Understanding The Order Of Draw And Color-Coded Tubes In Phlebotomy

Summary

• Understanding the order of draw is crucial in phlebotomy to prevent sample contamination and inaccurate Test Results.
• Color-coded tubes are used in the order of draw to indicate the additive present in the tube and the tests that can be performed on the sample.
• It is important for phlebotomists to be familiar with the color codes associated with the order of draw to ensure proper blood collection and handling.

Introduction

Phlebotomy is the practice of drawing blood from patients for laboratory testing. The order in which blood samples are collected is known as the order of draw. Following the correct order of draw is essential to prevent contamination of samples and ensure accurate Test Results. In phlebotomy, color-coded tubes are used to indicate the type of additive present in the tube and the tests that can be performed on the sample.

The Importance of the Order of Draw

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

1. Prevents Cross-Contamination: Following the correct order of draw helps prevent contamination of blood samples with additives from other tubes, which can lead to inaccurate Test Results.
2. Ensures accurate Test Results: Drawing blood in the proper order ensures that samples are collected in the correct tubes with the right additives, allowing for accurate Test Results.
3. Improves patient safety: By following the order of draw, phlebotomists can minimize the risk of errors and ensure that patients receive accurate diagnoses and appropriate treatment.

Color-Coded Tubes and Additives

In the order of draw, phlebotomists use color-coded tubes to indicate the additive present in the tube. Each tube color corresponds to a specific additive used for different types of tests. It is essential for phlebotomists to be familiar with these color codes to ensure proper blood collection and handling.

Common Tube Colors and Additives

Some of the most commonly used tube colors and their corresponding additives include:

1. Red: The red tube does not contain any additives and is used for collecting serum samples for various tests such as chemistry, serology, and blood typing.
2. Gold or Tiger Top: The gold or tiger top tube contains a gel separator and Clot Activator and is used for chemistry tests like Blood Glucose and cholesterol.
3. Light Blue: The light blue tube contains Sodium Citrate and is used for coagulation tests to measure blood Clotting Time.
4. Purple or Lavender: The purple or lavender tube contains EDTA (ethylenediaminetetraacetic acid) and is used for hematology tests like complete blood count (CBC).
5. Green: The green tube contains Heparin and is used for plasma determinations in tests such as electrolytes and ammonia levels.
6. Gray: The gray tube contains Sodium Fluoride and Potassium Oxalate and is used for glucose testing to prevent glycolysis.

Additional Tube Colors and Additives

There are also other tube colors and additives used for specific tests:

1. Dark Blue: The dark blue tube contains sodium Heparin or EDTA and is used for trace metal analysis and Toxicology studies.
2. Pink: The pink tube contains K2 EDTA and is used for blood bank tests like blood group and crossmatch.
3. Orange: The orange tube contains thrombin and is used for STAT serum chemistry tests to accelerate Clotting Time.
4. Yellow: The yellow tube contains acid-citrate-dextrose (ACD) and is used for Blood Culture tests to prevent clotting and preserve bacteria.

Understanding the Order of Draw

Phlebotomists must follow the correct order of draw to ensure the accuracy of blood samples and Test Results. The typical order of draw is as follows:

1. Yellow - Blood Culture tubes
2. Light blue - Coagulation tubes
3. Red - Serum tubes
4. Gold or Tiger Top - Serum separator tubes
5. Green - Heparin tubes
6. Lavender or Purple - EDTA tubes
7. Gray - Glucose tubes
8. Dark blue - Specialized additive tubes
9. Pink - Blood bank tubes
10. Orange - STAT chemistry tubes

Conclusion

Understanding the color codes associated with the order of draw is essential for phlebotomists to ensure proper blood collection and handling. By following the correct order of draw and using color-coded tubes with the appropriate additives, phlebotomists can prevent sample contamination, ensure accurate Test Results, and improve patient safety. It is crucial for phlebotomists to be familiar with the various tube colors and their corresponding additives to perform successful blood collections and provide reliable laboratory Test Results.

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