Obtaining Blood Samples From Peripheral Intravenous Catheters: Best Practice?

Occasionally, nurses perform phlebotomy via intravenous catheters, especially to improve efficiency in short-stay or procedural units. The intent of this practice is to reduce the number of venipunctures and thus increase patients’ comfort. However, obtaining laboratory specimens from peripheral intravenous catheters may hemolyze the specimens, and can even dislodge catheters and necessitate restarts. Both of these scenarios may lead to multiple needle sticks and delayed treatment, not only reducing patients’ satisfaction but also increasing costs of care.¹ 

Hemolysis is a rupture of red blood cells with a release of hemoglobin and other intracellular contents into the plasma.² In vitro hemolysis interferes with tests such as blood bank/coagulation testing and measurement of levels of creatine kinase, lactate dehydrogenase, potassium, iron, digoxin, alanine and aspartate aminotransferase, and β-human chrorionic gonadotropin.³ Depending on the level of hemolysis, specimens may need to be rejected and another sample would need to be...