles should be placed in a rack
• Wipe the rubber stopper of the bottle with poviodine-iodine 10% – leave to dry for 2 minutes
• Put gloves
• Prepare the syringe and needle

Collection of blood

• Puncture the vein and collect at least 10 ml of blood. Remove the tourniquet as soon as the blood flows.
• If the venipuncture does not succeed, use new sterile needle
• If you have touched the puncture site again, repeat antisepsis before proceeding
• Do not touch the sterile needle with finger or gauze/compress
• Press gauze on puncture site – you can ask patient to continue to press
• Transfer the blood into the culture bottle – the bottle should be placed in a rack, mix gently
• Remove the syringe with needle form the bottle and throw into the sharp’s container (Do not recap needle or separate syringe and needle)
• Use alcohol swab to clean poviodine-iodine from the puncture site
• Put a bandage onto the puncture site
• For the adults, repeat the same procedure at the other arm, start from tourniquet
• Clean your hands with 70% isopropyl alcohol hand rub after the procedure – if no alcohol hand rub available wash and dry hands before touching the patient
• Use a new sterile syringe and sterile needle
• There is no need to change gloves

Transport sample to laboratory

• Check if bottles are labelled correctly
• Transport the blood culture bottles with the laboratory request form to the laboratory immediately

In case of delay in transport never store blood culture bottle in the fridge, store only at room temperature.

• Blood culture request form filled in by the clinician
• For Adults: 4 adult blood culture bottles (one pair = 1 aerobic bottle + 1 anaerobic bottle)
  For Children: 1 pediatric blood culture bottle
• Rack for blood culture bottle(s)
• Alcohol hand rub
• Minimum 1 pair of gloves
• Tourniquet
• Minimum 2 isopropyl alcohol 70% pre-pads
• Minimum 2 non-sterile compresses
• Povidone iodine 10% solution
• Min 2 needles: recommended for adults = 21G needle (or 23G needle) andfor children = 23G needle (or 25G needle)
• Min 2 syringes: recommended for adults = 1 syringe of 10ml and 1 syringe of 20 ml and for children = 1 syringe of 10 ml
• Bandaids
• Sharps container
• Plastic bag for contaminated waste

• Collection before starting antibiotics
• Proper skin antisepsis
• Blood culture bottle disinfection
• Sampling at least 2 pairs (4 bottles)
• Collect 10mL of blood per bottle
• Prefer peripheral venipuncture (Catheter-drawn blood cultures have a higher risk of contamination (false positives).
• Transport time should be as rapid as possible at room temperature