Phlebotomy Order of Draw Guidelines
Phlebotomy is the process of drawing blood from a patient for various medical tests and procedures. It is a crucial step in diagnosing and treating many illnesses, and ensuring the accuracy of test results is of utmost importance. This is where the concept of the "Order of Draw" comes into play.
Understanding the Order of Draw
The Order of Draw refers to the sequence in which multiple blood samples should be collected during a single venipuncture procedure. Following the correct order helps minimize the risk of cross-contamination between different blood samples and ensures that the test results are accurate and reliable.
Importance of Following the Order of Draw Guidelines
There are several reasons why it is essential to adhere to the Order of Draw guidelines:
Prevents cross-contamination: Drawing blood in the wrong order can lead to contamination of samples with additives used in blood collection tubes, such as anticoagulants or clot activators.
Ensures accurate test results: Different additives in blood collection tubes can interfere with each other, leading to inaccurate test results if the Order of Draw is not followed correctly.
Patient safety: Following proper protocols ensures the safety and well-being of the patient by reducing the risk of errors and misdiagnosis.
The Correct Order of Draw
While the specific order may vary slightly depending on the healthcare facility and the tests being performed, there is a general guideline that is commonly followed by phlebotomists. The typical Order of Draw is as follows:
Yellow or SPS tubes: These tubes contain a solution of citrate, dextrose, and sodium polyanethol sulfonate. They are used for blood cultures and should be drawn first to prevent contamination.
Light Blue tubes: These tubes contain sodium citrate, used for coagulation studies such as PT and APTT.
Red or Tiger Top tubes: These tubes contain a clot activator and are used for chemistry tests and blood bank studies.
Gold or SST tubes: These tubes contain a clot activator and gel separator, used for chemistry tests.
Green tubes: These tubes contain heparin and are used for plasma determinations in chemistry tests.
Lavender tubes: These tubes contain EDTA and are used for hematology tests such as CBCs.
Gray tubes: These tubes contain potassium oxalate and sodium fluoride, used for glucose testing.
Exceptions and Special Cases
While the above sequence is the standard Order of Draw, there are some exceptions and special cases that phlebotomists should be aware of:
Pediatric patients: In pediatric patients, it is recommended to draw blood cultures last to minimize the risk of contamination.
Patients with difficult veins: For patients with difficult veins, it may be necessary to prioritize tubes that contain the most critical tests.
Conclusion
Following the correct Order of Draw is essential for ensuring the accuracy and reliability of blood test results. By adhering to the guidelines and understanding the reasons behind them, phlebotomists can minimize the risk of errors, improve patient safety, and contribute to effective healthcare delivery.
For more information on phlebotomy techniques and best practices, check out the Phlebotomy Examiner website.
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