Phleb - Order of Draw

What does following the correct order of draw do?

Prevents cross-contamination

Additive of Yellow/Sterile Bottles

SPS - Sodium polyethanol sulfonate

Additive of Light Blue tubes

Sodium Citrate

Additive of Red tubes (glass)

none

Additive of Red tubes (plastic)

Clot Activator

Additive of Gold/Tiger Top Tubes

SST (Thixotropic Gel) or Clot Activator + gel separator

Additive of Green Tubes

Heparin (Lithium, Sodium, or Ammonium)

Additive of Lavender Tubes

EDTA

Additive of Pink Tubes

EDTA

Additive of Grey tubes

Sodium fluoride + potassium oxalate

Common Tests of Yellow/Sterile Bottles

Blood Culture

Common Tests of Light Blue

Coagulation Tests (PT, INR, PTT, Fibrinogen, D-dimer)

Common Tests of Red Tubes

Serum Tests

(Glass - Antibody Testing; Plastic - Cold agglutination tests)

Common Tests of Gold/Tiger Top Tubes

Serum testing (CMP, BMP, Lipid panel testing, HIV, HEP. B, Bilirubin)

Common Tests of Green Tubes

Plasma Tests (Cortisol, Lactic Acid, Sodium, Ammonium lvls.)

Common Tests of Lavender Tubes

CBC, hematocrit, hemoglobin, iron

Common Tests of Pink Tubes

Blood Typing and screening, Rh factors

Common Tests of Gray

Glucose, lactate, alcohol levels, Fasting blood samples

Sample Type of Yellow/Blood Culture bottles

Whole blood

Sample Type of Light Blue Tubes

Plasma

Sample Type of Red

Serum

Sample Type of Gold/Tiger Top

Serum

Sample Type of Green Tubes

Plasma or Whole Blood

Sample Type of Lavender

Whole blood or plasma

Sample Type of Pink

Whole Blood

Sample Type of Grey Tube

Whole blood or plasma

Department of Yellow/Blood Cultures

Microbiology

Department of Light Blue Tubes

Coagulation

Department of Red Tubes

Blood Bank, Serology, Chemistry

Department of Gold/Tiger Tubes

Chemistry

Department of Green Tubes

Green

Department of Lavender Tubes

Hematology

Department of Pink Tubes

Blood Bank

Department of Grey Tubes

Chemistry

Primary Function/Role of Yellow/Blood Culture Tubes

• Prevents clotting, allowing bacteria to grow for cultures

Primary Function/Role of Sodium Citrate

• Anticoagulant; Binds calcium in blood to prevent clotting

Primary Function/Role of Clot Activators (eg. thrombin)

• Encourages clotting so serum could be separated after centrifuging

Primary Function/Role of Heparin

• Anticoagulant that inhibits thrombin (platelet) formation

• Prevents clotting

Primary Function/Role of EDTA

• Anticoagulant that binds to calcium

• Used to preserve size, shape, and morphology of blood cells

Primary Function/Role of Potassium Oxalate

• Antiglycolytic agent, preventing glycolysis

  • Ensures accurate blood sugar readings

Primary Function/Role of Thixotropic Gel

• Physical barrier separating liquid portion from cells during centrifugation

Light Blue Tube; Blood-to-anticoagulant ratio

9:1 (9 parts blood to 1 part citrate)

What tubes need to clot before centrifugation?

• Gold/SST Tubes - 30 mins of clotting time @ room temp before centrifuging

• Red-Top Glass Tubes- 60 mins for complete clotting

Order of Draw for… CBC, BMP, and PT/INR

Light Blue (PT/INR) » Gold SST (BMP) » Lavender (CBC)

Order of Draw for… Blood Cultures, CBC, and Glucose

Yellow/Bottles (Blood cultures) » Lavender (CBC) » Grey (Glucose)

Order of Draw for… PT/INR (Using Butterfly Needle)

Discard tube » Light Blue

Order of Draw for… Comprehensive Metabolic Panel (CMP) and Lipid Panel

One Gold SST tube (ensure volume is adequate enough for both panels)

Which tube additive works by binding calcium to prevent clotting and is used for hematology tests like CBC?

EDTA

Which tubes contain anticoagulants that work by binding calcium?

• Light Blue (Sodium Citrate)

• Lavender (EDTA)

• Gray (Sodium fluoride + potassium oxalate)

Which tube color contains a clot activator that accelerates the clotting process?

Gold (SST) (30 mins for clotting vs 60 mins for clotting w/ no additives)