Phlebotomy Chap 7 Order of Draw Pg 250-252
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| CSLI ORDER OF DRAW:to minimize the chance of specimen contamination CLSI recommends the following order of draw for both ETS collection and when filling tubes from a syringe. | CSLI memory jogger for order of draw is this:STOP LIGHT RED. STAY PUT, GREEN LIGHT GOFYI: memory jogger places red top before SST and places PST before green top for convenience in memorization.
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| Name the Order of Draw recommened by CSLI? | 1.Sterile tube (blood culture) 2.Blue-top coagulation tube 3.Serum tube with or without clot activator, with or without gel 4.Heparin tube with or without gel plasma separator 5.EDTA tube 6.Glycolytic inhibitor tube
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| pg 251 Table 7-5 ORDER OF DRAW:Give tube stopper color and rationale for collection order. Blood cultures (sterile collections) | tube stopper color: Yellow SPS,sterile media bottles Rationale:Minimized chance of microbial contamination.
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. Coagulation Tubes | Stopper: LIGHT BLUE Rationale: The first additive tube in order because all other additive tubes affect coagulation tests
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order.Glass non additive tubes | stoppers:RED Rationale: Prevents contamination by additives in other tubes
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order.Plastic clot activator tubes | Stoppers:Red, Red&Gray rubber,Gold plastic Rationale: Filled after coagulation tests because silica particles activate clotting and affect coagulation tests (carryover of silica into subsequent tubes can be overridden by anticoagulant in them)
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. Serum separator tubes (SSTs) | Stoppers:Red&Gray rubber,Gold plastic Rationale: Filled after coagulation tests because silica particles activate clotting and affect coagulation tests (carryover of silica into subsequent tubes can be overridden by anticoagulant in them)
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. Plasma separator tubes (PSTs) | stopper:Green&Gray rubber,Light green plastic Rationale:Heparin affects coagulation tests and interferes in collection of serum specimens,causes the least interference in test other than coagulation tests.
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order.Heparin | stoppers: GreenRationale:Heparin affects coagulation tests and interferes in collection of serum specimens,causes the least interference in test other than coagulation tests.
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. EDTA tubes | Stopper: Lavender, PinkRationale: Responsible for more carryover problems than any other additive elevates Na and K levels. Chelates and decreases calcium and iron levels, elevates PT and PTT results
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. Plasma Preparation tubes (PPTs) | Stopper: Pearl topRationale: Responsible for more carryover problems than any other additive elevates Na and K levels. Chelates and decreases calcium and iron levels, elevates PT and PTT results
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| pg 251 Table 7-5 ORDER OF DRAW: Give tube stopper color and rationale for collection order. Oxalate/floride tubes | Stopper: GrayRationale: sodium fluoride and potassium oxalate affect sodium and potassium levels. respectively. After hematology tubes because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interferes in enzyme reactions.
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| Why is there an alternate syringe order of draw at some institutions? | because the clotting process is activated the minute blood starts to fill a syringe, some places prefer to use a separate order of draw for syringe collection so that tubes most affected by microclot formation are filled as soon as possible.
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| What else does the alternate syringe order of draw assume about the specimen? | This order of draw assumes that the the blood that entered the syringe last is the freshest and least affected by microclot formation.
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| From pg251 Box 7-1 Alternate syringe order of draw. List the order of draw. six steps | 1. Sterile specimens (blood cultures) 2. Light-blue top (coagulation tubes)3.Lavender top and plasma preparation tube (PPT) 4.Green top and plasma preparation tube (PST)5.Gray-top oxalate fluoride tube 6.Red top and serum separator tube (SST)
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| How do you prevent carryover in the alternate syringe order of draw? | It is important to hold the syringe and transfer device vertical while filling tubes. This will keep the transfer needle above the fill level of the tube so that it is not contaminated by blood mixed with additve.
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| Memory Jogger for the Alternate syringe order of draw is : Silly Ladies Love Green & Gray Roses. List the order of draw by stopper colors. | Silly=STERILE Ladies=LT.BLUE Love=LAVENDER Green=GREEN/PST &Gray=GRAY Roses=RED/SST
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