Specimen Collection and Handling

Pre-sample Collection

1. Upon entering the patient room, cleanse your hands
2. Follow the Venipuncture and PID procedure to properly identify the patient
3. Apply tourniquet to look for best areas to use for the collection of the samples
4. Once you have secured an adequate vein and location, gather your supplies for the procedure following Table I and Table II below for the selection of appropriate bottles to use for the patient.
5. Remove the caps from the bottles and cleanse the top (septum) of the bottles with the 70% isopropyl alcohol pad and let air dry.

Note: It is important that the bottles stay in an upright position prior to collection until the sample has been inoculated into the bottles.

Cleansing the Draw Site

1. Remove the ChloraPrep from the package and do not touch the sponge
2. Hold the applicator horizontally with the sponge down. Pinch wings only once to activate the ampule and release the antiseptic.
3. Wet the sponge by pressing and releasing the sponge against the treatment area on the patient until the liquid is visible on the skin.
4. Completely wet the treatment area with antiseptic.
5. Use gentle repeated back and forth strokes for 30 seconds. Allow the area to air dry for approximately 30 seconds up to a minute depending on saturation of the skin. Do NOT blot or wipe away and do not blow on the site or fan the site. The site must air dry.
6. Discard the applicator after a single use along with any portion of the solution not required to cover the prep area. It is not necessary to use the entire amount available. Note: for pediatric patients age less than 2 months old, cleanse the draw site 2 times with an aseptic circular technique using separate pads saturated with 70% isopropyl alcohol.

Sample Collection

1. Determine the adequate gauge of BD Safety-Lok blood collection set you need for the vein that has been selected.
2. Open the BD Safety Lock winged infusion needed based on the gauge determined when locating the draw site, remove the luer adapter from the device and discard in a sharps container.
3. Open the syringe package to expose plunger side of the device
4. Remove the syringe from the package and attach to the BD Safety-Lok winged infusion needle. Do not touch the tip of the syringe or allow to touch any surface.
5. The unsheathed needle that has been connected to the syringe at this point can be set down on the surface. To assist for post collection, you may open the BD transfer device but leave it in its packaging. Note: Do not touch the tip of the transfer device or allow it to touch any surface before it’s attached to the syringe.
6. Re-apply the tourniquet. Precaution: After the skin has been cleansed, it must not be touched again. Do NOT re-palpate the vein/site--this will contaminate the sample.
7. Perform the Venipuncture using the adequate gauge BD Safety-Lok winged infusion set and adequate BD syringe, following the Venipuncture & PID procedure. Follow Table I below on the necessary amount of sample is needed for the blood culture bottles that you are collecting.
8. Once the adequate sample is collected, release the tourniquet.
9. Place gauze over the site and remove the BD Safety-Lok winged infusion set needle and immediately safety the device following manufacturer’s standard.
10. Ask the patient to hold pressure
11. Remove the BD Safety-Lok winged infusion device from the syringe and immediately dispose of the needle.

Post Sample Collection 

1. Attach the sample filled syringe to the BD transfer device
2. Using the tables below to determine what bottles are used and how much to dispense, dispense the appropriate amount of blood into the bottles. Always start filling the Aerobic Bactec (gray/blue) bottle first followed by the Anaerobic (purple/purple) bottle next, if enough specimen was obtained to fill both. Note: If 10ml’s or less of specimen could be obtained, the entire sample should be dispensed into the Aerobic (gray/blue) bottle.
3. After the Bactec bottles have been filled, the bottles need to be labeled ideally with an LIS label. In cases where LIS labels are unavailable, make sure to write the patients full last name, full first name, date of birth as well as the collection date/time and collectors initials on the bottles.
4. Bag the sample set and forward promptly to the laboratory.
5. Repeat all steps from Pre-Collection through Post Collection if additional sets have been ordered. Note: It is recommended that only 1 set of cultures are collected from a line as the line can be a source of contamination. Line collections are not performed by NorDx personnel, nursing staff at the locations would be responsible for line collections.

Table I:  Recommended Volumes per Blood Culture Set

Table II:  Sample Distribution for non-pediatric collection

Table III:  Optimum Fill per Bottle