Help with ER blood draw order and tube color!

  1. 0
    My sister is a new nurse < 1 year and just got her dream job in the ER. Now after 10 months of being a float nurse, she is doing blood draws and is having trouble with what color tube to use for what test. I only know the bare minimum that we use on peds, since most of our pts are done in the ER.
    Can anyone tell me where she can find this info? Thanks.
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  3. 21 Comments so far...

  4. 1
    Its individual to the facility and I found this out the hard way when I did agency in another city and drew the wrong colored tubes! Ugh! Usually, lab has little cheat sheets which tell which color for which tests:

    Lavender - CBC, type and x-match
    Red or tiger top - basic chemistries
    blue - coags
    yellow - blood cultures

    However, this is just at one facility where I work. At other places the colors are different.
    pedsRN121 likes this.
  5. 1
    It happens less these days, but still, when in doubt I call the lab. They are usually helpful.
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  6. 1
    I am thinking outside the box here, I really do not think it matters... If anyone has any actual scientific proof that order of tubes effects results please show it to me...

    I think as healthcare professionals we tend to do things a certain way jsut because it has been done that way for years even if what we do doesnt matter in the long run.

    Sweetooth
    pedsRN121 likes this.
  7. 1
    We draw a rainbow, that way the lab has tubes for every test. Even blood cultures (one set) can be drawn and placed in a tube but I have to always call the lab to remember which tube.

    And my lab tubes are different than traumaRU's lab tube colors......so it really does vary a bit from place to place.

    When in doubt, call the lab....
    Last edit by mom2michael on Jan 13, '08
    pedsRN121 likes this.
  8. 1
    Quote from Sweetooth EMT-P, RN
    I am thinking outside the box here, I really do not think it matters... If anyone has any actual scientific proof that order of tubes effects results please show it to me...

    I think as healthcare professionals we tend to do things a certain way jsut because it has been done that way for years even if what we do doesnt matter in the long run.

    Sweetooth
    Not scientific proof, but interesting rational.


    http://books.google.com/books?id=PY8...LKTXbgtbMBpysQ
    pedsRN121 likes this.
  9. 1
    I follow the example in mom2michael's reference. The rationale is reasonable, at least in my mind. We have a laminated sheet prepared by our lab services that helps us decide which tubes to use for which tests. We don't tend to use the red top tube in our facility, but we use millions of lavender, green and light blue ones, plus a ton of gold-top serum separators when doing a transplant workup.

    Green: chemistry, drug levels, LFTs, lipid profile, cardiac markers (often interchangeable with red tops)
    Lavender: hematology tests - CBC, diff, group and hold/match, tacrolimus levels
    Light blue: coags, anticoagulant levels
    Gold: serology (replaces red tops in our hospital)
    Dark blue: trace metals
    Gray: lactate (sent on ice)

    Our blood cultures go directly into culture medium bottles. We typically only send aerobic samples in our unit, not sure why.
    pedsRN121 likes this.
  10. 1
    Our labels for the labs tell which tube to use, and our PCAs do most of the blood draws, so I don't remember most of them...I know PT/INR/PTT in blue, BMP in gold, CBC in lavender, etc...as far as the order goes, I know most people I work with draw the blue tops first because you can't get away without filling it, and sometimes after a few tubes my old patients veins aren't giving so much
    pedsRN121 likes this.
  11. 0
    We always draw whole blodd or SST tubes first, blue tops last, and the rest in between. They claim there is a minute chance of EDTA passing into the blood and messing up results but with the vacutainers nowadays I don't know if that is much a concern than in years past?
  12. 0
    My facility requires the blue top (PT/PTT/INR) to be drawn first because they cannot run the specimen unless the entire tube is full... so I guess their rationale is, if you're gonna get one tube and blow it, get the important one!

    Lavender = CBC
    Green= C7
    Red= Troponins, hcg, etc
    Blood cultures to into culture bottles right from the Vacutainer
    Yellow/Gold top = SST tube, used for belly labs (lfts, amy, lip)
    Pink top=T+S

    When labs are ordered for a patient, the stickers for the tubes indicate what color tube needs to be drawn for said sticker.

    Call the lab and don't worry... because at the end of the day, if you order a lab to be added on.. the run it from whatever they have anyway! It can be done.


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