Specimen Consideration Flashcards
- Contain a vacuum
- Used with vacutainer and Syringe Systems
- Stoppers universal color coded: indicates
contents - Have an expiration date
BLOOD COLLECTION TUBES
TOP TUBES THAT HAVE NO ANTI-COAGULANT
Red-top tube, Gold or Mottled-red-gray top tube
- (Most common use in clinical chemistry)
- 5x invertions
Red-top tube
- In vitro clotting due to GLASS
- No additive
- Glass surface activates clotting sequence
- Do not mix
- SERUM: use for TDM (Therapeutic Drug
Monitoring)
. Red-top tube: GLASS
- Contain additive to activate clotting
sequence - contain inert gel → SST (Serum Separator
Tube) - Do invert to mix additive and initiative
clotting sequence - SERUM
Red-top tube: PLASTIC
- Contain clot activator and gel (SST)
- Invert to mix and initiate clotting sequence
- Serum
- 5 x inversion
-Not cos-effective
-5-15 mins clotting
-chem, sero, and immuno test
Gold or Mottled-red-gray top tube
- Trace metal-free
- Iron, copper, zinc
Royal blue-top tube
Label color indicates contents:
- Red:
- Purple:
- Green:
- Red: no additive = serum
- Purple: EDTA = whole blood or plasma
- Green: heparin = whole blood or plasma
- Anticoagulant = sodium citrate
- Binds calcium
- Must be full
Blood: anticoagulant ratio critical - Must be on ice if not analyzed within 30 minutes
- Coagulation studies
- Common test examples are: PT, Platelets, aPPT
Blue-top tube
important ion for coagulation,
necessary for clotting. Factor IV ionic Ca2+
CALCIUM
Anticoagulant = heparin
* Inhibits thrombin formation
* Must be full and on ice if need pH, ionized Ca
* Most chemistry tests, STAT lab (PST)
* Decreases time needed for blood to clot, makes
turnaround time better
Green-top tube:
– natural anticoagulant inside the body
(in vivo)
Heparan
Three formulations of Heparin
Lithium heparin,
Ammonium heparin, Sodium heparin
ionized Ca
Green-top tube
Commonly used for viral toxicology and stat
tests
- Arterial blood gas (ABG), Osmotic fragility
test (OFT), Ammonia
Green-top tube
- Anticoagulant = EDTA
(Ethylenediaminetetraacetic acid) - Binds calcium
- Chelates calcium
- Hematology studies: CBC
Purple-top tube (Lavender)
spray-dried: plastic tube; will not
dilute the sample
K2 – Versene
liquid form: glass tubes; dilutes the sample 1-2%
K3 – Sequestrene
Grey-top tube:
* Anticoagulant = ?
- Binds calcium
- PLASMA, Whole blood
potassium oxalate
Grey-top tube:
* Antiglycolytic agent = ?
- Maintains plasma glucose levels
- Prevent glycolysis
sodium fluoride
Limited use: glucose, lactic acid
Grey-top tube
Prevents glycolysis because it fluoride forms and
ionic complex with magnesium thereby inhibiting
the Mg++ dependent enzyme,
ENOLASE
- Light blue top tube with 2 yellow bands on the
label - Contains soya bean thrombin which causes the
blood to clot immediately
. Fibrin-split Products
Yellow-top tube:
* ACD = ?
- Paternity testing
- DNA
acid citrate dextrose
Yellow-top tube:
* SPS =?
- Used for special blood culture studies
- Inhibits certain antibiotics
sodium polyanethol sulfonate
- Both bind calcium
- PLASMA, whole blood
Yellow-top tube:
* ACD = acid citrate dextrose
* SPS = sodium polyanethol sulfonate
means against or preventing
Anti
– Pertaining to coagulation or act of
clottin
Coagulant
main purpose of anticoagulants
To prevent the clotting process by interfering in the
coagulation cascade;
And to preserve certain analytes and cell
morphology prior to testing
Ethylenediamine Tetra-acetic acid
o Optimal concentration in the blood:
1.5mg/ml of blood
EDTA tube Mode of Action:
Removes ionized calcium (Ca2+) through process
referred to as
CHELATION
Anticoagulant of choice for Hematology because:
- Preserves cellular morphology
- Excellent for cell counting
- Blood is stable for 2-3 hours before
smearing
- Prevents platelet aggregation
Ethylenediamine Tetra-acetic acid
EDTA tube disadvantage:
causes cell shrinkage in excess
used in blood banking for blood
typing; Rh typing and antibody screening: K2EDTA
PINK-TOP
: EDTA + gel
- Used more often for molecular diagnostic
testing
WHITE-TOP
Mode of action
- Precipitates calcium
Anticoagulant of choice for COAGULATION
STUDIES:
Preserves the labile factors V and VIII better
CITRATE
CITRATE Two forms:
- BLUE TOP
- BLACK-TOP
:0.105M or 3.2%
: most commonly
used
Anticoagulant to blood – 1:9
Blood to anticoagulant – 9:1
BLUE-TOP SODIUM CITRATE TUBE
: 0.129M or 3.8%
Blood to anticoagulant ration – 4:1
For Erythrocyte Sedimentation Rate using
Westergren Method
BLACK-TOP CITRATE TUBE
HEPARIN
o Optimal concentration:
15-20U/mL of blood
Mode of action: accelerating the action of
antithrombin III, neutralizing thrombin and
preventing the formation of fibrin
HEPARIN
Isolated from liver cells and is known to be the
naturally occurring anticoagulant.
HEPARIN
HEPARIN two forms
Lithium heparin:
Sodium Heparin:
- may be used for most chemistry tests except
lithium and folate levels - For Lithium testing: Royal blue: Sodium
heparin can be used instead
-has light green top
Lithium heparin:
- Is the injectable form used for anticoagulant
therapy; - Recommended for trace elements; lead and
toxicology
SODIUM HEPARIN
o Concentration: 0.2mg/mL of blood
o Anticoagulant of choice for:
- Blood Gas Analysis (0.05 ml per ml of blood)
- Osmotic Fragility Test
- Trace elements and toxicology
o DOES NOT affect levels of calcium
o Preferred for potassium measurement
o Gives a BLUE background with Wright’s stain
after 2 hours
HEPARIN GREEN TOP TUBE
FLUORIDE
o Gray top tube contains preservative or
antiglycolytic agents such as:
- Sodium fluoride: (Preserves glucose for 3
days) - Lithium Iodoacetate : (Preserves glucose
for 24 hours)
Mode of action: forms weakly dissociated
calcium components
FLUORIDE
o Mode of action: combines with calcium to form
an insoluble salt/comple
OXALATE
Three forms OF OXALATE
- Potassium oxalate
- Ammonium oxalate
- Double oxalate
o Disadvantage:
- Distorts ?
- Potassium Oxalate: ?
- Ammonium Oxalate: ?
o Disadvantage:
- Distorts cell morphology
- Potassium Oxalate: shrinks RBCs
- Ammonium Oxalate: swells RBCs
Generally called the SSTs (Serum separator
tubes) because they contain clot activator
+ separator gel)
Red/Gray and Gold tops
Mostly used for chemistry tests except for
TDM, blood bank and immunologic
reactions
Red/Gray and Gold tops
gel separator present in tubes
THIXOTROPIC
Clotting time:
- With gel separators: ?
- With clot activator: ?
- Plain tubes: ?
- With gel separators: 30 minutes
- With clot activator: 5 minutes
- Plain tubes: 60 minutes
is a cofactor for other factors to complete the coagulation process
CALCIUM
- Dependent upon
-Test- Amount of sample needed to perform test
- Multiple labs needing the same specimen at the
same time
TYPE AND AMOUNT OF SPECIMEN
