phlebotomy: tube colors, additives, depts, tests & order of draw

Sterile ( Light Yellow)

1st in order of draw

ADDITIVE: Sodium Polyethylene Sulfonate (SPS)

DEPARTMENT: Microbiology

TESTS: blood cultures, strep cultures, urine cultures, blood bank, HLA phenotyping, DNA, paternity, Opia, & Parasites

INVERSIONS: 8

SPECIMEN: whole blood

METHOD OF ACTION: inhibits immune system from destroying bacteria, neutralizes antibiotics, and anti coagulant that works by binding calcium

Light Blue

2nd in order of draw

ADDITIVE: Sodium Citrate (Na+ Citrate)

DEPARTMENT: Coagulation / Hematology

TESTS: PTT (activated partial thromboplatin time), FDP (fibrin degradation product), PT (prothrombin time),

INVERSIONS: 3-4

SPECIMEN: plasma

METHOD OF ACTION: anticoagulant by binding calcium

Red

3rd in order of draw

ADDITIVE: Plastic: clot activator; Glass: none

DEPARTMENT: Chemistry

TESTS: Serum chemistry tests (glucose, cholesterol, triglycerides, HDL, potassium, amylase, alkaline phosphatase, BUN, CK, liver enzymes); Serology tests (RPR, monospot, rheumatoid factor, ANA); blood bank

INVERSIONS: 5 (plastic); 0 (glass)

SPECIMEN: serum

SST Gold / Tiger top

4th in order of draw

ADDITIVE: clot activator and polymer gel (SST)

DEPARTMENT: Chemistry

TESTS: BMP, CMP, K, Iron, Lipid Panel

INVERSIONS: 5

SPECIMEN: serum

Light Green

5th in order of draw

ADDITIVE: Lithium Heparin and polymer gel (PST)

DEPARTMENT: Chemistry

TESTS: BMP, CMP, CK-MB, Stat electrolytes

INVERSIONS: 8

SPECIMEN: plasma

METHOD OF ACTION: inhibits clotting by preventing prothrombin's into thrombin

Green

6th in order of draw

ADDITIVE: Sodium Heparin (Na+ [sodium], NH4+ [ammonium])

DEPARTMENT: Chemistry

TESTS: Ammonia, CK, Plasma determinations in chemistry

INVERSIONS: 8

SPECIMEN: plasma is spun, whole blood if not

METHOD OF ACTION: anticoagulant by binding calcium

Lavender

7th in order of draw

ADDITIVE: EDTA

DEPARTMENT: Hematology

TESTS: CBC, ESR, Hemoglobin A1c

INVERSIONS: 8

SPECIMEN: whole blood if unspun, plasma if spun

METHOD OF ACTION: anticoagulant by removing calcium

Gray

8th in order of draw

ADDITIVE: Potassium Oxalate, Na+ [sodium] fluoride

DEPARTMENT: Chemistry

TESTS: GTT, ETOH, Glucose, Lactate

INVERSIONS: 8

SPECIMEN: plasma

Tan

last in order of draw

ADDITIVE: EDTA

DEPARTMENT: Immunology

TESTS: Lead Levels

INVERSIONS: 8

SPECIMEN: plasma

Pink

last in order of draw. usually drawn in lavender.

ADDITIVE: EDTA

DEPARTMENT: Blood Bank

TESTS: Blood Type, RH antibody

INVERSIONS: 8

SPECIMEN: plasma

Royal Blue

last in order of draw

ADDITIVE: EDTA

DEPARTMENT: Chemistry

TESTS: Hepatic function panel A

INVERSIONS:

SPECIMEN: Whole Blood

What are the three tubes that aren't sent to the Chemistry lab, and in which department do they get sent?

Yellow (sterile): Microbiology

Light Blue: Coagulation

Lavender: Hematology

Name the first 8 tubes in the order of draw by their color

Yellow (sterile)

Light Blue

Red

Gold / Tiger top

Light Green

Green

Lavender

Gray

Name the first 8 tubes in the order of draw by their color and their additive

Yellow (sterile): SPS

Light Blue: Na+ Citrate (Sodium Citrate)

Red: Plastic: clot activator; Glass: none

Gold / Tiger top: clot activator and polymer gel (SST)

Light Green: heparin and polymer gel (PST)

Green: heparin (Na+ [sodium], Li+ [lithium], or NH4+ [ammonium])

Lavender: Ethylenediaminetetraacetic acid (EDTA)

Gray: antiglycolytic agent (K+ [potassium] oxalate, Na+ [sodium] fluoride, EDT)

Blood Culture Bottle

ADDITIVE=SPS (sodium polyanethol sulfonate)DEPT=Microbiology (SPS)

BAG Collection

ADDITIVE=ACD(acid citrate dextrose)

DEPT.= Blood Bank, Immunohematology (ACD)

ORDER OF DRAW (CLSI)

1. Sterile tube (blood culture bottle)

2. Light-blue top (coagulation tube)

3. Red Serum tube with or w/out clot activator, with or w/o gel

4. Green Heparin tube with or w/o gel plasma separator

5. Lavendar EDTA Coag

6. Gray Glycolytic inhibitor

ORDER OF DRAW (color tube)

1. Sterile SPS Blood Culture Bottles

2. Lt. blue

3. Red glass

4. Red plastic

5. Gold/red-gray

6. Green

7. Lav.

8. Pink/Pearl

9. Royal Blue

10. Tan plastic

11. Gray

PT/PTT

prothrombin time / partial thromboplastin time

Lt. Blue top. Must draw discard tube if this is first tube drawn!! INVERT 5-8 times

To get serum, use:

Plain Tubes or Clot Activators (CAT)

To get plasma, use:

Anticoagulants

BLOOD CULTURES

Sterile SPS Blood Culture Bottles

COAGULATION STUDIES

Light Blue

SERUM STUDIES

Gold, Red Glass, Red Plastic

PLASMA STUDIES

HEPARIN -> green,light green,tan glass

EDTA->lavender,pink,royal blue,pearl, tan plastic

O&F->Gray