![]() However, in standard practice, a discard blood volume of 5 mL, greatly in excess of the estimated intraluminal volume, is generally recommended for all lines.Ī single occasion of blood sampling may cause minimal blood loss however, cumulative volume of discarded blood from sequential sampling may become clinically significant. The discarded volume before blood sampling is likely to be determined by the size and type of the CVAD. To ensure that the blood sample is not diluted or contaminated with the residual heparinized saline or fluid, the first blood is usually not sent to the laboratory.ĭifferent methods of blood sampling, including discard method, push–pull method, reinfusion method, and dead space method, have been reported to have their own advantages and potential complications.ĭiscard method is widely practiced worldwide and is considered reliable. When not in use, they are flushed with heparinized saline to clear the lumen of blood. Thus, nurses in critical care are uniquely positioned to limit the diagnostic blood loss while obtaining blood samples.Ĭentral venous access devices (CVAD) are an essential part of safe practices in oncology and critically care. The practice of discarding 3 mL of blood for discard method is suggested, instead of the standard 5 mL to reduce iatrogenic blood loss. All serum parameters showed excellent reliability, except for sodium which demonstrated good reliability. The agreement limits of sodium, potassium, creatinine, and direct bilirubin were outside the clinically accepted interval, but the proportion of samples outside these intervals was less than 10%. Potassium and creatinine levels showed significant proportional bias. When tested for fixed bias, there is no statistically significant difference between the methods. Bland–Altman plot analysis and intraclass correlation were used for clinically meaningful analysis. test and Wilcoxon signed rank test were used for comparing the two methods. Six serum parameters were measured on each of the paired samples and compared. ![]() Two blood samples, using 3 mL and 5 mL discarded volume methods, were collected from each patient. ![]() Within-subjects comparative design was adopted for 64 adult patients in the medical intensive care unit of a tertiary hospital. The study aims to reduce diagnostic blood loss, ensuring that the subsequent blood sample is not diluted or contaminated by residual intraluminal fluid. A single occasion of blood sampling may cause minimal blood loss however, the cumulative volume sequential sampling may become clinically significant. Discard method is widely practiced for blood sampling. Central venous access devices (CVAD) are an essential part of safe practices in critical care, which enable effective venous access and help in avoiding repeated venipuncture. ![]()
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