Blood Sampling and Order of Draw

Jul 7, 2024

Review flashcards

Blood Sampling and Order of Draw

Introduction

  • Presenter: Eddie Watson
  • Topic: Blood sampling (phlebotomy) and the order of draw
  • Importance: Ensures accurate lab results, reduces contamination, and aids in proper patient diagnosis and treatment.

Initial Question

  • Do you know the proper order of draw?: Reflect at the end of the lesson.

General Importance

  • Proper order prevents cross-contamination and inaccurate results.
  • Misdiagnosis and incorrect treatment can result from improper order.

Types of Blood Collection Tubes and Bottles

Blood Cultures

  • Types: Aerobic and Anaerobic
  • Key Details:
    • Sterile collection
    • Contains film and nutrient broth for bacterial growth
    • Anticoagulants and chemicals to reduce bactericidal action
    • Order: Draw aerobic first, then anaerobic
    • Importance: Reduce contamination risk

Light Blue Tube

  • Type: Coagulation Tube
  • Tests: PT, INR, PTT, Anti-10a, Fibrinogen, D-dimer, TEG
  • Additive: Sodium Citrate
    • Binds calcium to prevent clotting
    • Requires proper blood-to-additive ratio

Red Top Tube

  • Type: Chemistry Panel (some tests)
  • Details: Often no additives, sometimes silica clot activator
  • Usage: Tests requiring serum

Gold or SST (Serum Separator Tube)

  • Type: Chemistry Panel (common for send-out tests)
  • Details: Contains gel to separate serum from cells
  • Usage: Antigen-antibody tests

Green Top Tube

  • Type: Common Chemistry Tests
  • Tests: Chemistry panels, cardiac markers (e.g., Troponin)
  • Additives:
    • Heparin (anticoagulant)
    • Plasma-separation gel
  • Special Handling: Some tests require samples to be on ice (e.g., ammonia, ionized calcium, lactate)

Purple Top Tube

  • Type: Hematology
  • Tests: CBC, ESR, A1C
  • Additive: EDTA (preserves cell morphology, prevents clotting)

Pink Top Tube

  • Type: Identical to Purple, specific for Blood Typing
  • Additive: EDTA

Gray Top Tube

  • Type: Specific Tests
  • Tests: Lactate, Ethanol, Fasting Glucose
  • Additives:
    • Sodium Fluoride (prevents glycolysis)
    • Potassium Oxalate (binds calcium)

Proper Order of Draw

  1. Blood Cultures: Sterile collection first
  2. Light Blue Tube: Coagulation studies
  3. Red Top Tube: Chemistry panel
  4. Gold/SST Tube: Send-out chemistry tests
  5. Green Top Tube: Common chemistry tests
  6. Purple Top Tube: Hematology
  7. Pink Top Tube: Blood typing
  8. Gray Top Tube: Specific tests like lactate, ethanol, fasting glucose

Importance of Order

  • Prevents cross contamination of additives, ensuring accurate lab results
  • Example issues: Heparin and EDTA causing false readings for coagulation, calcium, and potassium

Mnemonic for Order of Draw

  • Mnemonic: Stoplight Red Stay Green Power Light Go
    • S (Stop): Sterile/Blood Cultures
    • L (Light): Light Blue
    • R (Red): Red Top
    • S (Stay): Serum Separator (Gold/SST)
    • G (Green): Green Top
    • P (Power): Purple Top
    • L (Light): Light Pink (Pink Top for Blood Typing)
    • G (Go): Gray Top

Conclusion

  • Recap of proper order and its importance
  • Use mnemonic to memorize order
  • Encouragement to practice and understand the 'why' behind it

Call to Action

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