A "full" light blue top tube

[psu_213]

I have alluded to this in the past, and I'm just wondering what others' experiences are with this...

I was recently helping a nurse draw blood on a very confused older pt. In an attempt to finish drawing blood before the pt. bit here, the nurse pulled the light blue tube (for coags) off the adaptor before the tube was filled all the way (it was not even close to being filled) and said "that's good enough" and the lab ran it. On the other hand, I have gotten calls from the lab saying that I have to recollect the blue tube because it was not full enough. I was pretty sure it was full, but I drew another one, double checked that it was all the way full, and, sure enough, got the call that the tube was not filled enough.

Has anyone else noticed an inconsistency in how their lab treats blue tube samples?

[klone, MSN, RN]

I do a lot of lab draws for my job (research) and while pretty much every other tube, it doesn't matter how much is in it, the light blue tube is filled with about 15% sodium citrate, and the ratio of Na Citrate to blood has to be correct in order for it to be accurate. That's pretty much the only tube where that matters. It needs to be 80% filled (generally to the top of the label) for it to be good. And of course, as with all other tubes (except a red top, which is a clot tube), you need to invert it 5-10 times after drawing in order to mix the medium with the blood.

[psu_213, BSN, RN]

My issue is not with 'the tube has to be full'...and I always make sure that tube is full when I send it to the lab. I was just frustrated (if that is the right word) that sometimes--particularly at night--the lab will run a tube that is not totally full. While I would think this would skew the results, I've seen instances where our lab will result a coag tube that would be rejected on day shift.

[NurseOnAMotorcycle, ASN, RN]

Wellllll, ummm, maybe ...

::remembering when my 10-month old in the grocery cart kiddie seat decided it was snack time in the produce aisle and yanked mine right down... yellow, though ... .::

ACK!!

(Talk about some surprising gold top results!)

If 10% of lab techs run a blue tube not completely full, it still leaves 90% calling for a re-draw. I fill the tube.

[nightbreak]

Light blue citrate tubes should be filled to the line on the tube, this gives the correct ratio of blood to sodium citrate. Overfill or underfill will not provide a correct reading. Who wants an incorrect PT or PTT?

I highly recommend that the OP write a friendly email to the lab manager asking why the difference between day shift and night shift's rejection of improper specimens. It is the manager's job to ensure that all tests are being run in accordance with best practice. And our job to advocate for patient safety. :)