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:
- Yellow or SPS (sterile, sodium polyanethol sulfonate) tubes for blood cultures
- Light blue tubes for coagulation studies containing Sodium Citrate
- Red/Gray, Gold, or Tiger Top tubes for chemistry tests containing Clot Activator and gel separator
- Light Green or Dark Green tubes for chemistry tests containing Heparin
- Lavender tubes for hematology tests containing EDTA (ethylenediaminetetraacetic acid)
- Gray tubes for glucose studies containing Sodium Fluoride and Potassium Oxalate
- 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.
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