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CLINICIAN’S POCKET REFERENCE - PART 3

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khối lượng đầy đủ sẽ làm tăng tỷ lệ phát hiện. Hãy cẩn thận không chạm vào kim hoặc các trang web da prepped. Vẽ khoảng 10 ml máu. Hủy bỏ các đồ ép cho máu cầm lại, và nén các trang web venipuncture và áp dụng một băng dính. 4. Loại bỏ các kim được sử dụng trong thủng và thay thế nó bằng một cây kim, mới 20 22gauge vô trùng. Đặt máu trong các chai bằng cách cho phép hút chân không | 130 Clinician s Pocket Reference 9th Edition 7 1-5 mL in children adequate volume will increase the detection rate. Be careful not to touch the needle or the prepped skin site. Draw about 10 mL of blood. Remove the tourniquet and compress the venipuncture site and apply an adhesive bandage. 4. Discard the needle used in the puncture and replace it with a new sterile 20-22-gauge needle. Place the blood in each of the bottles by allowing the vacuum to draw in the appropriate volume usually specified on the collection device. Submit the samples to the lab promptly with the appropriate lab slips completed including current antibiotics being given. Interpretation Preliminary results are usually available in 12 48 h cultures should not be formally reported as negative before 4 d. A single blood culture that is positive for one of the following organisms usually suggests contamination however on rare occasions these agents are the causative pathogen Staphylococcus epidermidis Bacillus sp. Corynebacterium diphtheriae and other diphtheroids Streptococcus viridans. Negative results do not rule out bacteremia and false-positives can result for the contaminants noted. Gram-negative organisms fungi and anaerobes are considered to be pathogenic until proven otherwise. SPUTUM CULTURES Cultures of sputum remain controversial. Many clinicians do not even order them and treat only based on the Gram stain and clinical findings. One problem is that sputum samples often contain only saliva. If you do a Gram stain on the specimen and see only a few squamous cells with many polys and histiocytes the sample is good and the culture will probably be reliable. Excessive numbers of squamous cells see previous section on Gram stain suggests that the sample is more saliva than sputum. An early morning sample is most likely to be from deep within the bronchial tree. Steps to improve the quality of the sputum collection 1. Careful instructions to the patient. 2. If the patient cannot mobilize the