TABLE 1.

Protocol of phlebotomy technique for obtaining blood cultures

1. Set up two sets of venipuncture devices with butterfly needles, adapter needles and holders.

2. Prepare two sets of venipuncture devices, four blood culture bottles, a tourniquet, a pair of gloves, two packs of swabs soaked in 70% isopropyl alcohol. Additionally, in the ward, a cup of sterile swabs soaked in povidone-iodine and a set of forceps are required.

3. Determine the site of venipuncture. If the patient condition permits, forearms are preferred, considering local cleanliness of the site. When the venipuncture site appears unclean, wipe the area with a swab soaked in 70% isopropyl alcohol only once before skin disinfection.

4. Scrub the venipuncture site firmly with a 70% isopropyl alcohol swab beginning in the center and continuing outwardly in a concentric fashion.

5. Repeat the antisepsis with a 70% isopropyl alcohol swab once more. In the ward, two swabs of povidone-iodine are additionally applied on the puncture site.

6. Wait until the area dries completely or for at least 30 s if povidone-iodine is used.

7. Open the cap of blood culture bottles and wipe the top with an alcohol pad.

8. Put on a tourniquet, puncture the vein by using the venipuncture device, and carefully avoid touching the vein. If the vein needs to be touched for localizing it, phlebotomists must wear sterile gloves.

9. Insert the top part of blood culture bottles into the holder so that the adapter needle can puncture the top, inoculating 5ml or more of blood into an aerobic bottle and an anaerobic bottle.

10. Repeat the same procedure on a different site to obtain another set of blood cultures.