hello everyone and welcome back to Flo's corner so in this video I'm going to be discussing the order of draw this is very crucial in photomy so if you're thinking about being a FLOTUS or embarking on a FLOTUS Journey then you need to embed the order of draw into your brain you need to eat sleep everything the order of draw because this is something that you are going to be using in your whole photomy career also just a quick disclaimer I am in no way form or fashion a professor of photomy or anything like that everything I explain is all that I have learned and that I have put into my photomy career and these are the things that I just kind of just picked up and just know exactly what is and what is not if you do feel that I am wrong in any way please just put it down in the comments if you think maybe I just misinformed or however but this is just my personal opinion cuz I've been doing this for quite some time so let's get right into it okay so what is the order of draw you may wonder the order of draw is pretty much the correct or precise order of blood that you are going to draw from a patient and the right correct tubes that it's supposed to go into so in layman terms all it means is this is the test that you are going to draw and this is the color tube that it's supposed to go into so why is the order of drawer important why is it crucial who cares just pour the blood into any type of tubes and uh-uh that's not right you have to follow the order of draw because certain tubes have additives in them and and if you're not drawing correctly from the order of drawway you can and will contaminate your blood specimen which is going to give an inaccurate result or it's just not going to read right at all which is going to delay the patient's care so that's why the order of draw is very crucial okay now on to the fun part let's learn about the tubes the test and things like that so the first one is blood cultures these are always number one when it comes to the order of draw so blood CES check the bloodstream if it has any type of bacteria or fungi which is causing an infection a sterile procedure has to be performed before actually um drawing the blood cultures and that's pretty much just a certain way we wipe down the skin in for any type of contamination that could happen or anything like that I'll discuss that in more in another video but that's pretty much the first one is blood coaches so the tube that comes after the blood coaches is called the sodium citate the sodium citate is the light blue top okay the light blue top is the second one after the blood cultes this contains sodium citate this is an anti-coagulant anticoagulant just acts like a blood thinner so it makes it where the blood is not clotting so the sodium citrate which is the light blue top normally tests for like the D diers PT test fibrinogen test it's like good in coagulation studies so normally with the light blue top you have to fill it to that Top Line like right underneath a little bit underneath the light blue part the top part you have to fill all your specimens in that tube all the way to that or if not normally the lab will kind of send it back and tell you you have to well not send it back you know but they'll tell you that you have to redraw because it wasn't enough of the blood specimen so I almost forgot the sodium citate has to be inverted three to four times so pretty much I know it's not the light blue but this is just a demonstration so pretty much invert means like you're going to turn it upside down and then you're going to bring it back so inverting you do one two three and obviously it says three to four so you could four boom there you go oh my gosh I forgot about the blood coers okay so the blood coosur inversion now this is kind of crazy because I've heard sometimes the blood cultures can be inverted four to five times and I also heard that blood cultures can be inverted 8 to 10 times so just do exactly where the type of place that you're working how they do the blow cultures you invert as many times as they say just to be on the safer side um obviously if you ever uh invert too many times you could cause hemolysis of the blood Co I mean the blood specimen and you don't want that so always kind of know how how many times to invert a blood uh blood the next one after that is going to be the red no additive um tube which means that the red is just really a clock activator um I honestly don't really use the red as to collect a specimen and send it off to the lab I have when I worked at the hospital but what the way I use it now is normally I have this to start like the vacuum seal of like my butterfly and anything like that and then I normally discard this one and then go after and do my other tubes that's normally what I use it for as of now like I said in the hospital I have drawn the red tubes before but wasn't all very common so they are a clot activator which means that they do clot the blood um most of the time I believe the red ones are used as a serum separator which pretty much means you have to put it in the Cent fuge and you know it comes to serum state but yeah that's normally what I know about like the red ones um but we also used the SST which I'll get right into right after this but if you just look you can see that there is like no additive no anything in this tube that's why it's literally let me try to get it clear yeah so pretty much I've known they are used for like specialized test or like I said to discard them so on to the next also when using these these should only be inverted five times don't forget 1 2 3 4 5 this is the proper inversion method I have seen other fotus kind of do that like a shaky kind of thing I don't believe in doing that I mean honestly I was never taught to do that but you normally and do the inversion method next after the red no additive we are going to go straight into our ssts which is considered serum separator tubes these tubes pretty much I've seen them in a few different colors um some places do use red as a serum separator tube um I've seen them look like a gold tube as well I've seen them look red and gold I've seen them tiger tops and stuff so different places I know I guess depending on the brands that the company uses gives different types of serum separated tubes so the company that I'm with we had started out with one specific uh C separator tube and then we went to a different ssts so they do come in variety of colors so you do invert ssts five times before actually letting them clot they will clot on its own about 30 minutes normally you're supposed to give it at least 30 minutes before you centrifuge them if you do centrifuging in your job some fotus when I work in the hospital like I said we just draw invert and then you know send it down to the lab or however but if you do if you are the one that's going to be cusing it you give it 30 minutes to clly and then you're going to spun it down spin it down excuse me these are normally used for like cmps which is comp comprehensive metabolic panel these check bmps these checks like thyroid panels renal panels um lipid panels hepatitis um HIV pregnancy the serum separated tube is used a whole lot that I've noticed it's used a lot for different kinds of tests these are just some of the tests I know there's way more out there but I'm just kind of putting out there just the main things that I normally will draw for the serum separated there's another one that I've seen in my photomy career but I have never used and it is an orange tube and this is an rst which is which is called a rapid serum test and I was like oh these are so cute cuz they're all orangey and citrusy and stuff like that but any who they are literally just the serum separated just as much but they take a shorter time to actually let the blood clot so normally I've seen like the orange rsts used as a stat instead of doing the ssts where you have to wait 30 minutes for the blood to clot you use the orange rst and then you send that down cuz it's already clotting very quickly so when they do have the gel you want to invert it five to six times here's another one that you may see but you probably don't use them as often and that is the royal blue it's a clot activator and it has no additive in it and pretty much is the royal blue just is checks like the trace of metal like elements and this one in particular comes into a serum and you will invert it 8 to 10 times I have not used that one in a very long time but I know of it after your serums comes your heprin tubes so the heprin tubes is going to be a they have two different ones which is a lithium heprin and they have a sodium heprin all the tops are green you do have two that are considered light green and then I think I've seen two dark green as well if I'm not mistaken the light green one normally checks like your electrolyte um levels and your liver function um I think the one of the tubes have gel in it at the bottom and then one of them don't they are inverted 8 to 10 times so so I know one of the tests that the sodium Hein checks is like bone marrow um it just pretty much the difference between the both but between the two of them is that normally sodium Hein and what I learned has uh can preserve your white blood cell count like better than actually lithium Hein I know the sodium Hein can also check like your vitamin B6 uh levels your lucco cytes if I'm not mistaken and also like your lithium levels it can also check as well now we're going to move on to our Eda tubes there Ed St stands for I hope I'm pronouncing this correctly it's ethylene diamine tetratic I believe I said that right it's a very long one one of these you're going to invert 8 to 10 times so now we're just going to get into the first one which is the lavender you've probably seen this one this one is very common it's lavender color top it can check for so many things um one of like a couple of tests like the CBC with auto diff with PL platelets the CVC without Auto diff with platelets can also be checked as well your hemoglobin A1c can be checked with the lavender um and something like your sedimentation rate as well there are so many tests that lavender can check for I'm just going to like I said I'm just going to get into some of them not all of them um they're all an anti-coagulant so pretty much these do not clot at all which means that it's whole blood that you're going to be needing for when you're drawing and stuff like that so the pink tubes I haven't drawn for like my adult patients I have drawn pink tubes for my pediatric patients I do know that you can use the pink one to um find the blood type of a patient normally in adults um if I'm not mistaken I believe when I was learning about the tubes and stuff I think the pink one is like used like a blood blank kind of thing like for that type of use but that's pretty much all I know of it but like I said I don't draw it often there's a tan Eda that I know is used for uh to check for lead a royal blue Ed TTA top which checks for like the trace of elements like Metals uh selenium zinc uh copper like things of that nature and also be careful with some of the tubes like I said they is certain colors that are similar like you do have a royal blue serum you do have a royal blue Eda so make sure you know which one have additives which one doesn't that is the same color like I said you do have your greens heprin one with gel one without like you know kind of get to know your tub so that you don't have any kind of confusion or make any really big mistakes I did draw from a royal blue one time what like I say when I was first starting out and it was the additive one which was the Ed and yeah I couldn't change that they called and said oh this is the wrong you know tube for this so I we did have to call the patient for the pression to come back and like I said you know I can't stand to do redraws because you know I know it's like inconvenience for the patient and sadly that's what happened because I wasn't paying attention at first and the Royal Blues I got confused so when she told me hey go in there and draw the the royal blue and I looked at the test and everything and that's my fault for not actually knowing which one was you know which and i w up drawing in the wrong tube so it was a mistake on my part but luckily the patient was very very okay with coming back and however but this is just an an experience that I had learned from when I started out so the next one is our sodium fluoride which is also our pottassium oxalate tube and that is the gray tube this normally checks like glucose the fasting blood sugar and your lactic acid uh normally when I had some of my patients like in the labor delivery Ward or however who is doing the um glucose test which is the fasting blood sugar and then you check them an hour later however we would just keep drawing those blood specimens in the gray tube I've always seen them as that in the hospital I've always seen them as for the lactic acid as well you will invert that tube 8 to 10 times it can be in a plasma state or it can be in a whole blood State depending on the test the next tube is usually the ACD which stands for acid citrate dextrose this tube normally is used in special testing I haven't used it often I think I've used it maybe twice in my whole photomy career and pretty much it does like it can help with like DNA study pH cytometry also like tissue typing like the genetic risk that a patient may have or symptomatic patients I believe it comes it has different tests like solution A or B I'm going to study up a little bit more on that like I said I don't often draw those the yellow tubes like that I know that you have to invert them between 8 to 10 times and it is also whole BL now onto our honorable mentions this Pearl tube is considered the PPT which is a plasma preparation tube if I'm not mistaken this is the K2 Eda tube which pretty much it separates the Eda plasma from the blood in the tube so this is used I haven't honestly seen this used often in my photomy career I know probably it's very um useful in other uh Laboratory Testing or however but I've seen the pro ones I haven't used it personally myself but that's pretty much all I know about it here is another tube this black one is considered the ESR that's the arthrite sedimentation rate tube I believe it uses sodium citate as the anti-coagulant I haven't used those often either these are one of those I'm telling you I see them what especially when I was when I was in the hospital cuz we had like every two you name it but I never used them but I do know things about them I know I might be skipping some of them but this is like the basic ones that I definitely feel that you should know in your photomy career I honestly feel that these tubes come of every color of the rainbow honey but like I said just try to get to know the ones that you should know in the order of draw obviously and and anywhere that you go that you may see a tube that doesn't look familiar to you like I said in my other video always ask what is it what this do why I look like that no don't ask why it look like that but what test is this you know am I going to know for sure to draw from this tube or what is it going to be called when you guys need me to draw this type of test is it going to be you going to tell me is that Tobe so anything that looks confusing to you or something you may have not seen before or however ask questions so that you don't mess up just simple and also I want to mention my little pediatric neonates little tubes how cute they are I love them this small like honestly I already see the tube naturally for us as adults and like you know a little bit like older children and stuff but these little tubes are just the cutest you cannot tell me they are not that cute I mean it's never fun to stick my little newborns and stick my Pediatrics but the tubes are just so cute but any but if y'all do want me to do like a pediatric order of draw or anything like that or how to do heel sticks or anything like that just comment down below don't forget to like this video I really hope this was helpful for anyone who was a little confused or however like I said in my prior videos definitely go out there if you are really interested into getting into photomy don't wait to sign up to find out like the order of drawers the kind of test and things like that there is so much things out here on the internet in the library however that can these books of photomy that can teach you these things and also hey why not before you get there already know a little bit of something but you can always have like these little um order of draw on your badges or however things like that anything that you feel that may help you in your photomy career or even if you just want to know about photomy in the type of test that we do and you don't want to be a fotus that is okay knowledge is power but yes y'all this is the end of my video if anything if you felt that I was misinformed if I misinformed you or however if you have anything to share please write that down in the description box I mean description box please write that down in the comment box below I am okay with you know criticism and however you know like I said it makes me learn it teaches me some things that I might need to change or maybe just you know learn a little bit more about something but I really hope this video was helpful for any one and I hope to see you all in my next video bye