The Importance of Order of Draw for Phlebotomy Tubes in the United States

Summary

• The standard order of draw for phlebotomy tubes in the United States is crucial to ensure accurate Test Results and patient safety.
• It is important to follow the proper order of draw to prevent Cross-Contamination of blood samples and to maintain the integrity of the specimens.
• The dark blue tube, also known as the citrate tube, is typically used for coagulation studies and should be drawn last in the order to avoid contamination with additives from other tubes.

Introduction

Phlebotomy, the practice of drawing blood from patients for diagnostic testing, is a critical component of healthcare delivery. Proper phlebotomy techniques are essential to ensure accurate Test Results and patient safety. One important aspect of phlebotomy practice is the standard order of draw for phlebotomy tubes in the United States. Following the correct order of draw helps prevent Cross-Contamination of blood samples and maintains the integrity of the specimens.

Why is the Order of Draw Important?

The order of draw is essential in phlebotomy for several reasons:

1. Prevent Cross-Contamination: Drawing blood in the wrong order can lead to contamination of samples with additives from other tubes, such as anticoagulants or clot activators.
2. Maintain Specimen Integrity: The order of draw helps ensure that blood samples are collected in the correct sequence to prevent interference with Test Results.
3. Patient Safety: Following the standard order of draw helps reduce the risk of mislabeling and misidentification of specimens, which could have serious consequences for patient safety.

What is the Standard Order of Draw?

The standard order of draw for phlebotomy tubes in the United States may vary slightly depending on the facility and specific collection requirements. However, the general order of draw is as follows:

1. Sterile Tubes: These tubes are typically used for blood cultures and should be drawn first to avoid contamination with additives from other tubes.
2. Light Blue Tubes: These tubes contain Sodium Citrate and are used for coagulation studies. They should be drawn second to prevent contamination of the sample.
3. Red Tubes: These tubes are used for chemistry tests and other blood bank studies. They should be drawn after the light blue tubes to prevent interference with coagulation studies.
4. Gold or Tiger Top Tubes: These tubes contain a gel separator and are used for chemistry tests. They should be drawn after the red tubes.
5. Light Green Tubes: These tubes contain Heparin and are used for plasma tests. They should be drawn after the gold or tiger top tubes,
6. Lavender Tubes: These tubes contain EDTA and are used for complete blood counts and blood bank studies. They should be drawn after the light green tubes.
7. Gray Tubes: These tubes contain Potassium Oxalate and Sodium Fluoride and are used for glucose testing. They should be drawn after the lavender tubes.
8. Dark Blue Tubes: These tubes contain Sodium Citrate and are used for coagulation studies. They should be drawn last in the order to avoid contamination with additives from other tubes.

Conclusion

Following the standard order of draw for phlebotomy tubes in the United States is essential for ensuring accurate Test Results and maintaining patient safety. By understanding the proper sequence for drawing blood samples, phlebotomists can help prevent Cross-Contamination and maintain the integrity of specimens. The dark blue tube, also known as the citrate tube, should always be drawn last to avoid contamination with additives from other tubes.

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