The Importance of Order of Draw and Additives in Healthcare Settings

Summary

  • Understanding the order of draw and additives is crucial in home healthcare, clinical labs, and hospitals in the United States.
  • Proper order of draw ensures accurate Test Results and prevents Cross-Contamination.
  • Each additive serves a specific purpose in preserving blood samples and ensuring the reliability of Test Results.

The Importance of Order of Draw and Additives in Home Healthcare, Clinical Labs, and Hospitals

Order of draw and additives play a critical role in healthcare settings such as home healthcare, clinical labs, and hospitals. When collecting blood samples for laboratory testing, it is essential to follow a specific order of draw to avoid Cross-Contamination and ensure accurate Test Results. Additionally, the type of additive used in blood collection tubes serves various purposes, such as preserving the integrity of the blood sample and preventing clotting. Understanding the order of draw and additives is essential for healthcare professionals to provide accurate diagnoses and effective treatment for patients.

Order of Draw

The order of draw refers to the sequence in which blood samples are collected into different tubes during Venipuncture. Following the correct order of draw is crucial to prevent Cross-Contamination between tubes and ensure the accuracy of Test Results. The standard order of draw recommended by the Clinical and Laboratory Standards Institute (CLSI) is as follows:

  1. Yellow or SPS (acid-citrate-dextrose) tubes - used for Blood Culture tests.
  2. Light blue tubes - containing Sodium Citrate, used for coagulation studies.
  3. Red or gold-topped tubes - containing no additive or Clot Activator, used for serum chemistry tests.
  4. Light green or mint green tubes - containing Heparin, used for plasma chemistry tests.
  5. Lavender tubes - containing EDTA (ethylenediaminetetraacetic acid), used for hematology studies.
  6. Gray tubes - containing Sodium Fluoride and Potassium Oxalate, used for glucose tests.

By following this order of draw, healthcare professionals can mitigate the risk of specimen contamination and mix-ups, ensuring the reliability of Test Results. Failure to follow the correct order of draw can lead to inaccurate results, potentially compromising patient care.

Additives in Blood Collection Tubes

Each additive used in blood collection tubes serves a specific purpose in preserving the integrity of the blood sample and ensuring the accuracy of laboratory Test Results. Understanding the function of these additives is essential for healthcare professionals to choose the right tube for specific tests.

Sodium Citrate

Sodium Citrate is an additive commonly found in light blue-topped tubes and is used for coagulation studies to prevent blood from clotting by binding to calcium ions. It is essential for tests such as Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT), which evaluate the blood's ability to clot properly.

Heparin

Heparin is an Anticoagulant that prevents blood from clotting by inhibiting thrombin. It is commonly used in light green or mint green-topped tubes for plasma chemistry tests such as electrolytes, liver function tests, and cardiac markers. Heparin is available in different forms, such as lithium Heparin, sodium Heparin, and ammonium Heparin, each tailored for specific tests.

EDTA (Ethylenediaminetetraacetic Acid)

EDTA is a chelating agent that binds calcium ions, preventing blood from clotting by inhibiting coagulation factors. Lavender-topped tubes containing EDTA are used for hematology studies, including complete blood count (CBC), Blood Smears, and blood typing. EDTA also helps preserve cell morphology for accurate microscopic examination.

Sodium Fluoride and Potassium Oxalate

Sodium Fluoride and Potassium Oxalate are additives commonly found together in gray-topped tubes and are used for glucose testing. Sodium Fluoride inhibits glycolysis, while Potassium Oxalate acts as an anticoagulant. These additives help preserve Blood Glucose levels for accurate testing in patients with diabetes or hypoglycemia.

Conclusion

Understanding the order of draw and additives in blood collection tubes is essential for healthcare professionals in home healthcare, clinical labs, and hospitals in the United States. Following the correct order of draw and using the appropriate additives for specific tests is crucial to ensure the accuracy and reliability of laboratory Test Results. Proper specimen collection, handling, and processing are essential steps in providing quality patient care and delivering accurate diagnoses for optimal treatment outcomes.

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