Evacuated Tubes

• Evacuated Tubes


  Comes in various sizes and volumes ranging from 1.8-15 mL. Sterile inside to prevent contamination. Have an expiration date. Can be glass or plastic. Filled automatically because of vacuum
• Vacuum


  Negative pressure
• Vacuum


  The amount of _ is equivalent to the amount of blood requirement of the tube
• Additives


  Prevents, enhances or, activates clotting/preserves blood component
• Additive Tubes


  Requires proper inversion
• Non-additive Tubes


  Clearing or discarding purposes. Yield serum samples
• Serum


  Liquid portion of coagulated or clotted blood; fibrinogen and other clotting factors are not present since it is being used up during clotting
• Plasma


  Liquid portion of anticoagulated blood; fibrinogen and other clotting factors are present since it is not used up because of the presence of an anticoagulant
• Water, proteins (including enzymes and some hormones) and others


  The liquid portion contains...
• Expiration Date


  Reliablity of additives and tube vacuum
• 4-25 degrees celsius


  Evacuated tubes stored between
• Yellow Top


  •A: Acid Citrate Dextrose

  •MOA: Acid Citrate- prevents coagulation, Dextrose- RBC viability

  •T- Blood bank, HLA Phenotyping, DNA testing
• Blood Culture Bottle (Yellow)


  •A: Sodium Polyanethol Sulfonate

  •MOA: Aids in bacterial recovery by inhibiting complement, phagocytes and certain antibiotics

  •T: Serum Microbiology
• Red Top


  •A: None

  •MOA: Separate blood clots and serum through centrifugation

  •T: Chemistry, Serology, Blood Bank
• Gold Top


  •A: None (Thixotropic Gel)

  •MOA: Separate blood clots and serum through centrifugation

  •T: Chemistry, Serology, Blood Bank

  Barrier between serum and red cells
• Light Blue Top


  •A: Sodium Citrate

  •MOA: Chelates Calcium

  •T: Coagulation studies (PT, APTT, Fibrinogen, D-dimer)
• Black Top


  •A: Buffered Sodium Citrate

  •MOA: Chelates Calcium

  •T: Sedimentation test
• Green Top


  •A: Sodium or Lithium, Heparin

  • MOA: Inactivate thrombin to prevent clot formation

  • Tests: Chemistries (Ammonia, Plasma, Hemoglobin), STAT requests
• lithium, sodium and ammonium heparin


  3 forms of heparin
• Lithium


  least interference in chemistry test
• Sodium


  immunology test
• Ammonium


  microcapillary tubes for hematocrit determination
• Light Green Top


  •A: Sodium Heparin with Plasma Separator Tubes (PST)

  •MOA: Enhances anti-thrombin Ill to inhibit thrombin formation

  •Tests: Chemistry
• Lavender Top


  •A: Ethylenediamine Tetraacetic Acid (EDTA)

  • MOA: Chelates Calcium

  • Tests: Hematology (CBC), Blood Banking (crossmatching)
• Dipotassium EDTA, Tripotassium EDTA, and Disodium EDTA


  3 Concentrations of EDTA
• Dipotassium EDTA


  •Plastic (spray-dried)

  •Recommended because it preserves the cell morphology and provides stable microhematocrit result
• Tripotassium EDTA


  •Glass (liquid)

  •Commercial name: sequestrene
• Disodium EDTA


  Commercial name: versene
• Gray Top

  • Anticoagulant: Potassium Oxalate
  • MOA: - Chelates calcium
  • inhibits glycolysis by binding to Mg2+ needed by enolase in the glycolytic pathway
  • T: Glucose testing, Lactate testing, and blood alcohol levels
• Sodium Fluoride


  Gray top also contains an antiglycolytic agent called —
• Iodoacetate


  If sodium fluoride is not available, this can be used as an alternative antiglycolytic agent
• Pink Top


  •A: Spray-dried Dipotassium EDTA

  •MOA: Chelates calcium

  •T: Blood banking, Molecular diagnosis
• White Top

  • A: EDTA or ACD

  • MOA: Chelates calcium

  • T: Molecular Diagnosis
• Royal Blue Top


  • Anticoagulant: Sodium Heparin

  •MOA: Inhibits thrombin

  • Tests: Chemistry, Toxicology or trace elements
• Tan Top


  • Anticoagulant: Glass (Sodium Heparin), Plastic (K2 EDTA)

  • MOA: Inhibits thrombin (glass), Chelates calcium (plastic)

  • Tests: lead testing
• Orange Top


  • Anticoagulant: Thrombin

  • MOA: Clot activator

  • Tests: STAT chemistry
• Clinical and Laboratory Standards Institute


  Order of Draw is mandated by -
• Order of Draw


  Prevent contamination of blood specimens by carryover of:

  • Additives that can interfere with some tests
  • Tissue thromboplastin that can affect some coagulation tests
  • Microorganisms that can invalidate blood culture results
• Cross-contamination


  Wrong order can lead to interference in testing from -
• Directly proportional


  Relation of the amount of volume to the amount of blood requirement of the tube