Proper Order of Draw and Tube Additives in Phlebotomy Procedures in the United States
Summary
- Following the proper order of draw and tube additives is crucial for accurate laboratory Test Results.
- Understanding the correct sequence of tubes and additives can help prevent specimen contamination and ensure patient safety.
- Phlebotomists play a vital role in following these guidelines to maintain the integrity of blood samples collected during healthcare procedures.
Introduction
Proper phlebotomy procedures are essential in healthcare settings to ensure accurate laboratory Test Results. One crucial aspect of these procedures is the order of draw and the appropriate tube additives used during blood collection. In the United States, Healthcare Providers follow specific guidelines to prevent specimen contamination and ensure patient safety. This article will discuss the proper order of draw and tube additives for phlebotomy procedures in the United States.
Order of Draw
The order of draw refers to the sequence in which different blood collection tubes are filled during phlebotomy procedures. Following the proper order of draw is crucial to prevent Cross-Contamination between tubes and ensure accurate Test Results. In the United States, Healthcare Providers typically follow the following order of draw:
Correct Order of Draw
- Yellow Tube - Sterile
- Light Blue Tube - Sodium Citrate
- Red Tube - No Additive or Clot Activator
- Gold or Tiger Tube - Clot Activator and Gel Separator
- Light Green Tube - Lithium Heparin
- Dark Green Tube - Sodium Heparin
- Lavender Tube - EDTA (Ethylenediaminetetraacetic acid)
- Gray Tube - Sodium Fluoride
Reasoning Behind the Order
The order of draw is based on the additives present in each tube and their potential for Cross-Contamination. Following this sequence helps prevent carryover of additives from one tube to another, which could lead to inaccurate results. For example, drawing a lavender (EDTA tube) before a red (Clot Activator) tube could result in clotting of the specimen due to the presence of Anticoagulant in the lavender tube.
Tube Additives
Each type of blood collection tube contains specific additives that are designed to preserve the integrity of the specimen and facilitate proper testing. Understanding the purpose of these additives is essential for phlebotomists to ensure accurate Test Results. Here are some common tube additives used in phlebotomy procedures:
Sodium Citrate (Light Blue Tube)
Sodium Citrate is an Anticoagulant used to prevent blood clotting by binding to calcium ions in the blood. It is commonly used for coagulation tests, such as PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time).
Clot Activator (Red and Gold Tubes)
Clot activators promote the clotting of blood by accelerating the coagulation process. These tubes are used for serum chemistry tests that require a clot-free specimen. The serum is separated from the clot after centrifugation.
Lithium Heparin (Light Green Tube)
Heparin is an Anticoagulant that inhibits the clotting cascade by enhancing the activity of antithrombin III. Lithium Heparin tubes are used for tests that require plasma, such as electrolyte panels and some cardiac markers.
EDTA (Lavender Tube)
EDTA is a chelating agent that binds to calcium ions and prevents blood from clotting by sequestering coagulation factors. Lavender tubes are used for hematology tests, such as complete blood count (CBC) and Blood Smears.
Importance of Following Guidelines
Adhering to the proper order of draw and tube additives is crucial for maintaining the integrity of blood samples collected during phlebotomy procedures. Failure to follow these guidelines can lead to inaccurate Test Results, specimen contamination, and compromised patient safety. Healthcare Providers rely on phlebotomists to be knowledgeable about these procedures to ensure the quality of laboratory testing.
Conclusion
Proper order of draw and tube additives are essential components of phlebotomy procedures in the United States. Following the correct sequence of tubes and additives helps prevent specimen contamination, ensure accurate Test Results, and maintain patient safety. Phlebotomists play a vital role in adhering to these guidelines to uphold the standards of quality healthcare practices in clinical labs and hospitals.
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