Blood Culture

Laboratory : Microbiology

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
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

BLOOD MMIC3

Specimen Type:

Blood

Tube Type:

Blood Culture Bottle

Collection Volume:

Click on "Blood culture" under the Specimen Collection Procedures (below) for Table: Blood Culture Recommended Volume Based on Patient Weight

Storage:

Ambient

Availability:

Daily

Methodology:

Automated Detection Instrumentation

Special Instructions:

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. NOTE: Be sure to cleanse top of blood culture bottle with chlorhexidine before inoculating with patient specimen.

Lab/Phone:

330-746-9623

TAT:

5 days

Additional Info:

Preliminary report available after 24 hours

CPT Code:

87040

Specimen Collection Procedures:

Blood Culture Collection, Venipuncture

Blood Culture

Test ID/Workstation :

BLOOD MMIC3

Specimen Type:

Blood

Tube Type:

Blood Culture Bottle

Collection Volume:

Click on "Blood culture" under the Specimen Collection Procedures (below) for Table: Blood Culture Recommended Volume Based on Patient Weight

Storage:

Ambient

Availability:

Daily

Methodology:

Automated Detection Instrumentation

Special Instructions:

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. NOTE: Be sure to cleanse top of blood culture bottle with chlorhexidine before inoculating with patient specimen.

Lab/Phone:

330-746-9623

TAT:

5 days

Additional Info:

Preliminary report available after 24 hours

CPT Code:

87040

Specimen Collection Procedures:

Blood Culture Collection, Venipuncture