Blood Culture
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Blood Culture | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
BLOOD
Test Workstation :
MIC3
Specimen Type:
Blood collected in set of blood culture bottle. Set is defined as one aerobic (green top) bottle and one anaerobic (orange top) bottle per draw site. Volume recommendation is based on patient weight. Click on "Blood culture" under the Specimen Collection Procedures link (below) for Table: Blood Culture Recommended Volume Based on Patient Weight
Cause for Rejection:
Bottles received unlabeled may be rejected if the provider decides to collect another specimen. Otherwise the "Mislabeled Specimen Collection Form" must be filled out.
Storage:
Ambient
Availability:
Mon-Sun
Methodology:
Automated Detection Instrumentation
Special Instructions:
If only one bottle can be drawn, please use the aerobic (green top) bottle. Blood cultures should be drawn prior to initiation of antimicrobial therapy. If more than one culture is drawn, the specimens should be drawn from different sites. The minimum amount of blood is only to be used in cases where there is a difficult draw. Do not overfill the bottles (>10mL in adult aerobic and anaerobic bottles), as this can lead to false positives. Routine blood culture is the recommended order for yeast blood infections. If other fungal blood infection is suspected, contact Infectious Disease at 3305433895.
NOTE: Be sure to cleanse top of blood culture bottle with chlorhexidine before inoculating with patient specimen.
Lab/Phone:
330-543-8406
TAT:
5 days
CPT Code:
87040
