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Understanding Order of Draw in Phlebotomy

Apr 23, 2025

Flo's Corner: Lecture on Order of Draw in Phlebotomy

Introduction

  • Importance of the order of draw in phlebotomy.
  • Critical for those pursuing a career in phlebotomy.
  • Disclaimer: Presenter shares personal experience and knowledge.

What is the Order of Draw?

  • The order of draw refers to the specific sequence of drawing blood samples and using the correct tubes.
  • Essential to avoid contaminating blood specimens and to ensure accurate test results.

Importance

  • Different tubes have specific additives that may interact if not used in the correct order.
  • Contamination can lead to inaccurate results, delaying patient care.

The Order of Draw Explained

  1. Blood Cultures

    • First in the order.
    • Checks for bacteria or fungi in the bloodstream.
    • Requires a sterile procedure.
    • Inversion: 4-5 or 8-10 times (depends on workplace protocols).

  2. Sodium Citrate (Light Blue Top)

    • Second in order.
    • Contains anticoagulant (blood thinner) used for coagulation studies like D-dimer tests.
    • Must be filled to the top line.
    • Inversion: 3-4 times.

  3. Red (No Additive)

    • Clot activator.
    • Used less frequently for specimen collection.
    • Inversion: 5 times.

  4. Serum Separator Tubes (SSTs)

    • Variations: Red, Gold, Tiger Tops.
    • Contains gel for serum separation.
    • Used for comprehensive metabolic panels, thyroid panels, etc.
    • Inversion: 5 times.
    • Requires centrifugation after clotting.

  5. Heparin Tubes (Green Tops)

    • Used for electrolytes, liver function tests.
    • Types: Lithium Heparin, Sodium Heparin.
    • Inversion: 8-10 times.

  6. EDTA Tubes (Lavender, Pink, Tan, Royal Blue)

    • Lavender for CBC, hemoglobin A1C.
    • Pink for blood typing.
    • Tan for lead testing.
    • Royal Blue for trace metals.
    • Inversion: 8-10 times.

  7. Gray Tube (Sodium Fluoride)

    • Checks glucose, fasting blood sugar.
    • Inversion: 8-10 times.

  8. ACD Tube (Yellow Top)

    • Used for DNA studies, though less common.
    • Inversion: 8-10 times.

Honorable Mentions

  • Pearl Tube (PPT) & Black ESR Tube
    • Specialized tests, rarely used.

Tips and Recommendations

  • Always ask questions about unfamiliar tubes.
  • Be aware of similar colored tubes with different functions.
  • Pediatric and neonatal tubes are smaller.

Conclusion

  • Knowledge about the order of draw is crucial for a successful phlebotomy career.
  • Always seek additional resources and information.

Community Engagement

  • Encouraged feedback and sharing of experiences in the comments section of the video.

This lecture provided a comprehensive overview of the order of draw in phlebotomy, emphasizing the importance of accuracy and the potential consequences of errors. The knowledge shared here is intended to support those in the field of phlebotomy as well as anyone interested in learning about the process.

Full transcript