STAND-ALONE BEDSIDE PROCEDURE PATHWAY

Blood cultures

Right patient, right volume, separate sites, before antibiotics without harmful delay
Safe blood culture collection including identification, antisepsis, peripheral collection, labelling and transport
1Identify2Prepare3Clean + dry4Collect5Label + send

Indications

  • Sepsis/septic shock, endocarditis or deep/endovascular infection
  • Fever in high-risk immunocompromise or implanted intravascular material
  • Specific syndromes where bloodstream pathogen identification changes treatment

Stop / escalate

  • Do not culture routine low-risk fever without a clinical question
  • Never collect only through an existing line unless catheter infection is being assessed
  • Do not delay urgent antibiotics to obtain a technically perfect sample

Illustrated step sequence

1Identify patient, indication, timing and number of sets; hand hygiene/PPE
2Disinfect bottle tops and skin with the locally approved chlorhexidine preparation; allow to dry
3Use a fresh peripheral venepuncture for each set; avoid touching the cleaned site
4Adult target commonly 20–30 mL per set divided between aerobic/anaerobic bottles—follow bottle marks/local policy
5Label site/time accurately and send promptly; never refrigerate

Samples / technical essentials

  • Usually at least two separate peripheral sets for suspected bloodstream infection
  • Paired peripheral + each relevant line lumen when catheter infection is suspected
  • Three appropriately timed sets may be requested for stable suspected endocarditis; do not delay treatment if unstable

Aftercare and complications

  • Document antibiotics already given and culture source
  • Act immediately on significant Gram stain/positive result; repeat clearance cultures for S. aureus/candida and as advised
  • Interpret organism, number of positive bottles, time-to-positivity, prosthetic material and syndrome together

Supervised clinician education. Use the current local checklist, competency standard, consent policy, infection-control procedure and escalation route. This pathway does not certify procedural competence.

Other bedside procedures

Lumbar punctureAbdominal paracentesisChest-drain insertionVenepunctureArterial blood gas sampling