The Correct Order of Draw and Tube Additives in Phlebotomy: Essential Guidelines for Healthcare Professionals

Summary

  • Understanding the correct order of draw and types of tube additives used in phlebotomy procedures is essential for healthcare professionals in the United States.
  • Following proper protocol ensures accurate Test Results and minimizes the risk of specimen contamination.
  • Knowing the correct order of draw and tube additives can help healthcare facilities maintain high standards of care and patient safety.

Introduction

Phlebotomy is a critical component of healthcare, involving the collection of blood specimens for diagnostic testing. Proper technique is essential to ensure accurate Test Results, prevent contamination, and promote patient safety. One important aspect of phlebotomy is understanding the correct order of draw and the types of tube additives used in the process. In this article, we will discuss the importance of following the correct order of draw and review the various tube additives commonly used in phlebotomy procedures in the United States.

The Correct Order of Draw

The order in which blood specimens are collected during phlebotomy is crucial to prevent Cross-Contamination and ensure the accuracy of Test Results. In the United States, healthcare professionals typically follow the order of draw recommended by the Clinical and Laboratory Standards Institute (CLSI). The correct order of draw is as follows:

  1. Yellow or SPS (sterile, sodium polyanethol sulfonate) tubes for blood cultures
  2. Light blue tubes for coagulation studies containing Sodium Citrate
  3. Red/Gray, Gold, or Tiger Top tubes for chemistry tests containing Clot Activator and gel separator
  4. Light Green or Dark Green tubes for chemistry tests containing Heparin
  5. Lavender tubes for hematology tests containing EDTA (ethylenediaminetetraacetic acid)
  6. Gray tubes for glucose studies containing Sodium Fluoride and Potassium Oxalate
  7. Dark Blue tubes for tests requiring whole blood samples without additives

Tube Additives Used in Phlebotomy

Each type of tube used in phlebotomy contains specific additives that help maintain the integrity of blood specimens and ensure accurate Test Results. Here are the most common tube additives used in phlebotomy procedures in the United States:

Sodium Polyanethol Sulfonate (SPS)

SPS is an Anticoagulant used in yellow tubes for Blood Culture collection. It prevents the coagulation of blood and inhibits the growth of bacteria in the specimen, ensuring accurate culture results.

Sodium Citrate

Sodium Citrate is an Anticoagulant used in light blue tubes for coagulation studies. It binds to calcium ions in the blood, preventing clotting and allowing for accurate Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT) testing.

Clot Activator and Gel Separator

Red/Gray, Gold, or Tiger Top tubes contain a Clot Activator and gel separator. The Clot Activator promotes blood clotting, while the gel separator isolates serum or plasma from the clot, preventing contamination and ensuring accurate Chemistry Test results.

Heparin

Green tubes contain Heparin, an Anticoagulant that inhibits the clotting process by preventing the formation of thrombin. Heparin is commonly used in chemistry tests to preserve the integrity of plasma samples.

EDTA (Ethylenediaminetetraacetic Acid)

Lavender tubes contain EDTA, an Anticoagulant that chelates calcium ions in the blood, preventing coagulation. EDTA is used in hematology tests to preserve cell morphology and facilitate accurate blood cell counting.

Sodium Fluoride and Potassium Oxalate

Gray tubes contain a mixture of Sodium Fluoride and Potassium Oxalate. Sodium Fluoride inhibits the enzyme glycolysis, preserving glucose levels in the blood for accurate testing. Potassium Oxalate enhances the Anticoagulant properties of the tube.

Whole Blood Samples

Dark Blue tubes are used for tests that require whole blood samples without additives. These tubes are typically used for blood bank testing or DNA analysis, where additives could interfere with the Test Results.

Conclusion

Understanding the correct order of draw and types of tube additives used in phlebotomy procedures is essential for healthcare professionals in the United States. By following proper protocol and using the appropriate tubes and additives, healthcare facilities can ensure the accuracy of Test Results, minimize the risk of specimen contamination, and promote patient safety. Maintaining high standards of care in phlebotomy is crucial for providing quality healthcare services and meeting regulatory requirements. By staying informed and adhering to best practices, healthcare professionals can continue to improve the quality and efficiency of phlebotomy services in the United States.

a-doctor-puts-a-tourniquet-onto-a-patient

Disclaimer: The content provided on this blog is for informational purposes only, reflecting the personal opinions and insights of the author(s) on the topics. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. No physician-patient relationship is created by this web site or its use. No contributors to this web site make any representations, express or implied, with respect to the information provided herein or to its use. While we strive to share accurate and up-to-date information, we cannot guarantee the completeness, reliability, or accuracy of the content. The blog may also include links to external websites and resources for the convenience of our readers. Please note that linking to other sites does not imply endorsement of their content, practices, or services by us. Readers should use their discretion and judgment while exploring any external links and resources mentioned on this blog.

Related Videos

Previous
Previous

The Importance of Renewing CLIA Waivers Online: Steps and Benefits

Next
Next

Strategies for Improving Employee Retention in Medical Labs and Phlebotomy Centers