The Importance of Order of Draw in Phlebotomy: Preventing Contamination and Ensuring Reliable Test Results

Summary

• The order of draw is crucial in blood collection to avoid contamination and inaccurate Test Results.
• Following the appropriate order of draw ensures that the blood samples are collected in the correct sequence to maintain Sample Integrity.
• Understanding the correct order of draw helps healthcare professionals in providing accurate and reliable Test Results for patient care.

The Importance of Order of Draw in Phlebotomy

Phlebotomy, the practice of drawing blood from patients for testing and medical purposes, is a critical aspect of healthcare. The process of collecting blood samples requires precision and adherence to certain guidelines to ensure accurate Test Results. One key factor in blood collection is the order of draw, which refers to the specific sequence in which different blood collection tubes should be used. Following the appropriate order of draw is vital in preventing sample contamination, ensuring reliable Test Results, and maintaining patient safety.

Why is the Order of Draw Important?

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

1. Preventing Contamination: Using the correct order of draw helps minimize the risk of sample contamination. Certain additives in blood collection tubes can cross-contaminate samples if collected out of sequence. For example, if a tube containing an Anticoagulant is drawn after a tube without additives, the Anticoagulant residue may affect the clotting process in subsequent samples.
2. Maintaining Sample Integrity: Following the appropriate order of draw ensures that blood samples are collected in the correct sequence. This helps maintain Sample Integrity and prevents erroneous Test Results. For instance, drawing a tube containing an additive like EDTA before a tube with a Clot Activator can lead to falsely elevated potassium levels due to the release of potassium from platelets in the EDTA tube.
3. Ensuring Reliable Test Results: Inaccurate Test Results can have serious implications for patient care and treatment. By adhering to the proper order of draw, healthcare professionals can minimize the risk of specimen hemolysis, contamination, and other factors that can affect test accuracy. This ultimately leads to more reliable Test Results and better patient outcomes.

The Correct Order of Draw for Blood Collection Tubes

While the exact order of draw may vary slightly depending on the facility and specific protocols, the general guideline for the order of draw in phlebotomy is as follows:

1. Yellow (Sterile): Used for blood cultures to check for infections.
2. Light Blue (Sodium Citrate): Contains an Anticoagulant for coagulation studies like PT and PTT.
3. Red (no additive): Typically used for serum testing, such as chemistries and blood bank tests.
4. Gold or Tiger Top (SST, serum separator tube): Contains a Clot Activator and gel for separating serum from cells.
5. Light Green or Dark Green (Heparin): Contains Heparin as an Anticoagulant for chemistry tests.
6. Lavender (EDTA): Contains EDTA as an Anticoagulant for hematology tests like CBC and other cell counts.
7. Gray (Sodium Fluoride): Contains an anticoagulant (EDTA) and a preservative (Sodium Fluoride) for glucose testing.

Following this order of draw helps ensure that blood samples are collected in a way that minimizes the risk of contamination and maintains Sample Integrity. Healthcare professionals should be well-versed in the appropriate order of draw and follow it diligently to provide accurate and reliable Test Results for patient care.

Conclusion

In conclusion, the order of draw is a fundamental aspect of phlebotomy that greatly influences the accuracy and reliability of blood Test Results. By following the correct sequence for blood collection tubes, healthcare professionals can prevent contamination, maintain Sample Integrity, and ensure reliable test outcomes. Adherence to the appropriate order of draw is crucial for providing quality patient care and maintaining the highest standards of clinical laboratory practice.

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