![]() ![]() In particular, we’ll talk about the importance of pausing infusions for 2 minutes, for collecting an adequate volume of waste blood when drawing from a line, and for choosing venipuncture sites distal to or preferably opposite of a peripheral IV.įor those interested in additional reading, there are some reviews of the older literature around this topic in the references listed here. This result could potentially reflect hemolysis of line- collected specimens, but no specific hemolysis data were provided to evaluate this point.ĭespite these limitations, the available literature is useful to guide proper procedure for sample collection from patients with vascular lines. For example, Mohler et al reported elevated potassium in some specimens collected from lines compared to venipuncture collections. However, it is possible that other tests may be compromised due to specimen integrity issues when collected from a line.Ī second notable limitation of the available studies is that many of them do not explicitly detail the levels of potential analytical interferences such as hemolysis in samples collected from lines. ![]() There is some logic to this strategy, since those tests are relevant to most clinical practices, and are involved in a large number of medical decisions. One notable limitation is that most of these studies only examined a handful of tests, typically basic chemistry and hematology tests. ![]() However, it is worth pointing out that the few studies reported also have some limitations. What evidence does exist suggests that both central and peripheral lines can usually provide adequate quality blood samples for lab testing. When it comes to determining the best way to collect blood from vascular lines, there aren’t a lot of studies in the literature, unfortunately. The question is, which of these is the best option for collecting blood? Slide 4: Options for Blood Collection: What Does the Evidence Say? However, even if the patient has a line, it is possible to collect blood using venipuncture or fingerstick. Many vascular lines, including various types of central lines, peripheral IVs, and arterial lines can be used for sampling blood. Notice the long catheter tubing which allows the PICC to empty into a large vein near the heart, while the external lumens are located some distance away. Central lines are common in critical care settings and in patients receiving protracted therapy such as parenteral nutrition or chemotherapy.Īt the lower right, I’m showing an example of a two-lumen PICC or peripherally-inserted central catheter, which is a type of central line. Central venous catheters, or CVCs, are intentionally designed to facilitate longer-term access for both infusion and blood collection. While lines are often utilized to infuse something into a patient, it is also possible to use vascular lines to collect blood. ![]() These fluids can be very simple in nature, such as normal saline, or extremely complex, such as total parenteral nutrition (or TPN), which can include protein, lipids, electrolytes, and other components. Lines are commonly used to administer a wide variety of materials. Vascular lines are used in a variety of clinical settings, including hospital inpatients, emergency departments, long-term care units such as those that administer chemotherapy, and clinical study units. ![]()
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