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  1. McBride, Clare BSN, RN, CCRN
  2. Miller-Hoover, Suzan DNP, RN, CCNS, CCRN-K
  3. Proudfoot, James A. MSc


Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project. Results show that the protocol can be used safely and reliably as a standard waste-free sampling method in the PICU.