1- Blood Collection Tubes Flashcards
Gold top tube - Department, Specimen Type, Action, Additive
Serum separator tubes(SST) - not immediate clotting must wait 30 mins
• silicone/gel (serum separating material)
• Contain thixotropic gel that forms a physical barrier of separation, separates the cellular components from the liquid portion of the blood.
Not suitable for Blood Bank or therapeutic drug monitoring
Biochemistry electrolytes, Magnesium, Phosphorus, Calcium, Proteins, lipids and alcohol, immunogloblulins
Light Blue top tube - Department, Specimen Type, Action, Additive
Department - Hematology Specimen Type - Plasma Action - Anticoagulant Additive - Sodium Citrate oagulation studies include • PT • APTT • Factor assays Factor V, Factor VIII • Activated protein C • Antithrombin III • D-dimer • Fibrinogen • Platelet function tests
MUST BE FILLED COMPLETELY and centrifuge
Lavender top tube - Department, Specimen Type, Action, Additive
Department- Hema
Specimen Type- whole blood
Action: Anticoagulant
Additive = EDTA (ethylenediaminetetraacid)
Hematology tests: CBC, WBC count, Hemoglobin, Hematocrit, Platelet count, Reticulocyte count, differential.
Chemistry tests: RBC Folate
Dark Green top tube - Department, Specimen Type, Action, Additive
Department- Chemistry
Specimen Type - Plasma
Action -Anti-coagulant
Additives: sodium heparin
stat VBG
Light Green top tube - Department, Specimen Type, Action, Additive
Department- Chemistry
Specimen Type - Plasma
Action -Anti-coagulant
Additive is lithium heparin
PST = Plasma Separator Tube - STAT chemistry testing immediate clotting
Has gel which, after centrifugation, permanently separates plasma from red blood cells
Biochemistry
electrolytes, ammonia level, Magnesium, Calcium, Arterial blood gas, Proteins, lipids and alcohol
Red top tube - Department, Specimen Type, Action, Additive
Department - Blood Bank Specimen Type - Clotted Blood Action- None Additive - None • May contain additives called colt activators that speed up the clotting process. Activators are substances that increase platelet activation and include silica, cellite, and glass particles. • Let blood sit for 30 minutes for clot formation
SERUM NEVER HAS ANTICOAGULANT
Pink top tube - Department, Specimen Type, Action, Additive
Department-Blood bank Specimen Type - Whole Blood Action- Anti-coagulant Additive - EDTA 1) ABO/Rh testing 2) Antibody screen AKA indirect antiglobulin test (IAT). 3) Type and Screen (T&S) 4) Crossmatch 5) Direct Antiglobulin Test (DAT or DC) 6) Rh Immune Globulin (RHIG) or Rhogam workup 7) Antibody titer 8) Antigen typing 9) Requests for components such as RBCs, platelets, cryoprecipitate (CRYO) and fresh frozen plasma (FFP) will be delivered to the blood bank.
Yellow top tube - Department, Specimen Type, Action, Additive
Department- Blood Bank
Specimen Type - Whole Blood
Action- Cell preservative
Additive- .(acid citrate dextrose) (ACD)
DNA testing, paternity testing, blood grouping
Red top tube - Department, Specimen Type, Action, Additive
Department - Immunology Specimen Type - Serum - Action- None Additive - None -• No anticoagulant. CRP, Mono, Hepatiti
Red/Yellow marble top tube - Department, Specimen Type, Action, Additive
Department - Chemistry
Specimen Type - Serum
Action- Clot activator
Additive - Glass particles
Red/grey serum separator marble top tube - Department, Specimen Type, Action, Additive
Department - Chemistry Specimen Type - Serum Action- Clot activator Additive - Thixo-tropic gel Biochemistry electrolytes, ammonia level, Magnesium, Phosphorus, Calcium, Proteins, lipids and alcohol
Navy -royal blue top tube - Department, Specimen Type, Action, Additive
Department - Chemistry
Specimen Type - Serum
Action- None
Additive -
- Therapeutic drug monitoring (TDM)
- Toxicology
- Trace metal assays
- Nutritional analysis.
- Drugs; Digoxin, Gentamicyn, Valproic Acid, Tobramicyn, Phenytoin, Carbamazipane, phenobarb, salysiataes, acetaminophen
Navy -royal blue top tube- Department, Specimen Type, Action, Additive
Department - Chemistry
Specimen Type - Plasma
Action-Anti-coagulant
Additive - These tubes display additive-specific color coding on the label: a red bar on the label indicates a clot activator, a lavender or blue bar on the label indicates EDTA, and a green bar on the label indicates heparin.
- Therapeutic drug monitoring (TDM)
- Toxicology
- Trace metal assays
- Nutritional analysis.
- Aluminum
- Arsenic
- Mercury
Grey top tube Department, Specimen Type, Action, Additive
Department - Chemistry
Specimen Type - Plasma
Action-Anti-coagulant and a cell preservative
Additive -Sodium fluoride and Potassium oxalate
lactic acid , pyruvate tests, glucose tolerance and alcohol levels : tube are placed in a icy water slurry (a cup with ice and water to keep the sample cold)
Yellow ivory top tube Department, Specimen Type, Action, Additive
Department - Micro
Specimen Type - Whole blood
Action-Anti-coagulant
Additive -Sodium poly-anetholesulfonate (SPS)
White top tube Department, Specimen Type, Action, Additive
Department - Molecular Diagnosis
Specimen Type - Whole blood
Action-Anti-coagulant
Additive -K2EDTA and gel for plasma separation
What is the order of draw?
- Blood culture bottles (sterile) or yellow SPS tubes
- Coagulation tubes
- Red top
- Gel tubes (serum separator)
- Heparin (green)
- EDTA (lavender)
- EDTA (pink)
- Fluoride (grey)
- Black/Blue citrate (ESR)
What does Heparin do? and which tubes is it in?
• Heparin Tubes-green
o Heparin inhibits the action of thrombin and prevents coagulation for up to 24 hours
o Cannot be used for hematology because it causes background staining.
o Concentration is 0.4% or 0.2mL/1mLof blood
What are routine chemistry tests - electrolytes? and what tubes
o Sodium (Na) o Potassium (K) o Chloride (Cl) o Bicarbonate (HCO2)
- SST Tubes -red/gray or gold
- PST Tubes- green with lithium heparin or green/gray (non hemogard)
Tan top tube
Contains EDTA
• Use for lead levels in blood
• Chemically cleaned tubes and lead free
What do Potassium oxalate and sodium fluoride
- The additives inhibit the glycolytic activity of cells which helps maintain the glucose level for a minimum of 24 hours.
- Oxalates and fluoride remove calcium to prevent clotting.
- Fluoride is a powerful enzyme poison. Concentration 10mg/1mL blood it is a powder
- Used for lactate, pyruvate and glucose must place tube in a icy water slurry (a cup with ice and water too keep the sample cold)
What does EDTA do?
- Binds calcium
- Prevents platelet aggregation (clumping)
- Preserves the shapes of blood cells.
- Too much EDTA to blood will rupture the platelets
Used for: • CBC’s (Complete blood counts) • Smears (blood film) • Hemoglobin electrophoresis • Renin activity (transport on ice) • Reticulocyte • Molecular Diagnosis
• EDTA cannot be used for coagulation studies because it affects coagulation factor V one of the proteins involves in coagulation
What does sodium citrate do?
• Sodium citrate prevents coagulation by binding calcium.
• The ratio of sodium citrate to blood in the typical adult sized tube should be 9 parts blood to 1 part anticoagulant. (4.5 ml blood to .5 anticoagulant) if the tube does not fill completely coagulation results will be prolonged
Needed for PT, APTT, • Factor assays Factor V, Factor VIII, Activated protein C ,Antithrombin III, • D-dimer, • Fibrinogen
What ratio is needed in (Black)-Sodium Citrate tubes
- Ratio of blood to anticoagulant is 4:1 .
* The greater ratio is needed for the Westergren sedimentation rate. - ESR
