The Correct Order of Draw for Tan Top Tubes in Phlebotomy: Importance, Best Practices, and Guidelines

Summary

• The correct order of draw when using a tan top tube for phlebotomy is crucial to ensure accurate Test Results and patient safety.
• Following the proper order of draw helps prevent sample contamination and ensures the integrity of the specimen collected.
• Understanding the correct order of draw for different types of tubes is essential for healthcare professionals working in clinical labs, hospitals, and home healthcare settings.

Introduction

Phlebotomy is the process of drawing blood from a patient for diagnostic testing, transfusions, donations, or research. It is a critical skill practiced by healthcare professionals in various settings, including clinical laboratories, hospitals, and home healthcare. When performing phlebotomy, it is important to follow the correct order of draw to avoid sample contamination, ensure accurate Test Results, and prioritize patient safety.

Importance of Order of Draw

The order of draw refers to the sequence in which blood samples are collected in different tubes during a phlebotomy procedure. Following the correct order of draw is essential for several reasons:

1. Prevents sample contamination: Following a specific order ensures that additives from one tube do not contaminate samples collected in subsequent tubes.
2. Ensures accurate Test Results: Collecting samples in the correct order helps maintain the integrity of the specimens and prevents inaccurate Test Results due to Cross-Contamination.
3. Prioritizes patient safety: By following the proper order of draw, healthcare professionals minimize the risk of errors and ensure that patients receive appropriate care based on accurate Test Results.

Order of Draw for Tan Top Tubes

When using a tan top tube for phlebotomy, healthcare professionals must adhere to the correct order of draw to maintain Sample Integrity and ensure accurate Test Results. The tan top tube is typically used for coagulation studies to measure parameters such as Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT).

The correct order of draw when using a tan top tube is as follows:

1. Yellow top tube: The yellow top tube is used for blood cultures to detect infections caused by bacteria or fungi. It is important to collect blood cultures first to prevent contamination from other tubes.
2. Light Blue Top tube: The Light Blue Top tube contains Sodium Citrate and is used for coagulation studies. It is important to collect this tube before other additive tubes to prevent the introduction of anticoagulants that may affect Test Results.
3. SST (Serum Separator Tube) or Red Top tube: The SST or Red Top tube is used for various laboratory tests that require serum, such as chemistry panels and hormone assays. It should be collected after the Light Blue Top tube to prevent carryover of additives.
4. Tan top tube: The tan top tube is the last tube to be collected when performing a coagulation study. It contains Sodium Citrate and is used for PT and aPTT tests.

Best Practices for Phlebotomy

In addition to following the correct order of draw when using a tan top tube, healthcare professionals should adhere to best practices to ensure the quality of blood samples:

1. Properly identify the patient: Verify the patient's identity using at least two unique identifiers, such as name, date of birth, or medical record number, to prevent sample mix-ups.
2. Select the appropriate vein: Choose the best vein for Venipuncture based on factors such as vein size, visibility, and accessibility to ensure a successful blood draw.
3. Use aseptic technique: Follow proper Hand Hygiene and use sterile equipment to minimize the risk of infection and sample contamination.
4. Discard the first tube: When using a vacuum collection system, discard the first tube to remove air and prevent contamination of the sample with anticoagulants or additives from the equipment.
5. Label tubes accurately: Label each tube with the patient's information, date, time of collection, and phlebotomist's initials to ensure proper identification and traceability of the sample.

Conclusion

Following the correct order of draw when using a tan top tube for phlebotomy is essential to maintain Sample Integrity, prevent contamination, and ensure accurate Test Results. Healthcare professionals working in clinical labs, hospitals, and home healthcare settings must understand the importance of proper phlebotomy techniques and adhere to best practices to prioritize patient safety and quality care.

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