yellow
Additive Specimen Type: SPS (Sodium Polyanetholsulfonate) ACD (acid citrate dextrose)
Specimen type: whole blood
Test Types: Plasma Cultures, HIV Cultures, Blood culture, Specialty blood banking (paternity/DNA)
Inversions: 8-10
Special instructions: Sterile (aseptic technique)—clean site with iodine rather than 70% alcohol swab
light blue
additive: Sodium Citrate (anticoagulant
specimen type: plasma or whole
test types: Coagulation studies: PT—Prothrombin time; time it takes for a clot to form. PTT— partial thromboplastin time; time for # of blood to clot
inversions: 3-4
special instructions: Ask if the patient is taking blood thinners—this will affect the times of coagulation studies. Use a trash tube if light blue is the ONLY tube! Fill all the way
red
additive: none
specimen type: serum
test types: Drug screen Blood chemistries,AIDS, antibody tests, viral studies, serological tests, blood grouping and blood typing
inversions: 0
special instructions: N/A
gold/tiger
additive: Clot activator + SST—serum separating tube using thixotropic gel to separate serum from buffy coat and hematocrit
specimen type: serum
test types:
Serum determination: same as tiger top
Lipid Panel (cholesterol + triglycerides) Liver enzyme, Pregnancy test, CMP (14 tests), BMP( 8 tests). Endocrine and serological tests, including HIV and hepatitis
inversions: 5
special instructions: N/A
green
additive: Sodium or Lithium Heparin (anticoagulant)
specimen type: plasma or whole
test types: Electrolyte Studies, arterial blood gas tests; Chemistry: Non-fasting glucose; BUN; ionized Ca2+; Creatinine
inversions: 8
special instructions: n/a
lavender
additive: EDTA (ethylenediaminetetraacetic acid)
specimen type: whole
test types: Hematology: CBC (w/ or w/o differential), H&H, ESR (erythrocyte sedimentation rate), Sickle cell anemia
inversions: 8
special instructions: at least 2/3 full
pink
additive: EDTA
specimen type: whole
test types: Blood banking: ABO-blood test determination, antibody identification.
inversions: 8
special instructions: n/a
navy
additive: EDTA
specimen type: plasma or whole
test types: Nutritional Studies: Heavy metal (arsenic, lead, mercury), toxicology screens, TDM (therapeutic drug monitoring)
inversions: 8
special instructions: n/a
grey
additive: Potassium oxalate Sodium Fluoride
specimen type: plasma or whole
test types: Fasting blood glucose (FBG), GTT (glucose tolerance test), blood alcohol levels, Lacti acid
inversions: 8
special instructions: Glucose is FASTING 8+ hours, otherwise reschedule the patient appointment.
Tube Labels should include:
Pt Name
Pt ID#
Date/Time
MA Initials
BC (Blood Culture)
yellow
microbiology
CBC
lavender
hematology
CMP (complete metabolic panel)
gold
chemistry
CMV (complete metabolic volume)
Gold
Blood Bank
drug screening
red
chemistry
FBG (fasting blood glucose)
grey
chemistry
HCT (hematocrit)
lavender
hematology
hep b. antigen
red
serology
hep c antibody
red
serology
hep c antibody + RNA (viral load)
gold
serology
HGB (Hemoglobin)
Lavender
Hematology
HIV - CD4
Lavender
Hematology
HIV - EIA - Westernbl
red
serology
HIV - Genotype
Gray, Plasma Prep
Serology
HIV - RNA (Viral Load)
Gray, Plasma Prep
Serology
PT/INR
Light Blue
Coagulation
RBC (Red Blood Cells)
Lavender
Hematology
Syphilis Titer
Red
Serology
Syphilis - Antibody
Red
Serology
WBC (White Blood Cells)
Lavender
Hematology
Cephalic Vein
The cephalic is the second vein of choice
This is the vein used for most obese patients.
brachial vein
basilic vein
The Basilic vein is the third vein of choice due to the location of the nerves by the vein
median cubital vein
Median cubital is the first vein of choice.
sclerosed veins
Sclerosed veins are damaged veins and are not suitable for venipuncture
capillaries
Are microscopic one cell- thick vessels that link arterioles and venules that form a bridge between arteries and veins.
1. Only vessels that permit the exchange of CO2 and O2 between blood and other tissues
2. Blood in the capillary bed is a mix of arterial and venous blood
coagulation issues that affect phlebotomy
Drugs like Heparin and Coumadin suppress clotting and may result in patient bleeding more than normal
Parts of a multi-sample needle:
1.) Bevel
2.) Shaft
3.) Threaded hub
4.) Rubber sleeve over needle
Needle size
1. The smaller the number of the needle the bigger it is.
a. most butterfly needles are usually a 23 to 25
Glucose Tolerance Test
(GTT) used to diagnose carbohydrate metabolism problems. Patient must eat well balanced meals 3 days prior to test and must fast at least 12 hours before the test. Patients must drink glucose prior to testing and have 5 minutes to finish the drink. Levels will peak within 30 minutes to an hour following glucose ingestion.
Lactose Tolerance Test
Same procedures as GTT but patient must drink lactose rather than glucose
Anticoagulants
Prevent blood from clotting.
Hematoma
When blood seeps into surrounding tissue during a venipuncture.
Clotting Disorder Patients
Need pressure to be applied for at least 5 minutes to insure blood stoppage.
Specimen Labels
patients name, date and time of collection draw, collectors initials.
Syncope
Patient might faint during venipuncture
Unlabeled Tubes
must be rejected automatically
Post-Prandial
after meal
Chain of Custody
MUST be followed EXACTLY when drawing patient test samples that may be used in legal proceeding.
Coumadin is known as what type of medication?
anti-coagulant
What color tube do you use for glucose testing?
grey
What is the most common analytical error that occurs during blood draw?
wrong order of draw
what is the purpose of EDTA in a lavender tube?
to prevent platelets from clumping together and maintain the appearance of the cells for microscopic examination
cbc and pt on patient requires what tubes?
light blue and lavender
which tubes and order of draw Pt, electrolytes, and blood culture
yellow, light blue, green
2 liters =
2000 mls
what tube(s) are needed for h & h, esr, reticulocyte ?
lavender - 1 tube