Post Dialysis Sampling (Green/Yellow Tube Top)

Slow-Blood-Flow Method

Drawing specimen from the blood line sampling port

  1. At the completion of hemodialysis, turn off the dialysate flow and decrease the UFR to 50mL/hr, to the lowest TMP/UFR setting or OFF. If the dialysis machine does not allow for turning off the dialysate flow, or if doing so violates facility policy, decrease the flow to its minimum setting.
  2. Decrease the blood flow to 100mL/min for 15 seconds (longer if the blood line volume to the sampling port exceeds 15 mL). To prevent pump shut-off as the blood flow rate is reduced, it may be necessary to manually adjust the venous pressure limits downward. At this point, proceed to obtain your specimen. You can either shut off the blood pump before sampling or leave it running at 100 mL/min while the specimen is being drawn.
  3. Immediately after drawing, gently invert the tube 5-10 times to activate the anticoagulant and prevent clotting.
  4. After the specimen has been obtained, stop the blood pump (if not already stopped) and complete the patient disconnection procedure per your facility’s protocol.

Drawing specimen from the arterial needle tubing using a Holder with Preassembled Luer Adapter

  1. Follow Steps 1 and 2 above (Slow-Blood-Flow-Method).
  2. After the 15 second slow-blood-flow period (a slow-blood-flow period is still required to clear the small volume in the arterial needle tubing of recirculated blood), stop the blood pump. Clamp the arterial and venous blood lines. Clamp the arterial needle tubing. Disconnect the blood line tubing from the inlet blood line, and attach a Holder with Preassembled Luer Adapter to the arterial needle tubing (or arterial port of the venous catheter). Release the clamp on the arterial needle tubing and obtain the blood specimen.
  3. Immediately after drawing, gently invert the tube 5-10 times to activate the anticoagulant and prevent clotting.
  4. After the specimen has been obtained, stop the blood pump (if not already stopped) and complete the patient disconnection procedure per your facility’s protocol.

 

Stop-Dialysate-Flow Method

  1. At the completion of hemodialysis, turn off the dialysate flow (or set to bypass) and decrease the UFR to 50mL/hr, to the lowest TMP/UFR setting or OFF.
  2. Wait 3 minutes. Do not reduce the blood flow rate during this 3 minute period.
  3. Obtain the blood specimen, either from the sampling port on the inlet blood line, from the arterial needle tubing or from the arterial port of the venous catheter if using the needle-free method as described in the preceding section. If sampling from the inlet blood line, it does not matter if you stop or do not stop the blood flow while the specimen is being taken. It is best to stop the blood pump prior to obtaining the specimen. In the stop-dialysate-flow method, slowing the blood flow prior to obtaining the specimen should not be done.
  4. Immediately after drawing, gently invert the tube 5-10 times to activate the anticoagulant and prevent clotting.
  5. After the specimen has been obtained, return the patient’s blood in the blood lines and dialyzer per your facility’s protocol.