01.09 Drawing Blood from the IV

Okay. Guys, in this lesson we're going to take a look at when you would actually draw blood from an IV. The first thing you need to know is it's not recommended based on evidence. There's a lots of things that are out there that show that this can actually cause a lot of problems. There are devices on the market that allow you to draw blood through a peripheral IV, but there's a lot of training, uh, and there's just more that goes into it. However, that being said, if you have the opportunity when you first go to insert an IV that your patient has good blood return, it doesn't hurt anything because it's so fresh to actually get a sample. The first thing that you need to do before you even put the IV in is to make sure that you have an order for all your labs. 

You want to make sure that you have an order for the IV as well, but also make sure that you know specifically what blood tubes you need. Are you going to need a purple top? Are you going to submit a CBC or lactate? There's lots of things that you can do off that fresh stick, but the thing that you want to remember is that as you do it, you want to make sure that you're not causing damage to the IV itself. If you're getting blood this way on that patient's IV stick, make sure that you're using minimal negative pressure. The reason you want to do this is you also don't want to collapse that brand new IV that you placed caused patient problems because of a collapsed vessel and now you have an IV that doesn't work. But the other thing is you don't want to cause problems with your blood sample. 

That negative, that extreme negative pressure can actually cause a lysing of those cells and then you're going to have to redraw anyway and it becomes a big pain. So just make sure that it's a nice fluid motion with minimal negative pressure. If you get resistance and it stops flowing back, call it a day and make sure that you get blood by other means necessary, whether that's a fresh stick which is actually indicated, or if your patient has a different type of, uh, access. Maybe central access with several different lumens, maybe a pic, a, there are several different options that you can go for. It doesn't always have to be through that PIV. Now take a look at this video to see how to safely draw blood from an IV, but you get your IV set in the vein. What you're going to do is you're going to grab the flush and you're going to actually withdraw the sample that you need, and once you get that sample, the first thing you're going to do is waste three to five miles, and then you're going to pull the actual sample that you need.

After that, make sure you hook up a new flush and you want to flush that line that you just worked really hard to get. Grab a new flush in. The other thing you want to do is make sure that you're not clamped and to make sure that line stays Peyton. You're going to reflush and then after that, you're going to make sure that you spend the time securing that IV. Now that you've got your sample. What you're gonna do is take this blunt tip plastic Canyon and you're gonna attach it to the sample syringe. After you do that, then you're going to do is grab the necessary vacuum tanners or vials that you need. Use that blunt tip. You don't want to poke yourself, apply pressure and then what's going to happen is you're going to fill up this a tube, the blood tube and what you want to do is you want to continue filling that blood tube all the way up as full as it needs to be.

This is indicated on the label with that little black Mark you want to fill to that designated line. One other tip that you can employ is if your patient does start to have a little bit of a sluggish blood return, which you can actually do is manipulate the hub of the catheter up and down just slightly to maybe change the angle and you can sometimes get some blood back from that, but again, if it doesn't work, call it a day and move on. I hope that these tips have been helpful. Now go out and be your best selves today. And as always, happy nursing.