The Importance of Order of Draw in Blood Collection: Guidelines and Best Practices

Summary

  • The specific order of draw is crucial in blood collection to ensure accurate Test Results and prevent sample contamination.
  • Understanding the order of draw can help phlebotomists minimize the risk of sample hemolysis and improve patient care in clinical labs and hospitals.
  • By following the correct order of draw and corresponding tests, Healthcare Providers can maintain the integrity of blood samples and ensure accurate diagnosing and treatment for patients.

Introduction

In the United States, blood collection is an essential part of healthcare services provided in clinical labs and hospitals. Phlebotomy process involves drawing blood samples from patients to conduct various tests for diagnosis, monitoring, and treatment. The order of draw is a critical aspect of blood collection that must be followed to ensure accurate Test Results and prevent sample contamination. In this article, we will discuss the specific order of draw and corresponding tests for blood collection in the medical lab and phlebotomy process in the United States.

The Importance of Order of Draw

The order of draw refers to the sequence in which different blood collection tubes are filled during the phlebotomy process. Following the specific order of draw is essential to prevent sample contamination, ensure accurate Test Results, and maintain the integrity of blood samples. Here are some reasons why the order of draw is crucial in blood collection:

  1. Prevents sample contamination: Mixing blood samples from different tubes can cause Cross-Contamination and affect Test Results. By following the correct order of draw, phlebotomists can reduce the risk of sample contamination and ensure the accuracy of tests.
  2. Minimizes the risk of sample hemolysis: Hemolysis is the breakdown of red blood cells, which can release substances into the blood that interfere with certain tests. Following the proper order of draw helps prevent hemolysis and ensures reliable Test Results.
  3. Improves patient care: Accurate Test Results are essential for diagnosis, monitoring, and treatment of patients. By following the specific order of draw, Healthcare Providers can deliver high-quality care and enhance patient outcomes.

Correct Order of Draw

In the United States, the Clinical and Laboratory Standards Institute (CLSI) has established guidelines for the order of draw to standardize blood collection practices and ensure the accuracy of Test Results. The correct order of draw typically includes the following steps:

1. Yellow Blood Culture Tubes

Yellow Blood Culture tubes are used for collecting blood samples for microbiological culturing. These tubes contain special additives that help in the growth of microorganisms in the blood sample. It is essential to draw Blood Culture tubes first to prevent contamination from other tubes.

2. Light Blue Coagulation Tubes

Light blue coagulation tubes contain Sodium Citrate, which is used to prevent blood clotting. These tubes are typically used for coagulation tests, such as PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time). Drawing coagulation tubes after Blood Culture tubes helps prevent Cross-Contamination and ensures accurate Test Results.

3. Red or Gold Serum Tubes

Red or gold serum tubes are used for collecting blood samples for various chemistry tests, including lipid profiles, liver function tests, and glucose levels. These tubes do not contain any additives and are used to obtain serum samples for biochemical analysis. Drawing serum tubes after coagulation tubes helps prevent contamination and ensure proper clotting of the blood sample.

4. Green Heparin Tubes

Green Heparin tubes contain sodium Heparin or lithium Heparin, which prevent blood clotting by inhibiting thrombin formation. These tubes are used for collecting blood samples for various chemistry tests, such as electrolyte levels and liver function tests. Drawing Heparin tubes after serum tubes helps prevent clotting and ensures accurate Test Results.

5. Lavender EDTA Tubes

Lavender EDTA tubes contain EDTA (ethylenediaminetetraacetic acid), which is an Anticoagulant that binds calcium ions and prevents blood clotting. These tubes are used for collecting blood samples for hematology tests, such as complete blood count (CBC) and blood cell morphology. Drawing lavender tubes after Heparin tubes helps prevent clotting and ensures accurate hematological analysis.

6. Gray Glucose Tubes

Gray glucose tubes contain fluoride and Potassium Oxalate, which are used to preserve Blood Glucose levels by inhibiting glycolysis. These tubes are used for collecting blood samples for glucose tests, such as Fasting blood sugar and oral glucose tolerance tests. Drawing glucose tubes last helps prevent glycolysis and ensures accurate glucose measurements.

Conclusion

Following the specific order of draw is crucial in blood collection to ensure accurate Test Results and prevent sample contamination. Understanding the correct sequence of blood collection tubes and corresponding tests can help phlebotomists minimize the risk of sample hemolysis and improve patient care in clinical labs and hospitals. By following the established guidelines for the order of draw, Healthcare Providers can maintain the integrity of blood samples and ensure accurate diagnosing and treatment for patients.

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