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  • Title: Evacuated blood-collection tubes--the backflow hazard.
    Author: Katz L, Johnson DL, Neufeld PD, Gupta KG.
    Journal: Can Med Assoc J; 1975 Aug 09; 113(3):208-13. PubMed ID: 1095169.
    Abstract:
    Five cases of nosocomial infection caused by Serratia marcescens were traced to backflow of blood from nonsterile evacuated blood-collection tubes. The mechanism of backflow was investigated theoretically and the conditions were determined under which backflow can occur. The theory was confirmed by experiments conducted on a simulated venous system and by measurements of the venous pressure in the brachial vein of a patient during application and removal of a tourniquet. Various possible solutions to the backflow hazard include strict adherence to correct venipuncture technique, sterilization of all blood-collection tubes, improvement of the vacuum in the tubes and incorporation of a check valve into the system.
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