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Phlebotomy Essentials
Ch. 7 Blood Collection Equipment, Additives and Order of Draw.
56
Nursing
Not Applicable
11/16/2011

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Cards

Term

Light Blue Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

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.

Term

Red Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. None or Clot activator

2. Chemistry, serology, Immunology

3. Serum or Organ/ disease panel

4. (5)

Term

Red/light gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. None

2. Discard tube only

Term

Red/Black (tiger top) Tube

Gold (YELLOW)

Red/Gold

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. Clot activator and gel separator

2. Chemistry

3.

4. (5)

Term

Mint Green Tube

Green/Gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. Lithium heparin and gel for plasma separator

2. Chemistry

3. Plasma collection

4. (8)

Term

Green Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. Lithium heparin, Sodium heparin, Ammonium heparin

2. Chemistry

3. Stat tests

4. (8-10)

Term

Lavender (purple) Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. EDTA

2. Hematology

3. CBC, ESR, Hgb/ Hct

4. (8-10)

Term

Pink Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. EDTA

2. Blood Bank

3. Type and cross match

4. (0)

Term

Gray Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

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

2. Chemistry

3.Glucose, Renal, diabetic screen, Alcohol level

4. (8-10)

Term

Royal Blue Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

Definition

1. None; EDTA; Sodium heparin

2. Chemistry

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

4. (8)

Term

Yellow Tube

1. Additive

2. Department

3. Common tests

4. Inversion count

 

Definition

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

3. Blood cultures

4. (8)

Term

 

 

 

ECHO

Definition

The most common anticoagulants.

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

Term

 

 

phEDTA

Definition

Purple tubes go to hematology and contain EDTA

 

P(purple) h(hematology) EDTA

Term

 

 

 

Spring Creates Coloful Light-Blue Pansies

Definition

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)

Term

 

HH: Heparin inhibits

 

In-in: Heparin inhibits

Definition

Heparin inhibits thrombin formation;

 

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

 

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

 

Term

 

 

 

Greenhouses Have Courful Plants

Definition

Green tubes contain heparin for chemistry tests on plasma:

 

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

Term

 

 

GO (gray oxalate)

Gray ox (gray oxalate)

Definition

Gray tubes typically contain oxalate.

 

G(gray) O(oxalate)

 

Gray(gray) ox (oxalate)

Term

 

 

LL

(Lavender last except for gray)

Definition

Lavender is drawn last unless a gray top is ordered.

 

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

Term

 

 

 

EDTA

Definition

 

 

ethylenediamineteraacetic acid.

Term

 

 

Four types of anticoagulants

Definition

1. Ethylenediaminetetraacetic acid (EDTA)

2. Citrates

3. Heparin

4. Oxalates

Term

 

Ethylenediaminetetraacetic acid (EDTA) is found in which tubes?

 

General Info

Definition

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.

 


Term

 

Citrates are found in what tubes?

 

General Info

Definition

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.
Term

 

 

Heparin is found in which tubes?

 

General Info:

Definition

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
Term

 

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

Definition

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.

 

 

Term

 

 

Oxalates are used in which tubes?

 

General Info:

Definition

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
Term

 

 

Special-Use Anticoagulants

Definition

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.

Term

 

 

What is antiglycolytic agents and their purpose?

Definition

-- 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.

Term

 

 

What are clot activators used for?

Definition

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)

Term

 

 

What is Thixotropic Gel Separator?

Definition

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)

 

Term

 

 

What are Trace Element-Free tubes?

Definition

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.

Term

 

Order of draw by test type not tube color

Definition

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)

 

Term

 

 

Order of Draw by tube-top color

Definition
  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
Term

 

Multiple Sample Neele Color Coding:

  • Pink
  • Yellow
  • Green
  • Black
Definition

 

  • 18g
  • 20g
  • 21g
  • 22g

 

Term

 

Butterfly Color Coding:

  • Green
  • Light Blue
  • Dark Blue
Definition

 

  • 21g
  • 23g
  • 25g
Term

 

 

The name for a gel serum seporator and tube color:

Definition

 

 

Thixotropic gel separator

 

Red/Gray (tiger top) tube

Term

Which tube is used to enhance coagulation?

Definition

Light Blue tube

Term

Oxalate is used in which tube?

Definition

Gray

Term

Why is Sodium Fluoride used?

Definition

An additive used to stabilize a specimen for 3 days

Term

STAT electrolytes is requested which tube should you use?

Definition

Green

Term

Another name for buttery fly needle

Definition

Winged Infusion Set

Term

Sodium Citrate is used in which tube?

Definition

Light Blue

Term

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

Definition

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

Term

PT or PTT is ordered which tube do you use?

Definition

Light blue tube for coagulation

Term

Where do you immediately place used needles?

Definition

Sharps container

Term

What additive is used in green tubes?

Definition

Sodium Heparin or Lithium Heparin

Term
What is the most effective barrier/protection from infections in venipuncture?
Definition

Gloves

Term

What additive is used in lavender tubes?

Definition

EDTA (Ethylenediaminetetracetic)

Term

Royal blue is used to test for what?

Definition

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

Term

Color of SST?

Definition

Tiger top (red/gray)

Term

Why do we use a tourniquet?

Definition

To enlarge the vein, easier to find and enter.

Term

How do u know what gauge needle to use?

Definition

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

Term

What tube is for glucose testing?

Definition

Gray

Term

What is the standard gauge for venipuncture?

Definition

21g

Term

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

Definition

Indication of expired tubes

Term

What tube to you use for ESR?

 

What is ESR?

Definition

Lavender

Erythrocyte Sedimentation Rate

Term

Which blood cells are the most important in Blood transfusions?

Definition

Neutrophil because they fight bacteria/microbes

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