BACT/ALERT®: Blood Culture Collection: Winged Set Method

Summary

The script outlines the critical steps for collecting blood cultures to diagnose sepsis, emphasizing the importance of proper disinfection, sufficient blood volume, and prompt transfer to the lab. It details the process from preparation, including confirming patient identity and using non-sterile gloves, to the actual collection, prioritizing aerobic bottles first. The summary also highlights the need for accurate labeling and mixing of the samples to ensure reliable test results.

Takeaways

• 🔍 Properly collected blood cultures are essential for accurate sepsis diagnosis and improving patient outcomes.
• 💉 Two sets of blood cultures should be obtained before administering antimicrobial agents.
• 📦 Ensure all materials, including culture bottles with lot numbers and expiration dates, are gathered and checked for quality.
• 🧼 Hand hygiene and the use of non-sterile examination gloves are crucial before starting the collection procedure.
• 🆔 Confirm the patient's identity and match the requested laboratory test and patient information to prevent errors.
• 🛡️ Prepare the collection materials in a clean area to minimize contamination.
• 🔄 Disinfect the blood culture bottles using an approved disinfectant and allow them to dry completely.
• 🩸 The arm is the recommended site for drawing blood cultures, and proper vein preparation is necessary.
• 🌐 Start with aerobic bottles first to avoid altering the anaerobe bottle's atmosphere with air from the tubing.
• 👶 For pediatric patients, a special pediatric aerobic bottle may be used with a specific inoculation volume.
• 💧 Use the fill-to mark to gauge the sample volume accurately, avoiding overfilling the bottles.
• 🔄 Mix blood culture bottles and tubes by inverting to ensure proper mixing.
• 🏷️ Properly label the bottles with all necessary information and ensure barcodes and level check windows are visible.
• 🚫 Dispose of all used materials correctly and promptly transfer inoculated culture bottles to the laboratory.

Q & A

Why is a properly collected blood culture important for sepsis patients?

A properly collected blood culture is crucial for sepsis patients because it helps ensure accurate results that can improve patient outcomes by identifying the causative organisms and guiding appropriate antimicrobial therapy.

How many blood culture sets should be obtained for patients with suspected sepsis?

Two blood culture sets should be obtained as soon as possible and before antimicrobial agents are administered to increase the chances of detecting the causative pathogen.

What should be checked before using the blood culture bottles?

Before using the blood culture bottles, one should check the expiration date, ensure the media is not turbid or showing any visible defects, and confirm that the bottles are not damaged, deteriorated, or leaking.

Why is it necessary to wash hands or use an alcohol rub before starting the blood collection procedure?

Washing hands or using an alcohol rub is necessary to minimize the risk of introducing contaminants into the blood culture, which could lead to false-positive results or culture contamination.

How should the patient's identity be confirmed during the blood culture collection process?

The patient's identity should be confirmed by matching the requested laboratory test and patient information with the patient's identity, either using a printed label form or a mobile device.

What is the recommended site for drawing a blood culture?

The arm is the recommended site for drawing a blood culture, as it is typically more accessible and less likely to be contaminated.

Why is it important to disinfect the chosen puncture site before inserting the needle?

Disinfecting the puncture site is important to reduce the risk of introducing skin flora or other contaminants into the bloodstream, which could compromise the accuracy of the blood culture.

What should be done if the anaerobic bottle is collected first instead of the aerobic bottle?

If the anaerobic bottle is collected first, the air in the tubing could alter the anaerobic environment, potentially affecting the culture's accuracy. Therefore, the aerobic bottle should always be collected first.

How much blood should be inoculated into the aerobic bottle for an adult patient?

For an adult patient, 10 mL of blood should be inoculated into the aerobic bottle, as indicated by the fill-to mark on the bottle.

What should be done after collecting the blood samples to ensure proper mixing?

After collecting the blood samples, the culture bottles and tubes should be gently mixed by inverting them 3 to 5 times to ensure proper mixing of the blood with the culture media.

How should the blood culture bottles be labeled after collection?

The blood culture bottles should be labeled using the dedicated area on the bottle. If using a test label, it should be placed vertically with the same orientation as the bottle barcode, ensuring no coverage of the barcode, fill-to mark, or the window to check the blood level.

Outlines

00:00

💉 Proper Blood Culture Collection for Accurate Sepsis Diagnosis

This paragraph outlines the critical steps for collecting blood cultures to ensure accurate results in diagnosing sepsis. It emphasizes the importance of obtaining two sets of blood cultures before administering antimicrobial agents. The process includes checking the expiration and condition of the culture bottles, proper hand hygiene, patient identification, and preparation of materials. The script details the steps for disinfecting the puncture site, drawing blood without repalpation, and prioritizing the order of filling aerobic and anaerobic bottles. It also mentions the use of a pediatric bottle for children and the correct technique for attaching the collection adapter cap. The paragraph concludes with instructions on mixing the blood culture bottles and transferring them promptly to the lab.

05:00

🛑 Key Points in Blood Culture Collection to Prevent Contamination

The second paragraph highlights three essential points for successful blood culture collection: proper disinfection, sufficient blood volume, and prompt transfer to the lab. It reiterates the importance of avoiding contamination by using the correct disinfection method and not repalpating the vein after initial disinfection. The summary explains the correct order of inoculating bottles and the specific volumes required for adult and pediatric patients. It also covers the procedure for collecting additional blood tests, the safety measures for needle removal, and the correct disposal of sharps and materials. The paragraph ends with instructions on labeling and packaging the culture bottles for laboratory testing, stressing the need for accurate labeling and avoiding obstruction of barcodes or fill marks.

Keywords

💡Blood Culture

Blood culture is a medical test that involves collecting a sample of blood to identify the presence of microorganisms, such as bacteria or fungi, that may be causing an infection. In the video, it is emphasized that a properly collected blood culture is crucial for accurate results, which can improve patient outcomes, especially for those with sepsis. The script mentions the importance of collecting two sets of blood cultures before the administration of antimicrobial agents.

💡Sepsis

Sepsis is a serious medical condition that occurs when the body's response to an infection causes inflammation throughout the entire body. The video script highlights the urgency of collecting blood cultures for patients showing signs and symptoms of sepsis, as timely and accurate diagnosis can be critical for effective treatment and improved patient outcomes.

💡Contamination

Contamination refers to the presence of unwanted substances or organisms that can interfere with the accuracy of a medical test. In the context of the video, it stresses the importance of collecting a blood sample free of contaminants to ensure reliable results. The script provides detailed steps to prevent contamination, such as using proper disinfection techniques and handling the culture bottles correctly.

💡Antimicrobial Agents

Antimicrobial agents are substances that kill or inhibit the growth of microorganisms. The video script advises obtaining blood cultures before the administration of these agents because they can affect the growth of organisms in the culture, potentially leading to inaccurate results.

💡Expiration Date

The expiration date indicates the time until which a product is expected to remain in good condition. In the script, it is mentioned that one should check the expiration date of the culture bottles to ensure they are not expired, as expired media may not support the growth of microorganisms properly.

💡Turbidity

Turbidity is the cloudiness or haziness in a liquid caused by individual particles that are not soluble. The script warns against using culture bottles containing media that display turbidity, as this could indicate contamination or spoilage.

💡Disinfection

Disinfection is the process of killing or neutralizing pathogens using chemical or physical methods. The video script describes a step-by-step procedure for disinfecting the chosen puncture site on the patient's arm before drawing blood, which is essential to prevent introducing contaminants into the blood culture.

💡Vena Puncture

Vena puncture, also known as venipuncture, is the process of inserting a needle into a vein to draw blood. The script provides instructions on how to locate the vein, apply a tourniquet, and perform the puncture without repalpating the site to avoid introducing contaminants.

💡Aerobic and Anaerobic Bottles

Aerobic and anaerobic bottles are used in blood culture to differentiate between microorganisms that require oxygen to grow (aerobic) and those that do not (anaerobic). The script specifies the order of collection, starting with the aerobic bottle first, to prevent air from altering the anaerobic environment.

💡Fill to Mark

The fill to mark is a guideline on the culture bottle indicating the appropriate volume of blood to be collected. The script mentions using this mark to gauge the sample volume accurately, ensuring sufficient blood is collected for optimal organism detection.

💡Labeling

Proper labeling of blood culture bottles is essential for accurate identification and tracking of samples. The video script details the correct way to label the bottles, including placing barcode labels vertically and ensuring no information covers the barcode or fill to mark.

💡Biohazardous

Biohazardous refers to materials that are contaminated with or pose a risk of transmitting infectious agents. The script mentions placing inoculated culture bottles and blood collection tubes in a biohazardous plastic bag, indicating the need for proper handling and disposal to prevent the spread of infection.

Highlights

A properly collected blood culture sample is crucial for accurate results and improving patient outcomes in sepsis cases.

Two blood culture sets should be obtained before administering antimicrobial agents.

Ensure all materials are gathered, including bottle details and patient information for accurate blood culture.

Check the expiration date and condition of culture bottles to avoid contamination.

Wash hands or use alcohol rub, and wear gloves for the blood collection procedure.

Confirm patient identity and match laboratory test requests to ensure correct blood collection.

Prepare materials in a clean area and disinfect blood culture bottles using an approved disinfectant.

The arm is the recommended site for drawing blood culture with a disposable underpad and tourniquet.

Disinfect the puncture site with 70% isopropyl alcohol and allow it to dry before applying the second disinfectant.

Do not repalpate the vein after disinfection to maintain sterility.

Start with aerobic bottles first to prevent air in the tubing from affecting the culture atmosphere.

For pediatric patients, use a special pediatric aerobic bottle and inoculate with up to 4 mL of blood.

Grasp the adapter cap by the outer edge and avoid touching the center to prevent contamination.

Use the fill-to mark to gauge the sample volume accurately, 10 mL per adult bottle.

If other blood tests are required, collect blood cultures first to avoid contamination.

After collecting, gently mix blood culture bottles and tubes by inverting to ensure proper mixing.

Label the bottles properly with barcode labels and additional information as required.

Place inoculated culture bottles in a biohazardous plastic bag and transfer promptly to the laboratory.

Three key points for blood culture collection: proper disinfection, sufficient blood volume, and prompt transfer to the lab.

Transcripts

[Music]

a properly collected blood culture

sample free of contaminants can help to

ensure accurate results that can improve

patient outcomes for patients with signs

and symptoms of sepsis two blood culture

sets should be obtained as soon as

possible and before antimicrobial agents

are

administered gather all necessary

materials bottle Lot number expiration

date fill to Mark barcode Black Box

window for checking the level of

blood area to add patient information

and test

label check that the culture bottles are

within the expiration date do not use a

bottle containing media displaying

turbidity a yellow sensor or any other

visible

defs do not use bottles that show signs

of damage deterioration or leaking

AG wash your hands with soap and water

and then dry them or apply an alcohol

hand

rub then apply well-fitting non-sterile

examination

gloves before starting the collection

procedure confirm the patient's identity

check that the requested Laboratory test

and patient information matches the

patient's identity this could be either

using a printed label form or mobile

device

prepare the collection materials in a

clean protected area to help minimize

contamination remove the flip caps from

the blood culture

bottles disinfect using an approved

disinfectant use a fresh swab or

applicator for each

bottle remove the swab or applicator and

allow bottle tops to dry completely

attach the set to the collection adapter

cap if it is not already

connected note the adapter cap may have

an insert that needs to be removed when

collecting blood cultures the insert

will be used if additional blood test

tubes are needed the arm is the

recommended site for drawing a blood

culture place a disposable underpad

under the patient's arm locate the vein

and apply a disposable

tourniquet palpate to locate the vein

disinfect The Chosen vea puncture site

according to your facility's approved

procedure recommendations are to cleanse

the site with friction for 30 seconds

using 70% isopropyl alcohol allow to dry

then apply the second disinfectant

following the manufacturer's

recommendation the vena puncture site is

not considered a septic until the

disinfectant has fully evaporated

[Music]

do not rep palpate the prepared vein

before inserting the needle enter the

vein swiftly blood appearing in the

blood collection tubing confirms a

successful vein app puncture release the

tourniquet as soon as the Blood starts

to flow and always if it has been in

place for 2 minutes or

more always start with the aerobic

bottles first as the air contained in

the tubing will not affect the

atmosphere of the aerobic bottle if the

Anor robic bottle is collected first the

air contained in the tubing will alter

the atmosphere of the Anor robic bottle

for Pediatric patients a special

pediatric aerobic bottle may be used and

inoculated with up to 4 mL of

blood grasp the adapter cap Always by

the outer edge and don't put your finger

into the center place the adapter cap

over the aerobic bottle and press

straight down to pierce the septum

continue to hold the adapter cap down

during the collection keep the bottle in

an upright position below the patient's

arm during the collection to avoid back

flow of the media into the

tube use the fill two Mark to accurately

gauge the sample volume 10 ml per adult

bottle

the vacuum inside the bottle will not

stop at 10 mL so be sure to not overfill

for Pediatric patients a special

pediatric aerobic bottle may be used and

inoculated with up to 4 mL of

blood once the aerobic bottle has been

inoculated remove the bottle from the

adapter cap insert the Anor robic bottle

and repeat the collection

procedure use the fill two Mark to

accurately gauge the sample volume 10 m

per adult bottle if other blood tests

are required always collect blood

cultures first insert the adapter if

required for blood tubes to collect

blood taking caution not to put your

finger into the center to avoid a needle

stick remove the needle from the vein

gently and engage the safety device if

utilized by your facility cover the

patient's puncture site with a suitable

dressing and apply

pressure discard the the entire

collection device into a Sharps

container and dispose of other

materials when complete gently mix blood

culture bottles and tubes by inverting 3

to five

times to properly label the bottle use

the dedicated area on the bottle if

using a test label place the barcode

label vertically so the orientation is

the same as the Bottle Bar Code do not

cover any of the bottle bar codes or the

fill to Mark or window to check the

blood level add any additional

information if required such as date

time and collected by ensure that any

additional labels do not cover the

bottle

barcode Place bottles and blood

collection tubes in a biohazardous

plastic bag if available place the label

or request form in the outer compartment

of the

bag transfer the inoculated culture

bottles promptly to the test

laboratory three important points to

remember regarding blood culture

collection first proper disinfection is

crucial to the ensuring of a

contamination-free

culture second sufficient blood volume

will help ensure optimal organism

detection and third transfer the

inoculated bottles promptly to the

laboratory

[Music]