why do you draw blood cultures from 2 different sites

At my hospital, we get lots of elderly pts from LTC or SNF's. If these pts have existing PICC lines, Central Lines, or Udall's we always draw one of the cultures from the line in case the infection has originated there. If the draw from the line comes back positive, the line is removed, and the tip is cultured to confirm the bacteremia. In a pt where they do not have an existing line, the cultures are drawn from 2 sites because like checking stool for C-Diff, you can get false readings.

I have seen that generally, if the pt is afebrile, and not displaying signs of septicemia, but infection is suspected, the blood cultures are drawn from 2 sites to rule out false positives, since contamination can occur even with aseptic technique. The only times I see positive cultures as significant to our doctors is if both are positive, and they grow a bacteria that is not considered normal to the body, or if the indwelling line tests positive.

As to the time it takes to get results, it varies. I usually see preliminary reports at around 24 hours, which will state growth or no growth If there is growth, the determination of the type of bacteria, and what its sensitive to can take from 48-72 hours, at which point the MD will continue the same treatment, or change it if needed. Most positives I have seen from blood are staph bacteria.
greater than 0. 5% alcohol chlorhexidine (drying time 60 seconds) Dawson S. Blood cultures.

British Journal Of Hospital Medicine (17508460) April 2012;73(4):C53Б5. Accessed March 18, 2013. Jennifer Denno, Mary Gannon, Practical Steps to Lower Blood Culture Contamination Rates in the Emergency Department, Journal of Emergency Nursing, 10. 1016/j. jen. 2012. 03. 006. ( Flayhart D. Blood cultures and detection of sepsisБ БTips from the clinical experts. MLO: Medical Laboratory Observer. March 2012;44(3):34 Accessed March 18, 2013.

Halm M, Hickson T, Stein D, Tanner M, VandeGraaf S. BLOOD CULTURES AND CENTRAL CATHETERS: IS THE БEASIEST WAYБ BEST PRACTICE?. American Journal Of Critical Care. July 2011;20(4):335Б338. Accessed March 18, 2013. Kim N, Kim M, Oh M, et al. Effect of routine sterile gloving on contamination rates in blood culture: a cluster randomized trial. Annals Of Internal Medicine February 2011;154(3):145Б151. Accessed March 18, 2013.

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