Central Line Blood Sampling: Introduction (Nursing)

00:04 Hey guys, welcome to the skill central line blood sampling.

00:08 So this is a really handy skill because you're going to use this a lot in acute care.

00:12 We love getting blood sampling from central lines or a PICC line because this keeps us from having to continually have to puncture the patient to receive blood for lab results.

00:24 So let's take a look at this skill.

00:25 So when we're talking about central line blood sampling, let's take a look first at what we're going to need.

00:31 So as you see on this image, you notice at least 2 10 ml normal saline syringes.

00:44 after central line blood sampling to clear that line.

00:48 Now next, of course, you need plenty of antiseptic pads to clean in between So most central lines are going to require that you flush with a full 20 mls of normal saline and you may use an equipment such as this.

00:56 So one thing to know is that it depends on your facility and the type of central line that you have that each facility differs in regards to their equipment that they use for central line blood sampling.

01:08 So today we're going to use a needleless blood collection tube holder.

01:13 Now you might hear the brand name of vacutainer and many times as a nurse or staff that do central line blood sampling, you're going to hear the word vacutainer much more common than the needleless tube holder.

01:27 One thing to note if you look at the image as well, you may say these tube holders that are different So one may have a male end like you see here on this image, or you may have one that has a female end which is what we are going to be using today.

01:42 Now dont forget your luer lock 10 cc syringe, this is what we're going to use the pull back the blood for the sample to put this in our blood collection tubes.

01:52 Now before you get started with your central line blood sampling, it's really important that you check your physician's order to verify which tubes that you need.

02:03 Also, you want to verify if you're unfamliar to make sure you've got the right lab and the right tube before you start.

02:09 And of course our biohazard transport bag for those samples.

02:14 Now before you get started, it's important that you assess your patient and your central line.

02:19 There's different varying central lines that you may see.

02:22 You could see them in the neck, for example, you may see them in the arm, some have a little bit different look, maybe if you're in the ICU versus one that may look like a peripheral inserted central catheter, which is much what we're going to use today that you'll get to see.

02:37 Also, when you're talking about that, when you're looking at your central lines, just note that there is the lumen, the line itself.

02:46 So you may see a lumen like this, which is the tube, then on top of that tube or the lumen, there's the needleless connector, or what you may hear as known as the cap of the lumen on your central line.

02:58 Now this here, the needleless connector or the cap is where we're going to attach our luer lock syringe and get our blood sampling today.

03:06 So before we get started, don't forget to perform your hand hygiene and provide privacy to your patient.

03:12 Of course, make sure you let the patient know what you're doing when you enter the room and explain this thoroughly.

03:18 We want to raise the bed to an appropriate working height and assist the patient to a proper position.

03:23 Usually we're just positioning them so we have ease and access to the line itself.

03:29 Now perform hand hygiene again and put on our gloves.

03:32 Now, many times when a patient has a central line or a PICC line, for example, they're usually hooked up to fluids.

03:39 So we want to trace all that tubing to the point of where it's connected.

03:44 So we want to assess it here.

03:46 Now again, if that fluid is going, this is the time to stop the infusion.

03:52 Now there are different facility policies on this so make sure you check yours but of course, makes a lot of sense, we don't want a lot of extra fluid running in when we're trying to pull a blood sample.

04:03 we want the purest blood sample as possible.

04:06 So stop your infusion if they're going.

04:08 Now we want to check and select the appropriate lumen for withdrawing a blood sample.

04:13 Just know there's some variations on this.

04:16 There may be 1 lumen there may be 3, so just take a look and assess your line.

04:21 Now again, if we've got that IV tubing connected, we want to go ahead and disconnect that from the appropriate tubing.