emDocs - April 23, 2016 - Author: Brooks D - Edited by: Koyfman A and Long B
"Summary
- In general, patients who are acutely ill or have high likelihood of continuous bacteremia should have blood cultures drawn in the emergency department.
- Blood cultures should not be taken from routinely stable, immunocompetent patients with common or typical infections such as cellulitis, orchitis, and community acquired pneumonia.
- Blood cultures should be obtained prior to initiation of antibiotic therapy to maximize possibility of being useful clinically
- When you have high suspicion for endocarditis, you may order 3 blood cultures from different venipuncture sites in the ED, each drawn 1 hour apart, OR 2 blood cultures from different venipuncture sites with a third to be ordered >12 hours later by your inpatient team.
- Fever at the time of blood culture collection is neither sensitive nor specific for the presence of bacteremia.
- An IV catheter line at the time of IV insertion should not be used."