Blood Collection Tubes Order of Draw

1 Visit for the most current version of this document PX-SC460 Order of draw and Order of Transfer Attachment 1 Rev (GTS) Blood Collection Tubes Order of draw Blood Collection Tubes must be filled in a specific sequence to minimize contamination of sterile specimens, avoid possible test result error caused by carryover of additives between Tubes , and reduce the effect of microclot formation in Tubes . When collecting Blood samples, allow the tube to fill completely to ensure the Blood /additive ratio necessary for accurate results. Gently invert each tube the required number of times immediately after Collection to adequately mix the Blood and additive. Never pour Blood from one tube into another tube. See for specific information for the Collection and handling of each laboratory test. Order of draw Color Invert Additive Comments and Common Tests 1 Clear Not required No additive Tube used ONLY as a discard tube.

2 2 Blood Culture Bottle (aerobic, anaerobic and pediatric bottles have different colors of label and top) Invert gently to mix Bacterial growth medium and activated charcoal When a culture is ordered along with any other Blood work, the Blood Cultures MUST be drawn first. Refer to for Order of draw for Blood Culture bottles. 3 Yellow with clear label 8 to 10 times Sodium polyanethol sulfonate (SPS) Tube used for Mycobacteria (AFB) Blood culture. 4 Royal Blue (with red band on label) Not required Glass tube with no additive Tube used for serum trace element tests. Available from CLS Referrals 5 Red GLASS Not required Glass tube with no additive Tube used for serum tests, which CANNOT be collected in SST Tubes . NOTE: red PLASTIC Tubes are preferable for lab tests. 6 Light Blue 3 to 4 times buffered Sodium citrate anticoagulant Tube used mainly for PT (INR), PTT, and other coagulation studies.

3 7 Black 3 to 4 times Sodium citrate anticoagulant Tube used for ESR ONLY. 8 Red 5 times Clot activator, and no anticoagulant Tube used for serum tests, which CANNOT be collected in SST Tubes . 9 Gold or Orange 5 times Gel separator and clot activator Gold top Tubes are referred to as SST (serum separator tube) and orange top Tubes are referred to as RST (rapid separator tube). After centrifugation, the gel forms a barrier between the clot and the serum. 10 Dark Green 8 to 10 times Sodium heparin anticoagulant OR Lithium heparin anticoagulant (CRL sites only) Sodium heparin tube is used mainly for Amino Acids and Cytogenetics tests. Lithium heparin tube is used by Calgary Rural Laboratories (CRL) for some Chemistry testing 11 Light Green (mint) 8 to 10 times Lithium heparin anticoagulant and gel separator Usually referred to as PST (plasma separator tube).

4 After centrifugation, the gel forms a barrier between the Blood cells and the plasma. Tube used mainly for Chemistry tests. 12 Royal Blue (with lavender band on label) 8 to 10 times K2 EDTA anticoagulant Tube used for plasma and red cell trace element tests. Available from CLS Referrals. 13 Royal Blue (with no band on label) 8 to 10 times Na2 EDTA anticoagulant Tube used for whole Blood trace element tests. Available from CLS Referrals. 14 Lavender 8 to 10 times K2 EDTA anticoagulant Tube used mainly for CBC, pretransfusion testing, Hemoglobin A1C, and anti-rejection drugs. Note: EDTA Tubes specifically for Catecholamines also include Sodium metabisulfite. 15 Yellow with yellow banded white label 8 to 10 times Acid citrate dextrose solution A (ACDA) Tube used for Tissue Typing and some Flow Cytometry testing.

5 16 Grey 8 to 10 times Sodium fluoride and Potassium oxalate anticoagulant Tube used for Lactate.