1. Basic Principles of Phlebotomy Part II: Blood Collection Tubes CLS 424 Phlebotomy Student Lab Rotation

2. 2 Blood Collection Tubes: Contain a vacuum Used with Vacutainer and Syringe systems Stoppers universal color coded: indicates contents Have an expiration date

3. 3 Tubes containing no anti-coagulant

4. 4 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

5. 5 Gold or Mottled-red-gray top tube: Contain clot activator and gel (SST) Invert to mix and initiate clotting sequence SERUM

6. 6 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

7. 7 Tubes containing anti-coagulant

8. 8 Blue-top tube: Anticoagulant = sodium citrate Binds calcium Must be full Blood:anticoagulant ratio critical Must be on ice if not analyzed within 30 minutes Coagulation studies PLASMA Whole blood

9. 9 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

10. 10 Green-top tube: Most chemistry tests, STAT lab (PST) Decreases time needed for blood to clot, Makes turnaround time better

11. 11 Purple-top tube: Anticoagulant = EDTA Binds calcium Hematology studies: CBC PLASMA Whole blood

12. 12 Grey-top tube: Anticoagulant = potassium oxalate –Binds calcium –PLASMA, Whole blood Antiglycolytic agent = sodium fluoride –Maintains plasma glucose levels Limited use: glucose, lactic acid

13. 13 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

14. 14 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

15. 15 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

16. 16 Valid Test Results Require: Trained personnel –Causes of pre-analytical error –Invalid test results Quality control Quality assurance Sophisticated instruments