Understanding the Proper Order of Draw and Additives Used in Blood Collection for Accurate Lab Results and Patient Safety

Summary

• Understanding the proper order of draw and additives used in blood collection is crucial for accurate lab results
• Following the correct order of draw helps prevent sample contamination and ensures patient safety
• Phlebotomists and healthcare professionals must adhere to established guidelines to maintain the integrity of blood samples

Introduction

Proper blood collection is essential for accurate lab results and patient diagnosis in the healthcare industry. Phlebotomists and other healthcare professionals must follow specific protocols when collecting blood samples to prevent contamination and ensure patient safety. One crucial aspect of blood collection is the order of draw and the use of additives in blood collection tubes. In this article, we will discuss the proper order of draw and the additives used in blood collection for medical lab and phlebotomy procedures in the United States.

The Proper Order of Draw

The order of draw refers to the sequence in which different blood collection tubes should be filled during Venipuncture. Following the correct order of draw is crucial to prevent Cross-Contamination between tubes and ensure accurate Test Results. The recommended order of draw in the United States is as follows:

1. Yellow or SPS (Sterile, Preservative, Anticoagulant) tube - Blood Culture
2. Light Blue or Citrate tube - Coagulation studies
3. Red or SST (Serum Separator Tube) tube - Chemistry tests
4. Gold or SST Gel tube - Chemistry tests
5. Green or Heparin tube - Plasma determinations
6. Lavender or EDTA tube - Hematology tests
7. Gray or Fluoride tube - Blood Glucose and alcohol levels

Key Points to Remember

1. Always follow the recommended order of draw to prevent contamination.
2. Use separate needle and syringe for Blood Culture tube to avoid contamination with other tubes.
3. Discard the first tube collected when drawing multiple tubes to avoid carryover of additives between tubes.

Additives Used in Blood Collection Tubes

Various additives are used in blood collection tubes to preserve the integrity of blood samples and facilitate specific lab tests. Here are the common additives used in blood collection tubes:

Anticoagulants

Anticoagulants are additives that prevent blood clotting by interfering with the clotting cascade. Different anticoagulants are used for various blood tests, and their selection depends on the type of analysis to be performed. Common anticoagulants include:

1. EDTA (Ethylenediaminetetraacetic acid) - Used for hematology tests.
2. Citrate - Used for coagulation studies.
3. Heparin - Used for plasma determinations.
4. Fluoride - Used to inhibit glycolysis for Blood Glucose tests.

Serum Separator Gel

The SST Gel tube contains a gel separator that forms a barrier between serum and blood cells during centrifugation. This gel allows for easy separation of serum from cells, making it ideal for chemistry tests that require serum samples.

Preservatives

Preservatives are additives that help maintain the stability of certain analytes in blood samples. For example, SPS (Sterile, Preservative, Anticoagulant) is used in Blood Culture tubes to prevent the growth of bacteria and maintain Sample Integrity.

Coagulation Activators

Coagulation activators are additives that promote blood clotting by activating the coagulation cascade. These additives are used in coagulation tubes to facilitate clotting studies and other coagulation tests.

Conclusion

Proper blood collection is critical for accurate lab results and patient care in the healthcare industry. Understanding the proper order of draw and the additives used in blood collection tubes is essential for maintaining the integrity of blood samples and ensuring reliable Test Results. Phlebotomists and healthcare professionals should adhere to established guidelines and best practices to prevent contamination and ensure patient safety during blood collection procedures.

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