help with blood tubes!!!

  1. 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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    About farmergal13

    Joined: Sep '06; Posts: 2

    12 Comments

  3. by   Daytonite
    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!
  4. by   Jokerhill
    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
    Last edit by Jokerhill on May 31, '07
  5. by   farmergal13
    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
  6. by   Daytonite
    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!
  7. by   oMerMero
    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.
  8. by   MsShanRN
    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!!!
  9. by   onduty23
    red blood gives life
  10. by   MsShanRN
    duh!
  11. by   Myxel67
    Rita Made Bill Greet Laverne might work

    Red
    Marble (red & black)
    Blue
    Green
    Lavender (CBC)
  12. by   mt33133
    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.
  13. by   oMerMero
    Quote from mt33133
    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.
  14. by   Jokerhill
    You can draw a red or red/black tube before a blue tube to use as a waist as there are not any additives in these that can contaminate the coag test. The reason that you want to draw a waste tube first is that the skin and tissue that the needle passes through has thrombin in it that is a clotting factor. Thrombin will start the clotting process in the blue tube if it is drawn first, causing a prolonged pt/ptt test result. It prolongs the test because it binds/uses up the clotting factors prior to the test being run. PT/PTT test are a timed test to see how long it takes to for a clot in the intrensic and extrensic to form. You can use the red top tube for other testing if needed. An extra blue top if drawn first is just a waste and I would not want you to send it in for testing in error and toss out the second tube. But don,t use any other tubes first. As for blood cultures there are many other considerations to take into account and can be the most screwed up.

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