Equipment Selection and Maintenance

Vacutainer tubes

color-coded based on the presence of any additives within the tube.

Yellow Tube

Blood culture and sterile specimens, ACD solution - additive used is sodium polyanetholesulfonate.

Blue Tube

The additive used is sodium citrate. The additive prevents coagulation by binding calcium. It is advised to draw 2 to 3 ml of blood in a tube without additives before drawing this tube. Commonly used for coagulation tests (PT, PTT, fibrinogen).

Red Tube

No additives required. Commonly used for serum determinations in the following: • Chemistry testing. • Blood bank testing. • Thixotropic gel can be added (this is an inert (nonreacting) synthetic substance contained in or near the bottom of certain blood collection tubes).

Green Tube

The additive used is sodium heparin or lithium heparin, which is a natural anticoagulant that inhibits thrombin. Commonly used for routine chemistry testing.

Lavender Tube

The additive used is ethylenediaminetetraacetic acid (EDTA). The additive binds the calcium needed for clot formation. Commonly used for hematology testing (CBC, reticulocyte count, erythrocyte sedimentation).

Gray Tube

Additives used are sodium fluoride, a preservative that inhibits glycolic action, and potassium oxalate, an anticoagulant that binds calcium. Commonly used for glucose tolerance and lactic acid measurement.

Royal Blue Tube

Used to collect samples for nutritional studies, therapeutic drug monitoring, and toxicology. Also used for testing aluminum, copper, arsenic, calcium, etc.

Tan Tube

used for lead testing and contains EDTA.

Anticoagulants

prevent blood from clotting.

Clot Activators

promote coagulation.

Polymer gel (or thixotropic gel)

is used to separate plasma and serum.

Povidone-iodine (Betadine)

is used when sterile site preparation is required, particularly for blood cultures, arterial punctures, and arterial blood gas tests.

Chlorhexidine gluconate

serves as a potent alternative for blood culture collections, patients allergic to iodine, or central line access when authorized.

needle gauge numbers

indicate needle diameter, with smaller numbers representing larger needle diameters and higher flow rates.

Standard needles

consist of a bevel, shaft, threaded hub, and rubber sleeve, while syringe systems include a bevel, shaft, hub, graduated barrel, and plunger for manual blood collection control.

Multisample needles

(21-22 gauge) are standard for most adult patients with good veins and allow collection of multiple tubes in one venipuncture using a vacutainer tube holder.

Butterfly or winged infusion sets

(21-23 gauge) are best for small or fragile veins, hand or wrist veins, and pediatric or geriatric patients, as they provide greater control during insertion and can be used with either vacutainer systems or syringes.

Standard adult patients with good veins:

21-22 gauge multisample needle

Small, fragile, or hand veins:

21-23 gauge butterfly needle

Fragile veins prone to collapse:

21-23 gauge syringe system

Pediatric or geriatric patients:

Butterfly or syringe with appropriate gauge

Capillary puncture, also known as skin puncture, microcapillary stick, or finger stick

A procedure used to obtain a small amount of blood by puncturing the skin with a lancet.

The "5 D's":

death, disease, disability, discomfort, and dissatisfaction.