ORDER OF DRAW

• The first tube to be drawn during a venipuncture procedure is the Yellow (Blood Culture) SPS tube to prevent contamination.
• Yellow (Blood Culture) SPS has anticoagulant SPS (Sodium Polyanethol Sulfonate) & ACD (acid citrate dextrose) additives
• Yellow (Blood Culture) SPS additive prevents the blood from clotting and stabilizes bacterial growth
• Light Blue (Coagulation tube) is also called 3.2% citrate tube
• Light Blue (Coagulation tube) is used for hematology tests involving the clotting system, which require inactivated whole blood for analysis.
• Light Blue (Coagulation tube) has Sodium Citrate additive
• Light Blue (Coagulation tube) additive binds and remove calcium to prevent blood from clotting
• Laboratory uses of Light Blue (Coagulation tube)

  • PT (Prothrombin Time – evaluates the extrinsic system of the coagulation cascade & monitors coumadin therapy)
  • APTT/ PTT (Activated Partial Thromboplastin Time – evaluates the intrinsic system of the coagulation cascade & monitors heparin therapy)
  • FDP (Fibrinogen Degradation Products)
  • TT (Thrombin Time)
  • Factor assays
• Light Blue (Coagulation tube) needs to be inverted 3-4 times
• Red (Glass non-additive tube; Plastic clot activator tube)

  • It is used for biochemistry tests requiring serum which might be adversely affected by the separator gel used in the yellow bottle.
• In Red tube...

  • For glass: Hageman Factor - a contact in glass container, faster clotting
  • For plastic: Clot activator
• In red tube


  What additive does: Clot activator promotes blood clotting with glass or silica particles
• Laboratory Uses of Red (Glass non-additive tube; Plastic clot activator tube) 

  • Serum testing: 

  1. Glucose
  2. Cholesterol
  3. Triglycerides
  4. HDL (High-density lipoproteins)
  5. Potassium
  6. Amylase
  7. alkaline 
  8. Phosphatase
  9. BUN (Blood Urea Nitrogen)
  10. CK (Creatine Kinase)
  11. liver enzymes

  • blood bank
  • Serology: 

  1. RH Typing
  2. Antibody screening
  3. Red Cell Phototyping
  4. DAT (Direct antiglobulin test)
  5. RPR (Rapid plasma reagin)
  6. Monospot
  7. rheumatoid factor
  8. ANA (Antinuclear antibodies)
• Red (Glass non-additive tube; Plastic clot activator tube) needs to be inverted 5-6 times
• Gold (SST - Serum Separator Tube): 

  • Additive: glass particles or a thixotropic gel
• Gold (SST - Serum Separator Tube)

  • Contains a gel separator for serum separation.
• Laboratory uses of Gold (SST - Serum Separator Tube):

  • serum test
  • Psa (Prostate-specific antigen)
  • Lipids
  • Thyroid
  • majority of chemistry tests 
• Gold (SST - Serum Separator Tube) needs to be inverted 5-6 times
• Green (Heparin tube)

  is for biochemistry tests which require heparinized plasma or whole blood for analysis.
• • Green pst tube (light green)
  • plasma separating tube 
  • contains lithium heparin 
  • on ice
  • tests performed are basically all chemistry tests (gas elements) just like sst. the only difference between a pst and an sst is that a pst contains fibrinogen while an sst does not.
• Green (Heparin tube) has Sodium Heparin additive
• Green (Heparin tube) additive inhibits thrombin formation to prevent clotting
• Laboratory uses Green (Heparin tube)

  • Chemistry Testing (Plasma determinations in chemistry)

  1. Ammonia
  2. carboxyhemoglobin & STAT electrolytes
  3. chromosome screening
  4. Insulin
  5. Renin
  6. Aldosterone
  7. Gas elements
• Green (Heparin tube) inversion is 8-10 times
• Lavender (EDTA tube)

  used for hematology tests where whole blood is required for analysis.
•  Lavender (EDTA tube) contains EDTA (Ethylenediaminetetraacetic Acid) additive
• What EDTA additive does is it removes calcium preventing clotting of blood
• Laboratory uses of Lavender (EDTA tube)

  • Hematology testing

  1. ESR (Erythrocyte Sedimentation Rate)
  2. CBC w/diff. (Complete Blood Count with differential blood count)
  3. HbA1c (Hemoglobin A1C)
  4. Platelet/RBC/WBC Count

  • blood film for abnormal cells or malaria parasites, reticulocytes, red cell folate, 
  • Monospot test for 

  1. EBV (Epstein-Barr virus)
  2. parathyroid hormone (PTH)
• Lavender (EDTA tube) inversion is 8-10 times
• Grey (Oxalate/Fluoride tubes) has Antiglycolytic agents which prevents sugar/glucose consumption
• Grey (Oxalate/Fluoride tubes) Additives are Potassium Oxalate Monohydrate and Sodium fluoride
• In Grey (Oxalate/Fluoride tubes), Sodium fluoride acts as an antiglycolytic agent to ensure that no further glucose breakdown occurs within the sample after it is taken. Potassium oxalate removes calcium and acts as an anticoagulant.
• Laboratory uses Grey (Oxalate/Fluoride tubes)

  • Chemistry testing, especially glucose(sugar) and lactate
  • Glucose tolerance test (GTT)
• Grey (Oxalate/Fluoride tubes) needs to be inverted 8-10 times
• Royal Blue (Trace Element Tube) is made of materials that are free of trace element contamination
• Royal Blue (Trace Element Tube) has Sodium Heparin also Sodium EDTA additives
• Royal Blue (Trace Element Tube) What additive does is it Inhibits Thrombin formation to prevent clotting
• Royal Blue (Trace Element Tube) inversion is 8-10 times
• Black (Sodium Citrate ESR) is also called 3.8% citrate tube
• Laboratory uses of Black (Sodium Citrate ESR)

  • pediatric ESR (erythrocyte sedimentation rate)