Checklist for taking blood cultures

• The swabs you use must contain chlorhexidine 2% in addition to alcohol
   
• Wipe the tops of the bottles with swabs then discard (don't put the needle through the swabs)
   
• Prepare the site from the centre outwards going in a spiral; use as many chlorhex/alcohol swabs as you can, let it dry
   
• Don't change needles; use 1 single needle for the whole procedure
   
• Collect a full 20 mL and put 10 mL in each of 2 bottles
   
• Inoculate blood culture bottles before other blood tubes
   
• Never collect just 1 set, always take at least 2

Rationale

• Alcohol alone leads to way too many contaminants
• Sticking the needle through the swabs kills germs before they reach the bottle
• Working from the centre outwards stops from dragging germs back in from the outside
• Changing needles means more manipulation, more contamination, and heaps more needlesticks - just DON'T!
• Less than 10 mL per bottle means less germs and less chance of a positive
• Collecting 2 sets means (a) better chance of a positive and (b) MUCH easier to work out contaminants from pathogens (sometimes this is absolutely critical for patient care)