COLORS

• Containers with Coagulants:

  • Gold or Tiger Red/Black Top: contains spray-coated silica for clot formation and polymer gel separator
  • Red Top: may contain additive solution (Silica particles) and used in clinical chemistry
• Purple or Lavender Top:

  •contains K3 EDTA or K2 EDTA as the "Anticoagulant of Choice" for inhibiting clot formation

  •The action of EDTA why it inhibits clot formation because it chelates calcium, which is essential in the coagulation process

  • It is used in hematologic analysis (CBC) and can also be used in immunohematology, such as blood typing and screening

  • Generally preferred for molecular techniques.

  • Inversion – 8 times (Figure of 8)
• Green Top:

  • Contains either sodium heparin or lithium heparin
  • May also contain a polymer gel that separates plasma from cells
  • Heparin inhibits clot formation by binding with antithrombin III (AT III) and accelerates the rate at which ATIII inactivates coagulation enzymes
  • "Anticoagulant of choice" for STAT plasma analysis
  • Used for plasma analysis in clinical chemistry
• Gray/Grey Top:

  • May contain both potassium oxalate and sodium fluoride or Na2 EDTA and sodium fluoride
  • Sodium fluoride inhibits glycolytic enzymes in the sample, while oxalate and EDTA are anticoagulants
  • Used in glucose determination in plasma
• Light Blue Top:

  • Contains 3.2% buffered sodium citrate with concentrations of 0.105 M (glass) or 0.109 M (plastic)
  • May also contain citrate, theophylline, adenosine, and dipyridamole (CTAD)
  • Citrate chelates ionized calcium essential in the coagulation cascade
  • Used for coagulation studies in plasma (aPTT & PT)
  • 3 – 4 times (Figure of 8)
• Black Top:

  • Contains buffered sodium citrate
  • Primarily used in hematology, especially in the Westergren erythrocyte sedimentation rate (ESR) determination
• Containers with Specific Purposes Royal Blue Top:

  • May contain a clot activator (Glass) or anticoagulant (Plastic) to separate serum or plasma from cellular constituents of blood
  • Used in testing blood for trace elements within 4 hours after extraction and in nutritional-chemistry
  • Special stopper formulation provides low levels of trace elements
• Light Yellow Top:

  • Light yellow blood culture bottles contain sodium polyanethol sulfonate (SPS) used in microbiology, especially in blood culture
  • In some instances, yellow tops may contain acid citrate dextrose (ACD) used in blood bank studies, HLA phenotyping, and DNA and paternity testing
• Pink Top:

  • Contains K2 EDTA
  • Used in whole blood analysis in hematology, primarily used in immunohematology testing like crossmatching and blood typing
• Tan Top:

  • May contain sodium heparin or K2 EDTA as the anticoagulant
  • Specialized blood collection tubes that do not contain any traces of lead
  • Used in lead determination in patients with suspected lead poisoning
• Order of Draw:

  • Designed to eliminate the possibility of cross-contamination that may result in erroneous results
  • All additive tubes should be filled to their stated volumes
• Order of Draw (Microtainer):

  • Microtainers are often used on pediatric patients or patients with small vessels
  • Specific sequence to reduce the effect of microclot formation in tubes
  • Additive tubes should be filled rapidly to avoid clotting
  • The first drop of blood should always be wiped away
  • The order of draw for microtainers: Capillary Blood Gases, EDTA Tubes, Other Additive Tubes, Serum Tubes
• The order of draw for multiple tubes:

  • Blood Culture Tubes (YELLOW)
  • Coagulation Tubes (LIGHT BLUE)
  • Serum Tubes (RED)
  • Heparin Tubes (GREEN)
  • EDTA Tubes (PURPLE)
  • Oxalate/Fluoride Tubes (GRAY)