Blood Culture Collection Algorithm - Adult Patients with Suspected Systemic Infection
Pawlowicz et al evidenced based algorithm to guide the decision to obtain blood cultures based on the Shapiro Rules.
Algorithm Source: https://www.oatext.com/Implementation-of-an-evidence-based-algorithm-reduces-blood-culture-overuse-in-an-adult-emergency-department.php
General Guidelines for drawing blood cultures:
- Patients who meet SIRS criteria and have unstable vital signs warrant blood cultures.
- Patients with suspected bacterial infections, whose clinical status appears sufficiently tenuous as to warrant an elevated level of care such as the intensive care unit or a stepdown unit warrant blood cultures, regardless of source.
- Patients with rigors and a suspected source of bacterial infection (ex. urinary tract infection, endocarditis, or pneumonia) warrant blood cultures.
- When EPs are concerned for an infection of indwelling catheters or lines, blood cultures should be obtained.
- Febrile neutropenic or immunocompromised patients warrant blood cultures.
- When feasible, blood cultures should be obtained prior to antibiotic administration.
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