MINISTRY OF HEALTH AND MEDICAL SERVICES

STANDARD OF PRACTISE FOR BLOOD CULTURE

COLLECTION

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 SOP #

Ministry of Health and STANDARD OPERATING

Drafter:
Medical Services PROCEDURE
Revision #

SOP Title: Presentation of Standard

Implementation Date
Operating Procedures
Last Reviewed/
Page #:
Update Date
Chief Medical Adviser,
SOP Owner: Approval / Date:
MHMS

CONTENTS
1.0 COLLECT RELEVANT EQUIPMENT
2.0 ASSEMBLE EQUIPMENT
3.0 INTRODUCTION
4.0 CHOOSING VEIN
5.0 INSERTING THE NEEDLE
REFERENCES

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Properly obtained blood cultures are important to identify organisms and to ensure proper
antimicrobial/antifungal coverage while minimizing false positive results

Preparation of the skin for venipuncture is important to prevent contamination of blood cultures by bacteria
that normally lie on the skin and to prevent introduction of these bacteria into the patient's bloodstream.

1.0 Collect the relevant equipment:

 Sterile gloves
 Gloves – single use / disposable tourniquet
 10 ml syringes with 3 needles
o A 21 gauge/20-25 mm needle is generally used for adults
o A 23 gauge/20-25 mm needle is generally used for children
 Blood culture bottles x 2 (anaerobic and aerobic)

For adults For pediatrics

 Sharps container
 Cleaning swab x 3 (povidine iodine and 70% isopropyl alcohol) - Alcohol with concentrations greater
than 70% should not be used because the increased concentrations result in decreased bactericidal
activity
 gauze
 plaster
 blood forms (microbiology forms) and transportation bag

2.0 Assemble equipment maintaining aseptic non-touch technique prior to placing in the
procedure tray:
 Attach the needle to the barrel (some blood collection systems come pre-assembled)
 Remove the caps from the blood culture bottles and clean the top of each with a separate cleaning
swab (povidine iodine and 70% isopropyl alcohol), allowing to dry before proceeding with bottle
inoculation.

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 3.0 Introduction:
 Wash hands with soap and water (practice 5 moments of hand-hygiene)

 Introduce yourself to patient (name and role)

 Confirm the patients name
 Explain the procedure and gain verbal consent
 Adequately expose the patient’s arms for the procedure
 Position the patient so that they are sitting comfortably (could also ask for patient preference)

4.0 Choosing The Vein to Withdraw Blood

Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site

Palpate the vein you have identified to assess if it is suitable:

 Tapping the vein and asking the patient to repeatedly clench their fist can make the vein easier to
visualise and palpate.
 An ideal vein feels ‘springy’. A vein that feels hard is likely sclerosed, thrombosed or phlebitic
(inflamed) and should be avoided

 Put on sterile gloves.

 Cleanse skin with povidine iodine and 70% isopropyl alcohol applicator for 30 seconds using back and
forth scrubbing technique
o Allow to dry for at least 30 seconds (skin must be dry prior to venipuncture).
o Do not fan or blow on skin once cleansed.
o Do not palpate site once cleansed

5.0 Inserting the Needle:

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 Unsheathe the needle
 Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the
insertion site.
 Warn the patient that they will experience a sharp scratch.
 Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. You
should see flashback into the needle’s chamber and feel a sudden decrease in resistance as the
needle enters the vein.
 Advance the needle a further 1-2 mm into the vein after flashback is noted to ensure you are within
the lumen
 Fill the blood in the syringe.
 Once collected withdraw the needle while applying gentle pressure to the site with some gauze or
cotton wool.
 Release the tourniquet afterwards
 Ask the patient to hold the gauze or cotton wool in place whilst you dispose of the needle into a
sharps container. Apply a dressing to the patient’s arm – with cotton wool and plaster
 Remove the needle used from the syringe and place a new needle for each culture bottle while
injecting the blood
o Adults 5-10 ml of blood in each bottle
o Children/infants – 0.5-4ml of blood
 Inject blood specimens into bottles, place specimen into the anaerobic Orange bottle, then
the aerobic Green bottle. If you only have enough blood for one bottle, place the specimen
in the aerobic Green bottle.
 Swirl the blood culture bottles several times to mix
 Discard the used equipment into the appropriate clinical waste bin.
 Label the sample and the correct lab form and send it to microbiology lab

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References:

Castillo, D., Harcourt, B., Hatcher, C., Jackson, M., Katz, L., Mair, R., Mayer, L., Mcgee, L., Novak, R.,
Rahalison, L. and Schmink, S., 2011. Laboratory Methods for the Diagnosis of Meningitis Caused by
Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenza: WHO manual.

Dr Lewis Potter 2022, Blood Culture Collection, OSCE Guide, Geeky medics, viewed 13 th February, 2023,
https://geekymedics.com/blood-culture-collection-osce-guide/