Lesson 3.2: Evacuated Tubes, Color Codes, and Anticoagulants Flashcards
Why are evacuated tubes color coded on their stoppers?
To reflect the presence or absence of anticoagulant inside the tube
The anticoagulant in evacuated tubes may vary in:
- Kind of anticoagulant (Sodium citrate, EDTA, Heparin, etc.)
- Amount of anticoagulant in the tube
- Volume of blood it can hold
The choices of evacuated tube depends on ___
What are to be obtained if:
a. anticoagulated?
b. non anticoagulated?
the type of blood specimen needed for laboratory analysis
- If anticoagulated, plasma and whole blood
- If non-anticoagulated, only serum
TRUE OR FALSE
Color codes of all brands of evacuated tubes are the same.
Color codes used by other brands, like Vacuette, may differ as it may be darker or paler.
Reference: Beckton Dickinson Color Coding of Vacutainer Tubes
COLORED TOP EVACUATED TUBES
Red Top
Additive: ____
Mode of Action: ____
Uses: ____
Red Top
Additive: None
Mode of Action:
* Blood clots. Serum is separated by centrifugation
Uses:
* Chemistries
* Immunology and Serology
* Blood Bank (Crossmatching)
COLORED TOP EVACUATED TUBES
Gold Top
Additive: ____
Mode of Action: ____
Uses: ____
Gold Top
Additive: None
Mode of Action:
* Serum Separator Tube (SST)
* Contains a gel at the bottom to separate blood from serum on centrifugation
Uses:
* Chemistries
* Immunology and Serology
COLORED TOP EVACUATED TUBES
Light Green Top
Additive: ____
Mode of Action: ____
Uses: ____
Light Green Top
Additive:
* Plasma Separating Tube (PST) with Lithium heparin
Mode of Action:
* Anticoagulates with lithium heparin
* Plasma is separated with PST gel at the bottom of the tube
Uses:
* Chemistries
COLORED TOP EVACUATED TUBES
Red-Gray Top
Additive: ____
Mode of Action: ____
Uses: ____
Red-Gray Top
Additive:
* Serum-Separating Tube (SST)
* With clot activator
Mode of Action:
* Forms clot quickly
* Separates serum with SST gel at the bottom of the tube
Uses:
* Chemistries
COLORED TOP EVACUATED TUBES
Purple Top
Additive: ____
Mode of Action: ____
Uses: ____
Purple Top
Additive:
* EDTA Liquid
Mode of Action:
* Forms calcium salts to remove calcium
Uses:
* Hematology (CBC)
* Blood Bank (Crossmatch)
Full draw required – Invert 8 times to prevent clotting and platelet clumping
COLORED TOP EVACUATED TUBES
Light Blue Top
Additive: ____
Mode of Action: ____
Uses: ____
Light Blue Top
Additive:
* Sodium citrate (3.2%)
Mode of Action:
* Forms calcium salts to remove calcium
Uses:
* Coagulation Tests (Protime and Prothrombin Time)
Full draw required
COLORED TOP EVACUATED TUBES
Dark Green Top
Additive: ____
Mode of Action: ____
Uses: ____
Dark Green Top
Additive:
* Sodium heparin or Lithium heparin
Mode of Action:
* Inactivates thrombin or thromboplastin
Uses:
* For lithium level, use sodium heparin
* For ammonia level, use sodium/ lithium hepatin
COLORED TOP EVACUATED TUBES
Dark Blue Top
Additive: ____
Mode of Action: ____
Uses: ____
Dark Blue Top
Additive:
* Sodium EDTA
Mode of Action:
* Tube is designed to contain no contmainating metals
Uses:
* Trace Element Testing (zinc, copper, lead, mercury)
* Toxicology
COLORED TOP EVACUATED TUBES
Yellow Top
Additive: ____
Mode of Action: ____
Uses: ____
Yellow Top
Additive:
* ACD (Acid-Citrate-Dextrose)
Mode of Action:
* Complement inactivation
Uses:
* HLA Tissue Typing
* Paternity Testing
* DNA Studies
COLORED TOP EVACUATED TUBES
Orange Top
Additive: ____
Mode of Action: ____
Uses: ____
Orange Top
Additive:
* Thrombin
Mode of Action:
* Quickly clots blood
Uses:
* STAT Serum Chemistries
COLORED TOP EVACUATED TUBES
Brown Top
Additive: ____
Mode of Action: ____
Uses: ____
Brown Top
Additive:
* Sodium heparin
Mode of Action:
* Inactivates thrombin and thromboplastin
Uses:
* Serum Lead Determination
COLORED TOP EVACUATED TUBES
Light Gray Top
Additive: ____
Mode of Action: ____
Uses: ____
Light Gray Top
Additive:
* Sodium fluoride and Potassium oxalate
Mode of Action:
* Antiglycolytic agent – preserves glucose up to 5 days
Uses:
* For lithium level, use sodium heparin
Glucoses require full draw, otherwise, it may cause hemolysis
Blood collection tubes must be drawn in a specific order.
Why?
To avoid cross-contamination of additives between tubes
Recommended Order to Draw
1. Blood Culture Tube - Yellow-black stopper
2. Non-Additive Tube - Red stopper/ SST
3. Coagulation Tube - Light blue stopper
4. Additive Tubes (in order)
* (1) SST - Red-gray/ gold stopper; Contains gel separator and clot activator
* (2) Sodium Heparin - Dark green stopper
* (3) PST - Light green stopper; Contains lithium heparin anticoagulant and gel separator
* (4) EDTA - Lavender stopper
* (5) ACDA/ACDB - Pale yellow stopper
* (6) Oxalate/ Fluoride - Light gray stopper
If just a routine coagulation assay is the only test ordered, what stopper and how many of this may be used to draw sample?
A single light blue stopper
If there is a concern regarding contamination by tissue fluids or thromboplastins, what is the order of draw?
- Non-Additive
- Light Blue Stopper Tube
Why should tubes with additives be thoroughly mixed?
Erroneous test results may be obtained when blood is not thouroughly mixed with the additive
Order of draw for plastic tubes
Key: Order of draw for tubes 2 and 3 is reversed. Thus:
1. Blood Culture Tube - Yellow-black stopper
2. Coagulation Tube - Light blue stopper
3. Non-Additive Tube - Red stopper/ SST
4. Additive Tubes (in order)
* (1) SST - Red-gray/ gold stopper; Contains gel separator and clot activator
* (2) Sodium Heparin - Dark green stopper
* (3) PST - Light green stopper; Contains lithium heparin anticoagulant and gel separator
* (4) EDTA - Lavender stopper
* (5) ACDA/ACDB - Pale yellow stopper
* (6) Oxalate/ Fluoride - Light gray stopper
