Specimen Requirements

Since media into which blood specimens are placed have been developed as enrichment broths to encourage the multiplication of even 1 bacterium, it follows that these media will enhance growth of any stray contaminating bacterium such as the normal inhabitants of human skin.

It is undesirable to draw blood through a vascular shunt or catheter, since these prosthetic devices may harbor colonizing bacteria that are not present in circulating blood of patient; and blood obtained through foreign material would yield false-positive results. It is also recommended to draw blood below an existing intravenous line, if possible, since blood above line will be diluted with fluid being infused.

Preparation of Patient and Collection of Blood
1. Collect blood 1 hour prior to expected fever/chills (usually mid-afternoon). Blood may be sterile by time fever begins.

2. Choose vein to be drawn by touching the skin before it has been disinfected.

3. Cleanse skin over venipuncture site in a circle approximately 5 cm in diameter with 70% alcohol, rubbing vigorously.

4. Starting in center of circle, apply 2% iodine (or povidone-iodine) in ever-widening circles until entire circle has been saturated with iodine. Allow iodine to dry on skin for at least 1 minute. The timing is critical; a watch or timer should be used.

5. If site must be touched by phlebotomist after preparation, phlebotomist must disinfect fingers used for palpation in identical fashion or must palpate through a sterile glove. (Universal Precautions dictates that phlebotomists wear gloves.)

6. Insert needle into vein and withdraw blood. Change needle, and clean tops of bottles with alcohol before injecting blood into culture bottles.

7. After needle has been removed, site should be cleansed with 70% alcohol again as many patients are sensitive to iodine.

8. Place 5 mL of blood in an Organon Teknika Mycobacterium bottle.

9. Label bottle with patient’s name (first and last), date and actual time of collection, and type of specimen.

10. Maintain sterility and forward promptly.