| Specimen Requirements |
Blood culture bottles are used for collection. If other blood work is to be collected, collect the blood cultures first.
Adults (14 years old and older):
- Collect 2 SETS (4 bottles) from 2 separate sites, e.g. right arm and left arm.
- Each set consists of a green (aerobic) and orange (anaerobic) bottle.
- Always collect the green bottle first. DO NOT use yellow (pediatric) bottles for adults.
Collect 10 mL per bottle. When an inpatient has an indwelling line, generally the unit will collect one set from the line (collect a discard tube before filling blood culture bottles) and may request the lab to draw the other set by venipuncture.
Pediatric collections (under 14 years old):
- Collect a yellow (pediatric) and orange (anaerobic) bottle.
- Always collect the yellow bottle first.
Blood Culture Bottle Descriptions and Volumes
IMPORTANT!
Total volume of blood drawn depends on the patient weight and volumes required for blood tests requested. Refer to Maximum Blood Draw on Patients Weighing Less than 45 kg (100 lb) for allowable draw volumes.
Draw the maximum amount of blood into blood culture bottles whenever possible. False negative results may occur if the optimum volume of blood is not placed into the blood culture bottle.
|
Color
|
Description
|
Maximum (optimal)
volume
|
Minimum
volume
|
|
Green
|
BAC T/ALERT BOTTLE, AEROBIC
|
10 mL
|
5 mL
|
|
Orange
|
BAC T/ALERT BOTTLE, ANAEROBIC
|
10 mL
|
3 mL
|
|
Yellow
|
BAC T/ALERT BOTTLE, PED. PLUS
|
4 mL
|
1.5 mL
|
Less than Optimal Volume
If it is not possible to collect the maximum (optimal) volume, use the following information to determine the volume of blood to transfer to each bottle:
Adults (14 years old and older):
Place as much blood as possible into the green bottle (at least the minimum volume, but no more than the maximum), then place remaining blood into orange bottle (at least the minimum volume, but no more than the maximum).
Pediatric collections (under 14 years old):
Use the following table to determine blood volumes to be transferred into each bottle:
|
Volume drawn for blood culture
|
Blood culture bottle
|
Blood transfer volume to bottle
|
|
1.5 to 4 mL
|
Yellow
|
All
|
|
5 mL
|
Yellow
|
4 mL
|
|
6 mL
|
Yellow
|
3 mL
|
|
Orange
|
3 mL
|
|
7 mL
|
Yellow
|
4 mL
|
|
Orange
|
3 mL
|
|
8 mL
|
Yellow
|
4 mL
|
|
Orange
|
4 mL
|
|
9 mL
|
Yellow
|
4 mL
|
|
Orange
|
5 mL
|
|
10 mL
|
Yellow
|
4 mL
|
|
Orange
|
6 mL
|
Collection
- Check the bottom of the bottle – if it is yellow, do NOT use (the bottle may be contaminated).
- Check the expiry date (y/m/d) found on the blood culture bottle labels. If expired, DO NOT use.
- Draw a line on bottle indicating appropriate fill level (DO NOT overfill or underfill).
- Disinfect bottle tops with 70% isopropanol and allow to dry for 1 minute. DO NOT use iodine.
- Use “butterfly” collection units. Syringe collection is not desirable. DO NOT use straight needle and Vacutainer.
- If other blood work is to be collected, collect the blood cultures first.
- After selecting blood collection site, scrub the site with 70% isopropanol for a minimum of 30 seconds. Allow to dry. Using 10% PVP Iodine or Chlorhexidine gluconate solution, cleanse the site for 30 seconds using a circular motion, starting at the center of the site and moving outward. Allow to dry, preferably for 2 minutes, minimum 1 minute.
- If patient is allergic to 70% alcohol, use double application of PVP Iodine; if patient is allergic to iodine, use double application of 70% isopropanol. Allow to dry.
- Re-palpation of blood culture collection sites is not recommended. If re-palpation of venipuncture site is necessary to locate vein, disinfect gloved finger with alcohol and iodine (or alcohol and chlorhexidine) and perform venipuncture just above or below the re-palpation site.
- After collection, gently mix bottles by inversion to prevent clotting.
- Remove residual iodine from skin with 70% isopropanol after venipuncture.
- Ensure both bottles are labelled with the minimum patient identifiers. If both sets are being sent to the lab in one bag, ensure each bottle is also labelled with "number 1" for the first set and "number 2" for the second set. |
| Specimen Handling |
Blood Culture specimens must arrive at the DSC within 3.5 hours of receipt.
Keep bottles at room temperature. DO NOT refrigerate. DO NOT incubate.
Check the bottom of each collected bottle; if it is yellow, transport to DSC STAT (indicates possible growth in bottles). |
| Additional Information |
Blood cultures should, whenever possible, be collected before administration of antimicrobial agents, therefore may be ordered and collected STAT.
3 sets per 24 hour period are ONLY permitted on patients suspected of having endocarditis or endovascular infection. Collect 3rd set at least 20 minutes after initial 2 sets.
Ordering physician must obtain Microbiologist approval (403-770-3757 ) for requests for more than 3 sets per 24 hour period, before collection.
Negative culture turnaround time:
Preliminary report - 48 hours
Final report - 5 days. |
