Light Blue Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. Sodium (Na) citrate

2. Coagulation

3. PT, PTT, Pro thrombin time, platelet count

4. 3-4

-- if winged blood collection set is used and the coagulation specimen is drawn first a discard tube is recommended to ensure proper ratio.

Red Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. None or Clot activator

2. Chemistry, serology, Immunology

3. Serum or Organ/ disease panel

4. (5)

Red/light gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. None

2. Discard tube only

Red/Black (tiger top) Tube

Gold (YELLOW)

Red/Gold

1. Additive

2. Department

3. Common tests

4. Inversion count

1. Clot activator and gel separator

2. Chemistry

3.

4. (5)

Mint Green Tube

Green/Gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. Lithium heparin and gel for plasma separator

2. Chemistry

3. Plasma collection

4. (8)

Green Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. Lithium heparin, Sodium heparin, Ammonium heparin

2. Chemistry

3. Stat tests

4. (8-10)

Lavender (purple) Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. EDTA

2. Hematology

3. CBC, ESR, Hgb/ Hct

4. (8-10)

Pink Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. EDTA

2. Blood Bank

3. Type and cross match

4. (0)

Gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. Sodium flouride & Potassium oxalate; Sodium flouride & EDTA; Sodium flouride

2. Chemistry

3.Glucose, Renal, diabetic screen, Alcohol level

4. (8-10)

Royal Blue Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1. None; EDTA; Sodium heparin

2. Chemistry

3. For trace elements, toxicology and nutritional-chemistry determinations.

4. (8)

Yellow Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

1,2. Sodium polyanethol sulfonate (SPS) for microbiology.  Acid citrate dextrose (ACD) for Blood bank / Immunohematology

3. Blood cultures

4. (8)

ECHO

The most common anticoagulants.

E (EDTA) C (citrate) H (heparin) O (oxalate)

phEDTA

Purple tubes go to hematology and contain EDTA

P(purple) h(hematology) EDTA

Spring Creates Coloful Light-Blue Pansies

Sodium citrate tubes go to coagulation, have light-blue stoppers, and yield plasma.

S(sodium) C(citrate) C(coagulation) L(light) B(blue) P(plasma)

HH: Heparin inhibits

In-in: Heparin inhibits

Heparin inhibits thrombin formation;

"H" in heparin and "H" in inhibits.

Heparin ends with "in," and inhibits starts with "in."

Greenhouses Have Courful Plants

Green tubes contain heparin for chemistry tests on plasma:

G(green) H(heparin) C(chemistry) P(plasma)

GO (gray oxalate)

Gray ox (gray oxalate)

Gray tubes typically contain oxalate.

G(gray) O(oxalate)

Gray(gray) ox (oxalate)

LL

(Lavender last except for gray)

Lavender is drawn last unless a gray top is ordered.

Gray tops are rarely ordered, so lavender is often last.

EDTA

ethylenediamineteraacetic acid.

Four types of anticoagulants

1. Ethylenediaminetetraacetic acid (EDTA)

2. Citrates

3. Heparin

4. Oxalates

Ethylenediaminetetraacetic acid (EDTA) is found in which tubes?

General Info

1. Lavender

2. Micro collection containers w/lavender tops

3. Pink plastic top tubes with blood bank patient ID label

4. Pearl-top tubes with thixotropic gel separator

5. Royal blue-top tubes with lavender color-coding on the label

• Primarily used to provide whole-blood specimens for hematology tests b/c it preserves cell morphology and inhibits platelet aggregation better than other anti-coagulants.

• Must be mixed immediately to prevent clotting. 8-10 inversions required.

Citrates are found in what tubes?

General Info

1. Light-blue tubes

• Most common citrate is Sodium Citrate which is used for coagulation tests.
• Imediate inversion 3-4 times
• Must have a 9:1 ratio of blood to anticoagulant or will be rejected
• Sodium Citrate binds calcium
• Coagulation test are performed on plasma

2. Yellow

• ACD (acid citrate dextrose)
  
• Used for blood bank studies, HLA phenotyping, DNA and paternity.
  

Heparin is found in which tubes?

General Info:

1. Green-top tubes

2. Mint green-top tubes

3. Green/Gray-top tubes

4. Royal blue-top tubes with green color coding on the label

• Prevents clotting by inhibiting thrombin formation.
• Heparinized plasma is often used for chemistry tests, espically stat tests and in other rapid response situations when a fast turnaround time (TAT) is needed.
• 5-10 inversions

Types of Heparin used and when not to use each heparin?

1. Ammonium heparin

  --

2. Lithium heparin (causes the least interference in chem tests)

  -- Do not use when testing for lithium levels

3. Sodium heparin

  -- Do not use to collect sodium specimens or electrolyte panels b/c sodium is apart of the panel.

Oxalates are used in which tubes?

General Info:

1. Gray-top tubes

• Prevents coagulation by precipitating calcium. Potassium oxalate is the most common.
• typically added to tubes with glucose preservatives to provide plasma for glucose testing. 
• 8-10 inversions

Special-Use Anticoagulants

They are combined with other additives and have additional properties for special-use situations.

Acid Citrate Dextrose (ACD) - 2 solutions A&B for immunohematology test such as DNA testing and human leukocyte antigen phenotyping for paternity and transplant compatability. The acid citrate binds calcium, dextrose acts as a RBC nutrient and presercative by maintaining RBC viability. Yellow-top tubes and need 8 inversions immediately after collection.

Citrate Phosphate Dextrose (CPD) - used in collecting units of blood for transfusion. The citrate prevents clotting by chelating calcium, phosphate stabilizes pH, dextrose provides cells w/energy to keep alive.

Sodium Polyanethol Sulfonate (SPS) - It binds calcium. Used for blood cultures  b/c it reduces the action of a protein called complement which destroys bacteria and slows down the ingestion of bacteria by WBC and reduces the activity of certain antibiotics. Yellow-top tubes and need 8 inversions.

What is antiglycolytic agents and their purpose?

-- An antiglycolytic agent is a substance that prevents gylcolysis, the breakdown of glucose by blood cells.

-- The most common agent is sodium fluoride it preserves glucose for up t o 3 days and inhibits the growth of bacteria.

-- Gray-top tubes

-- 5-10 inversions

***Sodium fluoride tubes are used to collect ethanol specimens to prevent either a decrease in alcohol concentration due to glycolysis or an increase due to fermentation by bacteria.

What are clot activators used for?

Clot activators include substances that provide more surface for platelet activation.

--Glass (silica) particle tubes cause the blood to clot within 15 - 30 min.

-- Thrombin tubes clot within 5 minutes

-- Celite tubes are used with some point-of-care coagulation systems.

-- 5 inversions required

-- Red-top tubes and serum-separator tubes (SSTs)

What is Thixotropic Gel Separator?

Thixotropic gel is an inert (nonreacting) synthetic substance in the bottom of certain tubes. When a specimen in a gel tube is centrifuged the gel undergoes a change in viscosity and moves to a position between the cells and the serum or plasma, forming a physical barrier between them. This separation prevents the cells from continuing to metabolize substances such as glucose in the serum or plasma.

-- Red/Gray (TIGER TOP)  tubes called serum-separator tubes (SSTs)

-- new BD tubes called rapid serum tubes (RSTs)

-- Heparinized plasma gel-barrier tubes are mint green or green/gray caled plasma-separator tubes (PSTs)

What are Trace Element-Free tubes?

Royal Blue indicates trace element-free tubes. Used for toxicology studies and nutrient determinations. The tube is made as free of contaminating elements as possible to avoid falsely elevated test results.

-- They contain EDTA, heparin or no additive depending on test requirements. The labels may be color-coded to indicate the type of additive if any.

Order of draw by test type not tube color

1. Sterile tube (blood culture) (Y)

2. Citrate - coagulation tube (Lt B.)

3. Serum tube with or w/out clot activator, with or w/out gel (R/SST)

4. Heparin tube with or w/out gel plasma separator (G)

5. EDTA tube (L)

6. Glycolytic inhibitor tube (G)

Order of Draw by tube-top color

1. Yellow - microbiology - SPS
   
2. Light Blue - coagulation - Citrate
   
3. Red - chemistry, serology - plain, clot activator 
   
1. Light Yellow - serum -
   
2. Mint Green - plasma
   
4. Green - STAT - Heparin
   
5. Lavender - all about blood - EDTA
   
6. Gray - K⁺ oxalate
   

Multiple Sample Neele Color Coding:

• Pink
• Yellow
• Green
• Black

• 18g
• 20g
• 21g
• 22g

Butterfly Color Coding:

• Green
• Light Blue
• Dark Blue

• 21g
• 23g
• 25g

The name for a gel serum seporator and tube color:

Thixotropic gel separator

Red/Gray (tiger top) tube

Which tube is used to enhance coagulation?

Light Blue tube

Oxalate is used in which tube?

Gray

Why is Sodium Fluoride used?

An additive used to stabilize a specimen for 3 days

STAT electrolytes is requested which tube should you use?

Green

Another name for buttery fly needle

Winged Infusion Set

Sodium Citrate is used in which tube?

Light Blue

What is Lavender tube used for and its order in draw.

Used for CBC and last order of draw unless gray is ordered

PT or PTT is ordered which tube do you use?

Light blue tube for coagulation

Where do you immediately place used needles?

Sharps container

What additive is used in green tubes?

Sodium Heparin or Lithium Heparin

Gloves

What additive is used in lavender tubes?

EDTA (Ethylenediaminetetracetic)

Royal blue is used to test for what?

Trace elements such as LEAD, COPPER, ZINC & ALUMINUM.

Color of SST?

Tiger top (red/gray)

Why do we use a tourniquet?

To enlarge the vein, easier to find and enter.

How do u know what gauge needle to use?

It will depend on the size, location and condition of the vein

What tube is for glucose testing?

Gray

What is the standard gauge for venipuncture?

21g

When you have 2-3 short draws in a row what is that an indicator of?

Indication of expired tubes

What tube to you use for ESR?

What is ESR?

Lavender

Erythrocyte Sedimentation Rate

Which blood cells are the most important in Blood transfusions?

Neutrophil because they fight bacteria/microbes