I was wondering what you guys are doing in regards to drawing specimens for patient who will be receiving or potentially receiving blood products (Type /Screen/ crossmatch) . 

 

1.  Do you allow IV/Port draws...flushed of coarse?

 

Thanks

Teresa

 

Yes, we allow line draws. Many samples from the Children's hospital are line draws to save these kids from extra sticks. Our samples are drawn by nursing, so it does require some education, but we have not had issues. Its a bigger problem when doing actual venous draws and they draw to close to an IV line and then we get a contaminated sample.

We will use blood from a port but we discard the 1st 10cc.

We have lots of oncology patients who have ports (and ICU patients with lines.) So yes, we accept sample collected from lines & ports. The nurses are supposed to follow the standard rule of discarding the first 10cc's drawn from the line/port, and we rarely have any problems.

We have alot of problems with line draws, and "decentralized" phlebotomy in gerneral.  The hemolyzed and clotted hematology specimens result in alot of redraws and delay of reporting patient results.

 

For example, even a tiny bit of heparin left in a heparin-locked line can blow an aPTT.  When we get a result off the scale, we have it redrawn venously (the unit initially uses a "flushed" port) and it is often in the therapuetic range. 

 

The ones we worry about though are those we don't catch.  What if the contaminated specimen gives a normal K or APTT when the result is rerally subclinical or critically low?

 

Scott