C BLOOD

Culture, Blood

EPIC Test Procedure Code: LAB2536

Performing Lab:
Saint Luke's Regional Laboratories
Container Type:
Aerobic and anaerobic blood culture bottles
Specimen Type:

Whole blood

Preferred Volume:
- Adults - Draw 16 to 20 ml per venipuncture. Divide evenly into aerobic and anaerobic bottles.
- Children and infants - Draw 0.5 to 5 ml and place in a pediatric blood culture bottle. If a pediatric bottle is not available, place total volume in an aerobic bottle.
Minimum Volume:
Adults Only:
- If only 5-10 ml is collected, place the total volume in an aerobic bottle.
- If 0.5 to 5 ml is collected, place the total volume in a pediatric bottle if available.
Collection Procedure:

Inpatient Collection:
Prepare the phlebotomy site and draw the specimen as follows:
1. Find a location and remove the tourniquet for preparation of the site. 
2. Open ChloraPrep™ One-Step Frepp™ Applicators packages and break the ampule by squeezing the 2 handles together (pinch).
3. Press the sponge on the site, thoroughly saturating the sponge (pump).
4. Clean the site for 30 seconds with a back and forth scrubbing motion being careful to remain within a 2-inch area around the draw site (prep). Allow to air dry for 30 seconds.
5. Do not touch the area with unprepped fingers after this point.
6. Remove the plastic caps and cleanse the BD blood culture tops using a fresh alcohol swab for each one. Remove the swabs from the bottle tops and allow the alcohol to air dry.
7. Reapply the tourniquet, maintaining sterility. Do not touch the draw site.
8.  Anchor the vein below the 2-inch sterile area.
9. Draw 2 bottles for one set of blood cultures filling the aerobic bottle first, and the anaerobic bottle second.
10.Affix the lab label to the bottles being careful to not cover the manufacturer's barcode on the bottle. Record collection information such as volume and site in the computer system. If system is down, and/or no label is available, write the following information on the bottle: patient's full name, unique identification number (date of birth, MRN), date, time of draw, and A# or initials of the person drawing the specimen, the site of the draw (important for result reporting), and the volume collected.
11. Send to Lab promptly. Blood culture bottles need to be in the Microbiology Lab and ready for processing within 24 hours of collection. If the specimen is not able to be processed within this time, it will need to be discarded and recollected if applicable. Physicians will receive a report 24 hours after the specimen is placed on the Lab instrument, not 24 hours after it is collected, so prompt delivery is important.

Outpatient Collection:
Prepare the phlebotomy site and draw the specimen as follows:
1. Find a location and remove the tourniquet for preparation of the site. 
2. If using iodine, apply in a circular path, working from inside to outside covering approximately 2 inches in diameter. Allow to air dry.
3. Next, apply the alcohol pad, same as directed in step # 2. Allow to air dry.
4. Repeat steps # 2 and # 3 once more.
5. If using Chlorhexidine:
           1) Open ChloraPrep One-Step Frepp Applicator package and break the ampule
               by squeezing the 2 handles together (pinch).
           2) Press the sponge on the site, thoroughly saturating the sponge (pump).
           3) Clean the site for 30 seconds with a back and forth scrubbing motion being 
               careful to remain within the 2-inch area around the draw site (prep).
               Allow to air dry for 30 seconds.
6. Do not touch the area after this point.
7. Remove the plastic caps and cleanse the BD blood culture tops using a fresh alcohol swab for each one. Remove the swabs from the bottle tops and allow the alcohol to air dry.
8. Reapply the tourniquet, maintaining sterility. Do not touch the draw site.
9. Anchor the vein below the 2-inch sterile area.
10. Draw 2 blood culture bottles, filling the aerobic bottle first and the anaerobic second. Fill with 10 mL of whole blood per bottle.
11. Affix the lab label to the bottles being careful to not cover the manufacturer's barcode on the bottle. Record collection information (volume and site), in the computer system. If system is down, and/or no label is available, write the following information on the bottle: patient's full name, unique identification number (date of birth, MRN), date, time of draw, and A# or initials of the person drawing the specimen, the site of the draw (important for result reporting), and the volume collected.
12. Send to Lab promptly. Blood culture bottles need to be in the Microbiology Lab and ready for processing within 24 hours of collection. If the specimen is not able to be processed within this time, it will need to be discarded and recollected if applicable. Physicians will receive a report 24 hours after the specimen is placed on the Lab instrument, not 24 hours after it is collected, so prompt delivery is important.

Stability:

The specimens must arrive in the Microbiology Lab and be ready for processing within 24 hours of collection.

CPT Codes:

87040 - Culture Blood (EAP 30660280)
87205 - Gram Stain (if appropriate)
87076 - Anaerobic identification (if appropriate)
87150 x 2 - Staph identification by PCR (if appropriate)
87154 - Strep, Yeast, or Gram Negative Rod Identification by PCR (if appropriate)
87077 - Other aerobic organism identification (if appropriate)
87186 - Susceptibility, MIC (if appropriate)
87184 - Susceptibility, Kirby Bauer (if appropriate)
87181 - Susceptibility E-Test (if appropriate)

Test Schedule:
Monday through Sunday
Reference Ranges:

No growth at 5 days.

Critical value (automatic call-back): Positive

If positive, aerobic bacteria will be identified and susceptibilities performed. Anaerobic bacteria will be identified.

Notes:

This specimen source is routinely cultured for anaerobes.

Lab Personnel

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