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ASCP Review for Blood Collection Additives

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Term
Definition
CAUTION: Never transfer blood collected in an additive tube into another additive tube.   show
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Blood Collection Additives:   show
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Additives are available in:   show
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Tube Inversion:   show
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Caution: Never Shake or Vigorously mix Tubes   show
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show Are substances that prevent blood from clotting (coagulating) >Must be mixed immediately after collection to prevent microclot formation. >Gentle mixing prevents Hemolysis. >Separate naturally or if centrifuged.  
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ANTICOAGULANTS - Two Methods:   show
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ANTICOAGULANTS - Used for:   show
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show >Available as a powdered di-potassium K2 >Available as a liquid tri-potassium K3 salt >Prevents coagulation by binding (chelating) calcium >Lavender, Purple, Pink, Pearl, Gray and Royal Blue top tubes >Must be mixed by inversion immediately 8-10times  
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show >Purple or Lavender top tubes for Hematology >Pink top tube for Blood Bank ( with special Blood Bank patient ID label & wrist band. >CLSI Recommends using Spray Dried EDTA to avoid dilution lowering Hemoglobin, RBC, WBC, Platelets and packed cell volum  
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show >Gray top for Chemistry (Glucose testing)  
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show >Royal Blue with Lavender Label for Chemistry >Pearl top with Thixotropic gel separator for Plasma Preparation Tubes (PPT) for  
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ANTICOAGULANTS - EDTA - Hematology & Blood Banking   show
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ANTICOAGULANTS - CITRATES: Lt Blue Stopper   show
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ANTICOAGULANTS - CITRATE: ESR   show
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show To avoid microclotting citrates must be mixed by inversion 3-4 times after collection >vigorous mixing can activate platelets and shorten clotting time giving erroneous results.  
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ANTICOAGULANTS - CITRATES: 9:1 ratio   show
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show Coagulation tests are performed on Plasma, so specimens must first be centrifuged to separate the plasma from the cells. >testing Ca added back clotting initiated and timed.  
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show Heparinized Plasma is preferred over Serum for Potassium test because when blood clots, potassium is released from cells into the serum and can falsely elevate results.  
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ANTICOAGULANTS - HEPARIN: Additive in:   show
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ANTICOAGULANTS - HEPARIN: 3 Formulations:   show
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show >Lithium Heparin causes the least interferenc in Chemistry Testing. >Most used for plasma and whole-blood chemistry tests.  
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show Prevent coagulation by precipitating calcium. >Potassium Oxalate is the most widely used. >Added to tubes containing Glucose preservatives (Anticlycolytic Agents)to provide Plasma for Glucose testing.  
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ANTICOAGULANTS - OXALATES: Grey Stopper Tubes   show
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ANTICOAGULANTS - OXALATES:   show
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show Fill to volume state on tube - excess oxalate causes hemolysis of RBCs and releases hemoglobin into the plasma.  
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show >For Immunohemological Testing >DNA Testing >Human Leukocyte Antigen (HLA) phenotyping (  
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SPECIAL-USE ANTICOAGULANTS ACID CITRATE DEXTROSE (ACD):   show
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show Yellow Top ACD Tubes must be mixed after collection by inversions 8 times to prevent clotting.  
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SPECIAL-USE ANTICOAGULANTS CITRATE PHOSPHATE DEXTROSE (CPD): Blood Banking   show
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SPECIAL-USE ANTICOAGULANTS CITRATE PHOSPHATE DEXTROSE (CPD):   show
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show It is used for blood culture collection >Reduces the action of protein called complement which destroys bacteria. >Slows Phagocytosis & reduces activity of antibiotics. >Prevents coagulation by binding Calcium.  
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SPECIAL-USE ANTICOAGULANTS SODIUM POLYANETHOL SULFONATE (SPS): Yellow Top   show
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ANTIGLYCOLYTIC AGENTS:   show
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show Is the most common antiglycolytic agent. It preserves glucose for up to 3 days and inhibits the growth of bacteria.  
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ANTIGLYCOLYTIC AGENTS - SODIUM FLUORIDE combined with POTASSIUM OXALATE:   show
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ANTIGLYCOLYTIC AGENTS - SODIUM FLUORIDE: Gray Stopper   show
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ANTIGLYCOLYTIC AGENTS - SODIUM FLUORIDE: ETOH Specimens   show
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show Enhance coagulation in tubes used to collect serum specimens. Clot activators include glass, (Silica) particles and inert clays like Celite and clotting factors such as Thrombin. Require 5 gentileinversions for mixing.  
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show >Particles provide more surface area. > Silica particle cause the blood to clot within 15-30 minutes.  
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show > Silica particle are the clot activators in Serum-Sepeartor Tubes SST and Plastic Red Top Tubes.  
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CLOT ACTIVATORS - CELITE:   show
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CLOT ACTIVATORS - SST tubes   show
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show Blood collected in Thrombin Tubes usually clot within 5 minutes.  
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show >Is and inert (nonreacting) gel contained in the blood collection tube. >When centrifuged the gel is between he cells and the serum or plasma. >Gel separation keeps the cells from further metabolism.  
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THIXOTROPIC GEL SEPARATOR - SST: Gold Plastic   show
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THIXOTROPIC GEL SEPARATOR - with EDTA: PPT   show
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show Rapid Serum Separator Tubes contain Thrombin and clot in 5 minuts  
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THIXOTROPIC GEL SEPARATOR - Heparinized Plasma Gel Barrier Tubes: PST   show
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show Royal Blue: Normally indicate a Trace Element Free Tubes. They are free of any trace of contamination.  
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TRACE ELEMENT-FREE TUBES - EDTA, Heparin, or No Additive   show
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ORDER OF DRAW:   show
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show 1. Sterile Tube (Blood Culture), 2. Blue Top Coagulation Tube, 3. Serum Tube w/wo clot activator or gel separator, 4. Heparin w/wo gel plasma separator, 5. EDTA tube, 6. Glycolytic inhibitor tube.  
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(1)ORDER OF DRAW - YELLOW SPS STERILE TUBE:   show
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show None  
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(2)ORDER OF DRAW - LT BLUE TUBE: Coagulation   show
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show Blood clots and the serum is separated by centrifugation.  
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show Serum separator tube (SST) contains a gel at the bottom to separate blood from serum on centrifugation.  
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show Acid-citrate-dextrose Complement Activation. HLA tissue typing and DNA studies  
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show Plasma Separating Tube (PST) with Lithium Heparin. >Anticoagulates with Lithium heparin; Plasma is separated with the PST gel at the bottom of the tube.  
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show Sodium heparin, Ammoniam heparin or lithium heparin inactivates thrombin and Thromboplastin. For levels of lithium, sodium or Ammonia, can not use corresponding heparin"s must use others  
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(7)ORDER OF DRAW - LAVENDER EDTA TUBE: Hematology   show
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(7)ORDER OF DRAW - PINK EDTA TUBE: Blood Bank   show
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show Sodium Fluoride and Potassium Oxalate antiglycolytic angents presreves glucose 3 days. May cause Hemolysis if draw is short.  
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show Cross-contamination is the transfer of additive from one tube to the next.  
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show EDTA in tubes has been the source of more carryover problems than any other additive.  
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CROSSOVER / CROSS CONTAMINATION: Heparin   show
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show >Make sure fill tubes from bottom up during collection. >Tube contents does not come into contact with needle. >Or in transferring blood into tubes from syringe.  
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show Thromboplastin is a substance present in tissue fluid activates the extrinsic coagulation pathway and can interfere with coagulation tests.  
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MICROBIAL CONTAMINATION: Blood Cultures   show
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show DEPARTMENT: Coagulation  
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show DEPARTMENT: Chemistry, Blood Banking, Serology, and Immunology  
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show DEPARTMENT: Chemistry  
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show NA Discard Tube Only  
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show DEPARTMENT: Chemistry  
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ADDITIVES - RED/GOLD (TIGER) Top: CLOT ACTIVATOR & GEL SEPEARTOR   show
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show DEPARTMENT: Chemistry  
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show DEPARTMENT: Chemistry  
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show DEPARTMENT: Chemistry  
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ADDITIVES - GREEN Top: SODIUM HEPARIN   show
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ADDITIVES - GREEN Top: AMMONIUM HEPARIN   show
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ADDITIVES - LAVENDER (PURPLE)Top: EDTA   show
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show DEPARTMENT: Blood Bank  
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show DEPARTMENT: Chemistry  
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ADDITIVES - GRAY Top: SODIUM FLUORIDE & EDTA   show
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ADDITIVES - GRAY Top: SODIUM FLUORIDE   show
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show DEPARTMENT: Chemistry Orange Top Tube  
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ADDITIVES - GRAY/YELLOW Top: THROMBIN   show
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show DEPARTMENT: Chemistry  
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show DEPARTMENT: Chemistry  
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ADDITIVES - ROYAL BLUE Top: SODIUM HEPARIN   show
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ADDITIVES - TAN Top: EDTA   show
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ADDITIVES - YELLOW Top: SODIUM POLYANETHOL SULFONATE (SPS)   show
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ADDITIVES - YELLOW Top: ACID CITRATE DEXTROSE (ACD)   show
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