Topic outline

  • General

  • Catether collection

    Speaker: Stephen Church (BD); on behalf of the EFLM Working Group on the Preanalytical Phase (WG-PRE)
    Moderator: Zorica Sumarac (SRB)

    Date: 18th September 2018 at 18:00 CET

    Abstract

    Vascular Access (VA) is a routine procedure, conducted worldwide, with an estimated 60-90% of hospital inpatients expected to require an intra-venous catheter (Helm et al., 2015), particularly in emergency situations or departments.  A number of vascular access devices (VADs) or IV catheters could potentially be used to collect blood samples, including peripherally-inserted venous catheters, centrally-inserted venous catheters and arterial catheters.  Practices and procedures for blood collection from conventional blood collection needles are well defined (Simundic et al., 2018).  Until recently, many guidelines have not commented on or proposed a best practice for collection from a VAD. The CLSI document GP41-A6 (2007) stated that without complete, thorough and documented training, “Phlebotomists should not draw blood from VADs.”  However the 2017 edition, GP41-A7, is the first to make recommendations for blood collection using VADs.  Trauma from VAD insertion, together with a tortuous blood path with increased shear forces, can contribute to increased cell lysis.  Further incomplete flushing of the collection site resulting in contamination and/or dilution of the specimen has the significant potential to create test errors and inaccurate results. While haemolysis is the most widely reported error (Lippi et al., 2011), impacts on coagulation parameters have also been reported (Strauss et al., 2012).  Furthermore, the collection may lead to dislodgement of the catheter and require a replacement.  In special circumstances, for example when obtaining samples from paediatric patients, adults with difficult venous access, presence of bleeding disorders or when serial tests are requested, blood collection from a short peripheral catheter may be clinically beneficial. In these patients, guidance on the best practice is required to ensure patient safety and care. 

    This webinar will overview the risks associated with blood collections from VADs, the type of VAD from which samples may be collected and also provide recommendations on best practices to obtain the highest quality sample and ensure patient care.

    REFERENCES:

    • Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189–203
    • Simundic, A.-M., Bölenius, K., Cadamuro, J., Church, S., Cornes, M. P., van Dongen-Lases, E. C., … Vermeersch, P. (2018). Joint EFLM-COLABIOCLI Recommendation for venous blood sampling. Clinical Chemistry and Laboratory Medicine (CCLM).
    • Clinical and Laboratory Standards Institute (CLSI). Procedures for the collection of diagnostic blood specimens by venipuncture; approved standard, 6th edition. CLSI Document GP41-A6. Wayne, PA: CLSI; 2007.
    • Clinical and Laboratory Standards Institute (CLSI). Collection of diagnostic venous blood specimens, 7th edition. CLSI Document GP41-A7. Wayne, PA: CLSI; 2017.
    • Lippi G, Plebani M, Di Somma S, Cervellin G. Hemolyzed specimens: a major challenge for emergency departments and clinical laboratories. Crit Rev Clin Lab Sci . 2011;48(3):143-153.
    • Strauss M, Sherman B, Pugh L, et al. Hemolysis of coagulation specimens: a comparative study of intravenous draw methods. J Emerg Nurs . 2012;38(1):15-21

    About the speaker

    Stephen ChurchStephen Church (BD) 
    - Clinical Director
    - BD Medication Management Systems

    Stephen Joined BD in 1990 and has played an active role in the design, development and implementation of Medical devices for over 25 years. Initially working as a member of BD R&D team, Stephen has conducted more than 40 evaluations of BD products at hospitals and laboratories in Western Europe.
    For the past 14 years Stephen has been working as a clinical specialist supporting the implementation of BD blood collection products at hospitals. In this role Stephen has been able to support hospitals by working together to make significant improvements in their processes & practices. 
    Stephen is a member of a number of working groups including ISO, EFLM & IFCC, has published a number of articles and made presentations at scientific meetings on various topics key on laboratory medicine (20+).
    Stephen has recently moved to the role of Clinical Director for the BD catheter business (BD Medication Delivery Solutions) and so has unique insight into both the needs of Laboratory Medicine and IV access.
    • Assessment & Certificate