Q&A: Tourniquet time for PIV blood draw

Q:  I saw the practice recommendation to limit tourniquet time to less than 1 minute when drawing blood to reduce hemolysis and inaccurate chemistry lab values. Once we stick and get a blood return, we wait till we’ve collected all our blood samples before we release the tourniquet and apply the dressing to the IV site. Is this not recommended?

Tourniquet

A:  You are correct, the 2016 Infusion Therapy Standards of Practice  (1) does state limiting tourniquet time to 1 minute for the reasons you’ve stated. (S43 Practice Criteria II F3) The studies reviewed indicate changes in vascular endothelium from increased pressure and hypoxia caused by prolonged tourniquet application. It is then recommended to release the tourniquet immediately once blood begins to flow into your blood tubes.

You stated you are drawing blood from a newly inserted short peripheral catheter. Their recommendation is to release the tourniquet, apply the dressing and securement device, then draw your blood samples instead of drawing blood samples during the insertion procedure.(2)

Thank you for your question.

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References:

  1. Infusion Nurses Society. Infusion nursing standards of practice. J Infus Nurs. 2016;39(suppl 1)
  2. Gorski, L; Hadaway L; Hagle, M. (2016, May). The Art and Science Behind the Infusion Therapy Standards of Practice PowerPoint presentation at the meeting of the Infusion Nurses Society, Fort Lauderdale, FL.