Lab draws after IV start

We draw labs all the time on on floor after IV starts and from existing peripherial IV lines. From what I've seen, it doesn't look as if it matters the order they're drawn. Depending on what's wrong with the pt, I would probably draw the most important tubes first, though. I'm looking forward to seeing what others have to add.

I believe that the specific order has to do with the additives in the tubes and the possibility of "contaminating" from one tube to another with the different additives, thus possibly altering lab results. But it's been a LONG time since I was inserviced on this...like ten years. So IMO it can't be that important!

Personally, I always get the most important tubes first as well and have not had any issues with wacky results or anything like that.

Blood Cultures, Blue top, Red Serum Separator (red tiger), Green Serum Separator (some places it's a tiger some places it's solid), Purple top. Some places reverse the order of the red and green.

there is a specific order, according to additives (indicated by color of tube). I dont know what the order is, I never followed it..lol. I just couldnt remember the order. I do know that a PTT is to be drawn first. I never had any problems with incorrect lab results resulting from the order I drew. But now we are not allowed to do blood draws unless its a PICC or Port so I dont have to worry about it. Why dont you ask your lab technician at work? Im sure they know and would be able to tell you.

What I got from a Ohio State edu website that we've been using in clinic:

ORDER OF BLOOD DRAW:

Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. The recommended order of draw is:

1. Blood culture tube (yellow-black stopper)

2. Non-additive tube (red stopper or SST)

3. Coagulation tube (light blue stopper). A light blue stopper (sodium citrate) tube is NEVER the first tube drawn. If a coagulation assay is the only test ordered, draw a non-additive tube (red stopper or SST) first, and then draw the light blue stopper tube. Fill tubes at least 90%.

4. Additive tubes in this order:

Heparin (dark green stopper)

EDTA (lavender stopper)

Oxalate/fluoride (light gray stopper)

Draw all trace metal tubes first so as not to contaminate the needle by puncture of the vacutainer stoppers

Hope this helps

Can't remember why, didn't really need to know, but when I worked in the ER, this was the order in which we drew labs:

Blood Cultures

Red

blue

Green

Purple

Gray

I don't think it was ever explained as to why - just that this was the order in which you drew.

Blessings

Babs0512 is correct. There is a specific order due to the additives. If you get even a little heparin for example, in a red top tube then you have compromised the whole thing. I remembered most of them this way: Red and blue gets purple. R,B, G, P

I can't remember who taught me the mnemonic "Red Blood Gives Life" for Red, Blue, Green, Lavender, but that's how I remember the order. If I have a gray tube, I draw that last, and if I have any weird draws or questions I always call our lab for the answers.

What I got from a Ohio State edu website that we've been using in clinic:

ORDER OF BLOOD DRAW:

Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. The recommended order of draw is:

1. Blood culture tube (yellow-black stopper)

2. Non-additive tube (red stopper or SST)

3. Coagulation tube (light blue stopper). A light blue stopper (sodium citrate) tube is NEVER the first tube drawn. If a coagulation assay is the only test ordered, draw a non-additive tube (red stopper or SST) first, and then draw the light blue stopper tube. Fill tubes at least 90%.

4. Additive tubes in this order:

Heparin (dark green stopper)

EDTA (lavender stopper)

Oxalate/fluoride (light gray stopper)

Draw all trace metal tubes first so as not to contaminate the needle by puncture of the vacutainer stoppers

Hope this helps

The "non-additive" tube is not really red it has a clear over red cap and is only needed if you are drawing from a butterfly or through and extension tube. It cannot be used for ANY lab test and is designed as a waste tube. You only need a few drops in that tube as it is used to get rid of the air in the tubing which if not discarded alters the amount of blood that will be drawn into the blue tube resulting in an incorrect additive/blood mixture. If your vacutainer device is being connected directly to the HUB of a NEWLY initiated PIV then you may draw the blue tube without using a waste tube. Because OSU uses the Intima winged IV catheter which has an attached extension tube a waste tube is necessary. If you are using a regular angio and no extension a waste tube is not necessary.

Good question - and good discussion, thanks! I learned something new today :)

I learned "Roast Beef Sure Gets Lots of Gravy"

Red

Blue

Sst

Green

Lavender

Gray

i was told to draw blues last off a picc or port because by then you will not have compromised the blood, because the line has been previously flushed with heparin per protocol but other then the blue top for coags i didnt know there was a certain order to draw cbllod....i always take 1 or 2 red discard tubes first and then start filling leaving the blue for last