Blood Culture Collection (OSCE)

Introduction 

1. Greet patient and introduce yourself
2. Briefly explain the procedure in a patient friendly manner 
3. Get patient consent ✅ 
4. Ask the patient to sit and expose their arm 
5. Check the patient is not any pain and if they have any allergies 
6. Wash hands ✋ 

Equipment 

 Disposable gloves ✋ 

 Apron  

 Laboratory paperwork ✍

 Transportation bag 📩

 Tourniquet 

 Blood sampling device and blood culture bottle adapter 

 Anaerobic blood culture bottle 

 Aerobic blood culture bottle 

 3 cleaning swabs 

 Sterile gauze and plaster 

 Tape 

 Sharps bin 🗑

Preparation 

1. Put gloves on ✋ 
2. Collect unpackaged equipment on a tray 
3. Prepare blood collection device (attach needle) 💉
4. Clean top of each blood culture bottle with a new cleaning swab 
5. Inoculate blood culture bottles 

Deciding which arm to use 

 Ask patient preference 

 Check medical records to identify anything which makes one of the arms unsuitable (e.g. previous stroke, lymphoedema, arteriovenous fistula) ✍

 If one arm has an intravenous infusion, choose the other 

 Position a pillow under the chosen arm 

Deciding which vein 

1. Inspect chosen arm for a suitable venepuncture site: 
2. Antecubital fossa’s median cubital vein is a common site 
3. Avoid bruised/broken skin 
4. Avoid the sites where 2 veins conjoin 
5. Extend arm 
6. Place 4 or 5 fingers above the chosen site and apply the tourniquet here 👉 
7. Palpate the chosen vein to ensure it is suitable 
8. Tap vein as patient clenched wrist repeatedly 
9. The vein should feel springy, not hard 
10. Release the tourniquet 
11. Put apron on 
12. Apply alcohol gel to wash your hands ✋ 
13. Put gloves on ✋ 
14. Clean the chosen venepuncture site with 2% chlorhexidine in 70% isopropyl alcohol 
15. Allow site to dry 

Inserting the needle 

1. Reapply tourniquet to same position as before 
2. Uncover the needle 💉
3. Pull the skin next to the chosen venepuncture site with your non-dominant hand ✋ 
4. Inform the patient you are ready to insert the needle and they may feel a sharp scratch  
5. Insert the needle and the venepuncture site, at a maximum of a 30° angle  📐
6. When you observe flashback, push the needle 1 to 2mm further into the lumen of the vein 
7. Use the wings of the butterfly needle to anchor the needle to the skin  
8. To the adaptor, attach the aerobic blood culture bottle 
9. Allow 10ml blood to fill the bottle 
10. Remove the aerobic bottle and replace it with the anaerobic bottle  
11. Allow 10 ml blood to fill the bottle 
12. Release tourniquet again 
13. Remove needle 💉
14. Apply pressure with gauze or cotton wool to venepuncture site  
15. Ask patient to hold the gauze or cotton wool in place 
16. Appropriately dispose of sharps 🗑
17. Apply dressing to site of venepuncture 
18. Appropriately discard of remaining equipment 

Completion   

1. Tell the patient the procedure is complete ✅ 
2. Thank patient 
3. Wash hands ✋ 
4. Write patient details on blood sample bottles  
5. Send blood sample to laboratory 
6. Document details of procedure in patient’s notes  ✍ 

Summary

1. Greet the patient and explain the procedure
2. Prepare by collecting the equipment, putting on PPE, washing your hands and inoculating the blood culture bottles
3. Identify the more suitable arm, and a suitable venipuncture site
4. Apply the tourniquet 4-5 finger-widths above the site, and palpate the vein
5. Insert the needle into the lumen of the vein
6. Fill the anaerobic then aerobic blood culture bottles
7. Apply pressure with cotton wool then apply a plaster
8. Complete the procedure by thanking the patient and appropriately disposing of waste