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help with blood tubes!!!

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by farmergal13 farmergal13 (New Member) New Member

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Does anyone know the phrases to help remember which tube should be used first??? any help will be appreciated!! thanks in advance!

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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Hi, farmergal13!

I've been drawing blood for years and I've never heard of anything like this. Never heard or can recall that I was ever told that certain tubes needed to be filled before others. If I draw into a syringe first and there is a question as to whether I had enough blood to fill all the tubes that were needed, then as a nurse I would make a decision to fill the tube(s) for the most important tests that needed to be run.

Welcome to allnurses! :welcome:

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172 Posts; 3,637 Profile Views

I don't know a phrase but you can rationalize it out. Red is a plain tube no additive so it wont interfere with other tubes/test. Red and Black just have a gel that also will not interfere. Then comes the anti-coagulant / blue tubes as the heparin and K- edta will effect the clotting test giving them a falsely prolonged result.The next tube will be the chemistry green and or green and black with the heparin as it is less likely to interfere with the CBC / purple tube that has the K-edta in it as we all know the "K" stands for potassium which if contaminating the chem. tubes will give a false high. I know the heparin can interfere with the CBC / purple tube but it just changes the shape of some of the cells and a good lab person can figure that one out. In chemistry the instruments just give how much it measures no interpretation needed and is more likely to be missed. There are other tubes for specialized testing but if you read the ingredients in them and know what they are for you can think it out.

NEVER TAKE BLOOD FORM ONE TUBE AND PUT INTO ANOTHER WITH THE EXCEPTION BEING YOU CAN TAKE OUT OF THE RED TUBE BUT ONLY BEFORE IT HAS TIME TO CLOT (and clotting / fibrin strands forming does not take a long time) joker

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2 Posts; 564 Profile Views

thanks so much!! my instructor had mentioned that there was a phrase or two to help remember... i'm sure most of the time it varies depending on the facilities policy...

thanks a bunch anyway!!

farmergal

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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If your instructor doesn't remember what it is I'd be asking every lab tech and lab assistant I ran into for the next 20 years until I found out what it was!

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oMerMero specializes in ICU.

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Actually different facilities have different protocols for the order of tubes. I was taught the way that is explained above, but my hospital now has a different order. It seems like that is something that changes every few years. In reality, I don't think it really matters, but that is just my opinion.

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23 Posts; 1,421 Profile Views

It does matter what order you draw because as stated above certain anticoagulants cause false results, and being a med tech, patient safety is very important to me. I could turn out false results and kill someone literally based on the treatment the patient would receive from my erroneus results!!!

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Myxel67 has 15 years experience and specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

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Rita Made Bill Greet Laverne might work

Red

Marble (red & black)

Blue

Green

Lavender (CBC)

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I was taught that blood cultures are done first, then the blue tube, and so on. If you are not doing blood cultures and you need to pull blood for coagulation test then you would pull 2.5 to 5 ccs in a blue top first which you discard as waste, then continue filling a second blue tube for your test sample. The thinking behind this is that the body senses a stick from the needle and all the clotting factors are activated therefore giving an incorrect read on the coagulation panel - therefore the blue waste tube is necessary before you can get a true read on a coagulation test. All other colors come next in a specific order so as not to cross contaminate.

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oMerMero specializes in ICU.

296 Posts; 3,819 Profile Views

I was taught that blood cultures are done first, then the blue tube, and so on. If you are not doing blood cultures and you need to pull blood for coagulation test then you would pull 2.5 to 5 ccs in a blue top first which you discard as waste, then continue filling a second blue tube for your test sample. The thinking behind this is that the body senses a stick from the needle and all the clotting factors are activated therefore giving an incorrect read on the coagulation panel - therefore the blue waste tube is necessary before you can get a true read on a coagulation test. All other colors come next in a specific order so as not to cross contaminate.

That is also the new policy at my hospital.

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