Whether an order of draw is still required has been an ongoing debate within the profession. If not followed the specimen could become contaminated. One of the problems when filling separate blood collection tubes is that additives contained on one tube may adhere to the needle inserted into the tube and carry-over to additional tubes. One question though, are tube colours universal across North America? This eliminates the time spent on waiting for a specimen to clot. Over the last few decades laboratories have become more automated and reduced errors in the analytical process to very low levels (<10% of all errors). The EDTA anticoagulant in tubes with lavender or purple stopper helps remove calcium by forming calcium salts. Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. This is great to learn and very easy to follow. Does anyone know why the red top used to be before the blue top? I really enjoy the subject and would love to see some samples of questions posted. I have been a phlebotomist for many years. I would recommend checking out http://clsi.org/ as they set the official order of draw. These blood tubes may contain different additives which may affect certain results should they contaminate another tube. Special considerations must also be applied when collecting indwelling catheter line draw and blood cultures. It is vital that the order of draw is followed not only to avoid contamination, but also to make sure that the test results are accurate. Taking these factors seriously can lessen discomfort and complications for your patient, lessen procedure time, and prevent errors in diagnosis caused by cross contamination of additives between blood collection tubes. Is it true? Before getting to the order of draw, familiarizing certain acronyms will make the entire process simpler and easier to understand. Question: What effect, if any, does drawing an EDTA tube before a sodium citrate tube have on coagulation testing? Tourniquets make the veins swell, making it easier to find a vein and draw a blood sample. I am completing a project for my phlebotomy class and this is one of the questions. A PST B RST C SPS D SST, Can you tell me if this is the current order of draw? Coagulation testing is highly sensitive to a myriad of specimen collection and handling variables, it is highly recommended that blood specimens for coagulation testing be collected by venipuncture using a vacuum collection device that collects the specimen directly into an evacuated tube with a non-wettable surface. Blood cultures are used in microbiology. The reason for the order of draw is to prevent cross contamination. Incorrect order of draw can lead to problems and misdiagnosis of health conditions or disease. The procedure is the same for all types of tubes or instruments used. As already mentioned, this is done to avoid cross-contamination and unreliable test results. The same order is used for glass and plastic venous blood collection tubes, evacuated system and a syringe. I found the mnemonics "Sally brings really good grease and leaves the gravy" absolutely helpful, very interesting! When a patient requires blood tests, often more than one tube is required. Using this mnemonics, remembering the order of draw would be easier. Since there is no room for error in phlebotomy, it is crucial that you memorize the order in the easiest way possible. Another problem is that when performing a draw a small amount of tissue fluid may be present in the first-draw specimen. In their opinion paper published in Clinical Chemistry and Laboratory Medicine, a group of researchers set out to review the evidence. This order of draw should ALWAYS be followed to prevent erroneous results due to additive crossover. It also covers proper care and handling of the specimen that will be used for laboratory testing or analysis. I have an older co-worker telling me that the order of draw is backwards when using butterflies. This process is called reflux, which means the chemical can move from the tube and enter the needle. Phlebotomy Order Of Draw As you may already know, blood must be drawn and collected in tubes in a specific order, known as the Order of Draw. Therefore, if a test for potassium is required, the tubes used must be those that are placed before those that contain EDTA. ... Why is the order of draw so important? For this reason, an order of draw was established. Nevertheless, studies that looked at real world situations, where conditions are frequently not ideal, provided clear evidence that contamination does still occur. Todays’ methods of Phlebotomy are considered a science, and one must receive formal education at an accredited phlebotomy school or certification in phlebotomy in order to perform blood drawing tasks. Happy Sticking! In today’s modern times, bloodletting is no longer practiced, except in instances of extremely rare diseases. which requires a lavender and ACD tube. Phlebotomy Jokes – Humor for Phlebotomists, How To Write A Phlebotomy Cover Letter w Examples, Plasma additive micro-collection tubes, such as green (lithium heparin) light green (lithium heparin with gel), gray (sodium fluoride and potassium oxalate), Serum micro-collection tubes, such as red (no additive), gold (clot activator and gel). I am going to be taking a phlebotomy course and finding this information is proving difficult online lol. This is why blood culture bottles or SPS tubes with yellow stopper must be collected first before any other tubes. in this method we use the culture bottol ,and sodium citrate ,sst/red top , heparin , edta , flouride aslo we used, THIS IS VERY USEFULL INFORMATION……THNK U SOO MUCH TO ALL……M SEARCHING JOB FR OR LAB TECHNITION …PLS HELP IF ANY HV SOME REFERENCE. In the era of lyophilized anticoagulants, order of draw is no longer important. Don’t let it confuse you. as of 2017 is there a new order of draw? All steps of the phlebotomy procedure must be included for every venipuncture. Prevent Cross Contamination. It is determined based on any additives that need to be included, or any special instructions that need to be given during the blood draw itself. New phlebotomists are taught the order of draw by the additive within the tubes and why there is an order of draw. A Glucose specimen was forgotten in a phlebotomist trays it was descovered 3 hours after it was drawn. There are also products in the market that are designed to aid phlebotomists in their jobs, such as a bracelet that is colored according to the draw specified. Blood analysis in the lab © Cecilie_Arcurs/Getty Images. Definitely helped me with the learning of the proper order! Collecting specimens in the incorrect order of draw can result in cross contamination. Tubes with green tops have lithium heparin anticoagulant. You can certainly use the information in a classroom setting without worry of copywright issues. Thank you again!!!! Coagulation tubes have light blue-colored stopper and a sodium citrate additive. Both facts led the authors to recommend that an order of draw remains part of the blood collection process, having resolved an on-going debate in the profession as to whether an order of draw was still required. Some phlebotomists know the order of draw for blood collection tubes and follow it religiously. Phlebotomy Blog. 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