order of draw (2nd time)

What is plasma

the liquid portion of unclotted blood and still contains clotting factors

What is serum

is the liquid portion of blood that has been allowed to clot/coagulate

Are clotting factors present in serum

no, they clotting factors have been used up to clot the blood

Which has clotting factors present - serum or plasma

plasma

What tubes have anticoagulants

Light Blue

Lavender

Green (light and dark)

Pink

Royal Blue with Lavender Stripe

Gray

tubes with anticoagulants will produce what when spun in centrifuge?

Plasma

tubes without anticoagulants will produce what when spun in centrifuge

Serum

Tubes without anticoagulants

clear - discard

Red - glass

Red - plastic (has clot activitator)

Tiger Top/Gold / Marble Top

Royal blue with Red stripe

Blood Culture must have how many bottles and is ordered?

Two; ordered stat or as timed specimens

What color bottle is aerobic bc done in?

blue cap

What color bottle is anaerobic bc done in

gold cap

what color bottle is a pediatric bc done in?

pink cap

what color bottle is a fungal bc done in?

red cap

When collecting bc what do you clean the skin and bottle caps with?

chloraprep or iodine and then let dry

your employer may request that you draw bc using this type of needle set up to keep the nutrient broth inside the bottle from going in the blood stream and you must keep the bottle upright during the draw to get the correct fill amount

winged infusion set

What is the additive inside BC bottles?

nutrient broth - SPS (sodium polyanethole sulfonate)

when are BC drawn?

when a systemic infection is suspected or fever of unknown origin (FUO)

What lab are the bc bottles taken to?

Microbiology

Mnenomic for order of draw?

Boys - Blood Cx

Clearly - Clear plastic or red glass

Love - Light Blue

Rude - Red

Girls - Gold/ Tiger, Marble

Like - Light green

Dogs - Dark green

Love - lavender

Petting - pink

aNd - Navy blue

Greek - Grey

Yogurt - yellow top tube glass

clear top tube is used for what?

discard tube

red glass may also be used in place of this

Light Blue Top goes to what lab?

coagulation lab or hematology

light blue top has what additive in it ?

Sodium Citrate

salty margs under a light blue sky

light blue has to be inverted how many times?

3-4 times

Light Blue tube yields ?

plasma

Sodium citrate does what?

prevents coagulation by binding to calcium so it preserves the clotting factors

What tests are light blue tops used for?

PT

PTT

aPTT

PRP

D-Dimer

What must be drawn before a light blue top tube?

Clear top or Red glass tube

do you need to invert a red top or plain top tube?

not typically, only if it is a red plastic top tube

Is there an additive in the red top tube?

Glass - no

Plastic - yes - clot activator

What tube has a clotting agent added bc the sides are too slick for natural clotting to occur?

red plastic top

what does a red top plastic or red glass tube test for?

Serum pregnancy

ETOH levels

Discard

PrP or PrF

What lab does a red top tube go to?

Chemistry

Blood clots naturally within this tube within 30-60 mins

Red top - glass or plain vacuum tube

this tube must be spinning in a centrifuge within 90 secs bc it has zero additives

red top glass

The blood will clot slower in what kind of material tube with no additives?

plastic

Is a red top plastic tube a clean specimen?

no, it has silica or silicone as the additive

What tube has silica or silicone as an additive

Red top plastic

what does silica additive do?

clotting agent, promotes faster clotting of blood

red top glass tubes play a part in bone grafts how?

they don't have silica in them like plastic red top,

why can't red top plastic tubes be used for collection

Bc they have silica - - which can become a part of the bone matrix/graft mixture and cause inflammation and intensive infection -- osteoblasts are degraded by silica and won't heal

what are the other names for a tiger top tube?

red tiger

marble top

red grey speckled

gel top

or gold top

What lab does a tiger top go to?

chemistry

What is the additive in tiger tops?

Silica and Serurm Separator /SST (thixotropic gel)

What does Thixotropic Gel do?

separates serum and formed cellular elements

creates a barrier between them

how many times must a tiger be inverted

8-10 times

What tests are run using a tiger top?

BMP

CMP

Serum Pregnancy Test (if ok with clotting factors left in)

Lipids/Chol

CRP

TSH

Tiger tops must be spun for how long?

15-30 mins

why is a clear top tube or red top glass tube drawn before drawing on a light blue top?

Discard tube prevents thromboplastin from venipuncture from entering light blue top

less risk of air and thromboblastin impacting coag results

light green top tube has what additive in it?

lithium heparin, thixotropic gel

Light green top yields what?

plasma

what department processes both green top tubes?

chemistry

what else is a green top tube called

PST - plasma separation tube

What does lithium heparin do?

anticoagulant

works by inhibiting thrombin in coag cascade

can you use a light green top tube for hematology tests?

No, the heparin interferes with Wright's stained blood smears

what does thixotropic gel do in the SST or light green top tube?

it creates a barrier between the plasma and formed cellular elements when centrifiuged

keeps plasma from being contaminated

how many times are the green tubes inverted?

8 times

What tests are the light green tube tops used for?

STAT Lytes - (Green apple gatorade)

hCG, + HCG quant and qual

Some light green tube tops have gel and some have no gel, what's the difference?

No gel = Plasma Tube

With gel = Plasma separator Tube

What tests require the tubes to be put on ice and what color tubes are they drawn in?

Lytes - light green, Stat on ice

Ammonia - dark green

Lactic Acid - Grey top

What additive does a dark green top tube have inside?

Sodium heparin

what does sodium heparin do?

anticoagulant - inhibits thrombin

Does the dark green tube have a gel additive?

NO

The dark green top tube yields what?

plasma

What tests are performed on a Dark green top tube?

Ammonia - Stat on ice

Lavender top tube has what additive in it?

EDTA (ethylene-diamine-tetra-acetic-acid)

What does EDTA do?

inhibits coagulation by binding to Calcium

is the purple top tube used for coagulation studies?

no, bc edta binds to calcium in the specimen stopping coag

PREVENTS CLOTS

What does a purple top yield?

Plasma

How full must a purple top be?

2/3 full

How many times should a purple top be inverted

8 times

If a CRP is required what tubes can be drawn?

if plasma is needed - purple top

if serum is needed - sst /tiger top

What tests can be done with a purple top tube?

CBC

ESR

Sickle Cell

H & H

PLT

A1C or HbA1C

if a purple top's blood hemolyzes can the tests still be done?

NO, the lab will reject it

What is hemolyzation

happens when the membranes of the RBC's break and release free hemoglobin into the circulating blood

What lab processes a purple top?

Hematology

should a CBC be centrifuged?

No, it NEVER should be centrifuged

is there a difference between light purple and dark purple?

only difference is amount of blood needed to fill and how much EDTA is in them, used for the same tests

What additive is in a pink top tube?

potassium EDTA

What does potassium EDTA do?

prevents clots / anticoag

how many times should a pink top be inverted

8-10 times

what lab does the pink top go to?

Blood bank or hematology

What lab does the purple top go to?

hematology

What tests are done on a pink top tube?

TSR (Blood types, Rh Factor, and ab's - A+ etc.)

Cross Match - required before transfusion

Viral Loads

can you use a pink top tube in place of a purple top tube?

No! You can't swap pink for purple tops.

BUT you can swap purple tops for pinks.

What's the difference between a pink and purple top?

Both have EDTA, but pink draws more blood and has more EDTA inside of the tube

What additive is in a grey top tube?

sodium fluoride + potassium oxalate

What does sodium fluoride do?

prevents the breakdown of sugar,

sugar will last in sample for 3 days

What does potassium oxalate do?

anticoagulant that binds calcium in the sample

how many times must a grey top tube be inverted?

8-10 times

What lab does a grey top tube go to?

Chemistry

What tubes can glucose be tested in?

serum - SST

plasma - grey top

What does a grey top tube yield

plasma

What tests use a grey top tube?

OGTT - 1h, 3h, 5hr

Lactic Acid - stat on ice, can't use tourniquet

ETOH - can't use etoh wipe though

when a lactic acid is ordered what must be done?

use a grey top

place it on ice

get it to chemistry STAT

Don’t use a tourniquiet (if left on it can increase LA by 100)

Royal Blue with Red Stripe yields?

Serum

Royal blue with lavender stripe yields

plasma

What lab should you take Royal Blue test tubes to?

Toxicology

what additives do the royal blue tops have?

Red Stripe= none

lavender Stripe = EDTA

when is a royal blue with red stripe drawn

after the light blue top and before other serum tubes

when is a royal blue with lavender or blue line drawn?

after the purple top tube