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I have a related question.  Do you draw lactate levels off the iv?  do you limit tourniquet time when doing so?

Thanks,

Lilia Guerra
Lawrence, MA


> On Feb 23, 2018, at 8:23 AM, Chamberlain, James <[log in to unmask]> wrote:
> 
> We have a similar bundle that emphasizes strict sterile technique. Our second major intervention was to reduce the number of blood cultures ordered using evidence-based guidelines. We have reduced our blood culture contamination rate from a contaminant every 3 days to every 14 to 16 days.
> 
> Jim Chamberlain
> Washington, DC
> 
> 
> 
> Sent from my Verizon, Samsung Galaxy smartphone
> 
> 
> -------- Original message --------
> From: Rick Place <[log in to unmask]>
> Date: 2/23/18 00:27 (GMT-05:00)
> To: [log in to unmask]
> Subject: Re: Second venipuncture for reducing blood culture contamination?
> 
> A medical question ?!?
> 
> We were running about 5% contamination rate last year with direct patient
> consequences. We pulled nursing together, looked at best practices, and
> created a bundle approach to peripheral blood cultures. We went 6 months
> with an average of about 2%, so it seemed to work.
> 
> We do draw from the IV line, pretty much in all ages.
> 
> One question I might ask the group is what lower limit of contamination is
> possible. I initially felt that 0% might be a stretch goal but have since
> learned that there may be bacteria in the skin plug that prevents 0%.
> 
> There is a device the adult ED has initiative that diverts the first 1 ml
> of blood to reduce contamination in adult patients. The company wants to
> trial that in pediatrics but I am afraid that in our smaller kids, even 0.5
> ml may simply be too much to waste.
> 
> Rick Place
> 
> On Thu, Feb 22, 2018 at 12:10 AM, Mathew George <[log in to unmask]> wrote:
> 
>> there has been an increasing number of blood culture contamination from our
>> PED recently.
>> 
>> All the peds EDs I work, we obtain the blood culture when the IV cath is
>> inserted.
>> 
>> How many of you use a second venipuncture for obtaining blood culture,
>> particularly in infants 2 months and less
>> 
>> Thanks
>> 
>> Mathew
>> 
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html