Taking blood cultures is a relatively common OSCE station. You’ll be expected to demonstrate your clinical skills and your ability to communicate effectively. This blood culture collection OSCE guide provides a clear, concise, step-by-step approach to obtaining blood cultures. There is wide variation in the type of equipment used for obtaining blood cultures and therefore you should always follow your medical school or local hospital’s guidance. You should note however that blood cultures should ALWAYS be obtained via a fresh stab and not use existing peripheral lines. If a patient has a central line, blood may be taken from this if the line is a potential source of infection, however, this should be performed in combination with a peripheral sample (which should be taken first).
Cleaning swab x 3 (2% chlorhexidine in 70% isopropyl alcohol)
Laboratory forms, labels and transportation bag
Ensure the patient is lying or sitting comfortably (place a pillow under their arm if possible).
Place the sharps bin and equipment tray within easy reach in preparation for venepuncture.
1. Don an apron
2. Wash your hands
3. Collect appropriate equipment and assemble, maintaining aseptic non-touch technique (ANTT), prior to placing into the cleaned tray. Ensuring no unnecessary packing is put into the tray.
4. Remove the caps from the blood culture bottles and clean the top of each with a separate cleaning swab (2% chlorhexidine in 70% isopropyl alcohol), allowing to dry before proceeding with bottle inoculation.
5. Position the patient’s arm in a comfortable extended position that provides adequate exposure to the planned venepuncture area.
6. Inspect the antecubital fossa or forearm for a suitable vein.
7. Apply the tourniquet about 4-5 finger-widths above the planned venepuncture site.
8. Palpate the vein:
Choose a vein has a sizeable lumen and feels “springy”
Tapping a vein gently can make it easier to visualise and feel
9.Wash your hands:
Using alcohol gel and the World Health Organisation’s hand hygiene technique shown in our guide here
If your skin is visibly soiled you should wash your hands using soap and water
10. Don gloves
11. Thoroughly clean the site:
Use 2% chlorhexidine in 70% isopropyl alcohol to disinfect the patient’s skin and allow to dry
If the patient’s skin is visibly soiled use soap and water to clean the site
Once the skin has been disinfected you should not touch the site again (even with gloves on)
Don apron and wash hands
Don gloves (optional at this stage)
Clean the equipment tray
Prepare blood collection system
Remove bottle cap
Clean bottle cap
Repeat process for second bottle
Apply a tourniquet
Identify a suitable vein
Wash hands again
Clean the skin
Clean the skin
Insertion of the needle
1. Unsheathe the needle.
2. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site.
3. Warn the patient of a sharp scratch.
4. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards (you should feel a decrease in resistance as the needle enters the vein).
5. Advance the needle a further 1-2 mm into the vein after the decrease in resistance is felt.
6. Lower and anchor the needle to the patient’s skin.
7. Use the other hand to attach the aerobic blood culture bottle to the adapter, piercing the blood culture septum and allowing the bottle to fill with 10ml of blood (using the bottle’s graduation lines to accurately gauge sample volume).
8. Remove the aerobic bottle and then attach the anaerobic bottle, also filling it with 10ml of blood.
9. Release the tourniquet.
10. Withdraw the needle and then apply gentle pressure to the site with some sterile gauze.
11. Ask the patient to hold the gauze in place whilst you dispose of the needle into a sharps container.
12. Apply a dressing to the patient’s arm (cotton wool/gauze/plaster).
13. Discard the used equipment into the appropriate waste bin.
Insert the needle and observe for flashback
Secure the needle
Attach aerobic blood culture bottle to the adapter
Fill the aerobic blood culture bottle
Detach aerobic blood culture bottle
Attach the anaerobic blood culture bottle
Fill the anaerobic blood culture bottle
Detach the anaerobic blood culture bottle
Release the tourniquet
Apply pressure with gauze
Engage needle safety device
Dispose of needle into sharps bin
Apply a plaster
To complete the procedure…
Thank the patient
Wash your hands
Fill out the patient details on the sample bottles at the bedside
Send the blood samples to the lab for testing
Document the following in the patient’s notes:
Reason for sample
Time and date of sample
Site the sample was obtained from
Your name, signature and contact details
Wash hands again
Complete the patient details at the bedside
Add patient details to the blood culture bottles
Senior Clinical Lecturer in Medical Education
1. Taking blood cultures. A summary of best practices. UK Government Web Archive. Published 2011[LINK]
2. WHO guidelines on drawing blood: best practices in phlebotomy. Published in 2010. [LINK]
3. WHO Guidelines on Hand Hygiene in Healthcare: a Summary. Published in 2009. [LINK]