Phleb: Correct Order of Draw

Blood cultures

Nutrient broth additive, microbiology lab department, culture & sensitivity (C&S) test

Draw aerobic then anaerobic bottles

BCx bottles can be maintained at room temp for up to 4 hours after collection

Light blue top tube

Sodium citrate additive, yields plasma, coagulation department

Common tests: PT/INR, PTT, aPTT, D-Dimer

Tube must be filled to the top; might require a discard tube

Red top tube

No additive in glass/clot activator in plastic tube, yields serum, chemistry department, non-STAT therapeutic drug monitoring (TDM) test/discard tube

Centrifuge after clotting is complete

Gold top/Tiger top tube

Silica + thixotropic gel additive, yields serum, chemistry department

Common tests: CMP, BMP, lipid panel, hepatic function panel, renal function panel, chemistry serum determinations

Centrifuge after clotting is complete

Orange top tube

Thrombin based clot activator additive, yields serum, chemistry department

Light green top tube

Lithium heparin additive, yields plasma, chemistry department

Common tests: STAT chemistry testing, hCG, electrolytes

If tube contains thixotropic gel, centrifuge it

Dark green top tube

Sodium heparin additive, yields plasma, chemistry department

Common tests: Ammonia, plasma chemistry determinations, chromosome studies

Ammonia test tube must be on ice

Lavender top tube

K2 EDTA additive, yields whole blood/plasma, hematology department

Common tests: CBC, ESR, H7H, HbA1c, ammonia

Pink top tube

K2 EDTA additive, yields whole blood, blood bank/immunohematology department

Common tests: Blood typing, crossmatching

White top tube

K2 EDTA and gel separator additive, yields plasma, molecular diagnostics department

Tan top tube

K2 EDTA additive, yields whole blood or plasma, chemistry department

Gray top tube

Sodium fluoride + potassium oxalate additive, yields plasma, chemistry department

Common tests: Glucose, lactic acid, blood alcohol

Use a non-alcohol based cleaner when collecting these specimens

Lactic acid tests require ice + patient must not wear tourniquet

Royal blue with red stripe tube

No additive, yields serum, chemistry department, selenium & copper (trace elements) test

Centrifuge sample after clot is formed

Royal blue with lavender stripe tube

K2 EDTA additive, yields plasma, chemistry department

Common tests: Zinc, arsenic, lead (trace elements) test

May require centrifugation depending on the lab order

Yellow top tube

Sodium polyanethol sulfonate/Acid citrate dextrose additive, whole blood or plasma, microbiology/blood bank department

Yellow top tube can be used for blood collection for micro