Basic Principles of Phlebotomy Part II:

Blood Collection Tubes

CLS 424 Phlebotomy

Student Lab Rotation

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Blood Collection Tubes:• Contain a vacuum

• Used with

Vacutainer and

Syringe systems

• Stoppers universal

color coded: indicates contents

• Have an expiration date

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Tubes containing no anti-coagulant

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Red-top tube:• Glass

– No additive– Glass surface activates clotting sequence– Do not mix– SERUM: use for TDM

• Plastic– Contain additive to activate clotting sequence– Contain inert gel SST– Do invert to mix additive and initiate clotting sequence– SERUM

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Gold or Mottled-red-gray top tube:

• Contain clot activator and gel (SST)

• Invert to mix and initiate clotting sequence

• SERUM

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Royal blue-top tube:

• Trace metal-free

• Iron, copper, zinc

• Label color indicates contents:– Red: no additive = serum– Purple: EDTA = whole blood or plasma– Green: heparin = whole blood or plasma

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Tubes containing anti-coagulant

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Blue-top tube:

• Anticoagulant = sodium citrate

• Binds calcium

• Must be fullBlood:anticoagulant ratio critical

• Must be on ice if not analyzed within 30 minutes

• Coagulation studies

PLASMA

Whole blood

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Green-top tube:• Anticoagulant = heparin

– Three formulations: Lithium heparin

Ammonium heparin

Sodium heparin

• Inhibits thrombin formation

• Must be full and on ice if need pH, ionized Ca

PLASMA

Whole blood

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Green-top tube:

• Most chemistry tests, STAT lab (PST)

Decreases time needed for blood to clot,

Makes turnaround time better

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Purple-top tube:

• Anticoagulant = EDTA

• Binds calcium

• Hematology studies: CBC

PLASMA

Whole blood

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Grey-top tube:

• Anticoagulant = potassium oxalate– Binds calcium– PLASMA, Whole blood

• Antiglycolytic agent = sodium fluoride– Maintains plasma glucose levels

• Limited use: glucose, lactic acid

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Fibrin-split Products tube

• Light blue top tube with 2 yellow bands on the label

• Contains soya bean thrombin which causes the blood to clot immediately

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Yellow-top tube:

• ACD = acid citrate dextrose– Paternity testing– DNA

• SPS = sodium polyanethol sulfonate– Used for special blood culture studies– Inhibits certain antibiotics

• Both bind calcium

• PLASMA, Whole blood

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Type and Amount of Specimen:• Dependent upon

– Test

Whole blood: EDTA or heparin?

Plasma: EDTA or heparin?

Serum: trace free? Separator gel interference?

– Amount of sample needed to perform test

– Multiple labs needing the same specimen at the same time

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Valid Test Results Require:

• Trained personnel– Causes of pre-analytical error– Invalid test results

• Quality control• Quality assurance• Sophisticated

instruments