Understanding the Importance of Tube Selection in Phlebotomy in the United States

Summary

• Understanding which tubes to use for blood collection is crucial in phlebotomy.
• Following the proper order of tube collection can ensure accurate Test Results.
• Adhering to guidelines in the United States is essential for patient safety and quality care.

Introduction

Phlebotomy is a critical aspect of healthcare, involving the collection of blood samples for diagnostic testing. Proper blood collection techniques are essential to ensure accurate Test Results and patient safety. In the United States, there are specific guidelines that dictate which tubes should be used for blood collection and the order in which they should be used. Understanding these guidelines is crucial for healthcare professionals working in home healthcare, clinical labs, and hospitals.

Types of Blood Collection Tubes

There are various types of blood collection tubes available for phlebotomy, each containing different additives to preserve the integrity of blood samples and facilitate specific tests. The most commonly used tubes include:

Serum Tubes

1. Red-top tubes: These tubes do not contain any additives and are used for serum tests that do not require anticoagulants.
2. Gold-top tubes: Also known as SST tubes (serum separator tubes), these tubes contain a gel that separates serum from cells after centrifugation.

Anticoagulant Tubes

1. Lavender-top tubes: These tubes contain the Anticoagulant EDTA and are used for hematology tests, such as complete blood counts (CBC).
2. Blue-top tubes: These tubes contain the Anticoagulant Sodium Citrate and are used for coagulation tests, such as PT and PTT.
3. Green-top tubes: These tubes contain the Anticoagulant Heparin and are used for various chemistry and STAT tests.

Other Specialty Tubes

1. Gray-top tubes: These tubes are used for glucose testing and contain an additive that inhibits glycolysis.
2. Pink-top tubes: These tubes are used for blood banking and contain an additive that preserves red cell antigens.

Order of Tube Collection

When performing blood collection, it is crucial to follow the proper order of tube collection to prevent Cross-Contamination and ensure accurate Test Results. The recommended order of tube collection according to guidelines in the United States is as follows:

1. Yellow-top tubes (Blood Culture bottles): These tubes should always be collected first to prevent contamination of other tubes with skin flora.
2. Light blue-top tubes (Sodium Citrate): These tubes should be collected second for coagulation testing.
3. Red-top tubes (no additives): These tubes should be collected third for serum testing.
4. Gold-top tubes (SST): These tubes should be collected fourth for serum separation.
5. Green-top tubes (Heparin): These tubes should be collected fifth for chemistry testing.
6. Lavender-top tubes (EDTA): These tubes should be collected last for hematology testing.

Conclusion

Understanding the specific tubes to use for blood collection and the order in which they should be collected is essential for healthcare professionals in the United States. Adhering to guidelines ensures patient safety, accurate Test Results, and quality care. By following these guidelines, healthcare professionals can provide the best possible outcomes for patients in home healthcare, clinical labs, and hospitals.

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