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Peripheral Blood Culture

Item Value
Approval req'd? No
Available Stat? No
Test code P060
Test group Bacterial culture
Performed by Microbiology
In House Availability Daily, all shifts
Method Culture
Collection Instructions 1. Adults:
Collect 2 sets of cultures from different sites.
Collect at least one set of cultures from a peripheral site.

2. Pediatrics:
Amount of blood depends on weight of patient (see weight based minimums).

Anaerobic sample should be sent only in the following circumstances: Outpatients, patients with immunodeficiency, malignancy or after bone or human stem cell transplant, patients with gastrointestinal disorder, or at physician's request due to concern for anaerobes. Sending only an aerobic specimen is sufficient for all other patient populations.

3. Cleanse venipuncture site:
For patients with NO contraindication for use of chlorhexidine products: Cleanse the venipuncture site with ChloraPrep Single Swabstick using a back and forth motion for 30 seconds. Allow it to air dry. NOTE: If skin is soiled, clean with 70% isopropyl alcohol before using ChloraPrep.

For patients with a contraindication for use of Chlorhexidine products, DO NOT USE CHLORAPREP & follow this procedure: Clean skin of venipuncture site with 60-second friction scrub of 70% isopropyl alcohol to a 5 cm circular area. Apply 10% PVP Iodine to venipuncture site skin in a circular motion to a 5 cm area starting in the center. Allow it to air dry. Following the venipuncture, remove residual iodine from patient's skin with 70% isopropyl alcohol.

4. Remove plastic cap of each bottle and scrub top of each bottle with 70% alcohol prep pad.

5. Perform venipuncture and obtain sample.
Nursing staff: Refer to Blood Culture Methods (General) procedure in Nursing Procedures Manual.
Clinical Labs Phlebotomy staff: Refer to Clinical Labs Blood Culture Collection procedure.

6. Instill sample into aerobic bottle first and then into anaerobic bottle. Do not aspirate air into the anaerobic bottle. Do not add more than 10 mL into each bottle. Gently invert bottles to mix contents.

7. Label each bottle with patient's name and medical record number and site of draw. Do not place label on neck of bottle or bottom (underneath) of bottle, and do not cover bar code on bottle with the label. Place label vertically on bottle.
Container type Paired blood culture bottles (BD BACTEC Plus Aerobic & Lytic Anaerobic bottles)
Amount to Collect Adults: 20 mL total (10 mL for each bottle)
Pediatrics: Collect blood sample amount according to weight:
< 1 kg = 1 mL for aerobic only (0.5 ml for neonates < 72h old)
1 – 5 kg = 2 mL total (1 mL for each bottle)
5 – 15 kg = 3 mL total (1.5 mL for each bottle)
15 – 40 kg = 6 mL total (3 mL for each bottle)
>40 kg = 10 mL total (5 mL for each bottle)
Sample type Blood
Preferred volume Adults: 20 mL total (10 mL for each bottle)
Pediatrics: Collect blood sample amount according to weight (see Amount to Collect above)
Min. Volume Adults: 10 mL total (5 mL for each bottle)
Pediatrics: Draw 1.0 mL minimum for culture (0.5 ml for neonates < 72h old) when collecting aerobic only (standard). If both aerobic and anaerobic needed, instill minimum of 1 mL in each bottle when collecting.
UCSF Rejection Criteria Samples that are not collected per "Collection Instructions"
Processing notes 1. If bottles are overfilled, enter OVRFIL (Blood culture appears overfilled; do not put >10ml/bottle.) in SREQ.
2. If actual source (Peripheral Blood, Central Blood) does not match order, complete a credit form and indicate reason BMIS (Specimen source on order/requisition and on bottle received do not match. Test performed and results available under separate order.)
3. Accession the specimen with the test code corresponding to the actual source, and enter MISB (Specimen source on order/requisition and on bottle received do not match. Source listed on bottle used for identification.) in SREQ.
4. If the time from collection to loading bottles on the instrument is more than 12 hours, give the bottles to a CLS to subculture before loading.
Normal range No growth
Critical value Inpatient results only. After hours outpatient results will be phoned the following morning.
Gram stain results from the first positive blood culture on a patient will be phoned. Additional calls only made if > 7 days have elapsed since first call or a different organism is identified.
Stability 36 hours at room temperature
Turn around times Up to 6 days
Reflex? If bacteria are detected they are identified and susceptibility testing is performed as appropriate.
Additional information Notify Microbiology when Brucella is suspect so that the cultures can be incubated for 14 days.
CPT coding 87040
Last Updated 6/30/2017 12:28:17 PM
Entry Number 1578
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