ASCP Review for Blood Collection Additives
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| show | Additives may interfere with each other or the testing process. If the additives are the same, and excess of additive is created, which can negatively affect testing.
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| show | The type of additive required for blood collection generally depends upon the Test that has been ordered.
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| Additives are available in: | show 🗑
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| show | Requires turning the wrist 180 degrees and back.
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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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| show | 1. Chelating (binding), precipitating calcium so it is unavailable to the coagulation process.
2. Inhibiting the formation of Thrombin needed to convert Fibrinogen to Fibrin in coagulation process.
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| show | >Tests that require whole Plasma
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| ANTICOAGULANTS - EDTA: (EXCESS EDTA = under filled tubes result in RBCs shrinking changing CBC results) | show 🗑
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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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| ANTICOAGULANTS - EDTA: Additive in Gray top with Sodium Fluoride for Department: | show 🗑
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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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| show | Used to both departments test because:
>Preserves cell morphology and inhibits platelet aggregation better than in other.
>
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| show | >Bind or chelate calcium
>Used for Coagulation department tests: PT & aPTT because it preserves Coagulation Factors.
>Lt Blue Stopper Tubes
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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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| show | Blue top tubes contain a 9:1 ratio of blood to anticoagulant with filled to stated volume.
>under filled will prolong clotting time so not acceptable and will be rejected.
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| ANTICOAGULANTS - CITRATES: Centrifuge | show 🗑
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| ANTICOAGULANTS - HEPARINized Plasma: | show 🗑
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| ANTICOAGULANTS - HEPARIN: Additive in: | show 🗑
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| ANTICOAGULANTS - HEPARIN: 3 Formulations: | show 🗑
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| ANTICOAGULANTS - HEPARIN: | show 🗑
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| ANTICOAGULANTS - OXALATES: | show 🗑
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| ANTICOAGULANTS - OXALATES: Grey Stopper Tubes | show 🗑
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| show | Must be mixed by inversion at collection to prevent clot formation and fibrin generation 8-10 times.
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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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| SPECIAL-USE ANTICOAGULANTS ACID CITRATE DEXTROSE (ACD) 2 Formulations (Solution A & B): | show 🗑
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| SPECIAL-USE ANTICOAGULANTS ACID CITRATE DEXTROSE (ACD): | show 🗑
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| SPECIAL-USE ANTICOAGULANTS ACID CITRATE DEXTROSE (ACD):YELLOW TOP | show 🗑
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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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| SPECIAL-USE ANTICOAGULANTS SODIUM POLYANETHOL SULFONATE (SPS): | show 🗑
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| SPECIAL-USE ANTICOAGULANTS SODIUM POLYANETHOL SULFONATE (SPS): Yellow Top | show 🗑
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| show | Prevents the metabolism of glucose (Glycolysis) by the blood cells. If metabolism not prevented glucose concentration decreases 10 mg/dL an Hour. Increased Glycolyis in Newborns due to increased metabolism. Leukemia patients do to WBC metabolism
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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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| show | Require 5-10 inversions after collection for proper mixing.
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| ANTIGLYCOLYTIC AGENTS - SODIUM FLUORIDE: ETOH Specimens | show 🗑
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| CLOT ACTIVATORS: | show 🗑
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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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| show | Used in POCT coagulation systems.
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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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| THIXOTROPIC GEL SEPARATOR: | show 🗑
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| show | Serum Separator Tubes
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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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| TRACE ELEMENT-FREE TUBES: Royal Blue | show 🗑
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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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| show | Prevents coagulation by binding Calcium.
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| show | None
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| show | Sodium Citrate Forms calcium salts to remove Calcium (PT & PTT) Full draw required and centrifugation.
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| (3)ORDER OF DRAW - RED GLASS NON-ADDITIVE TUBE: Chemistry, Immunology, Serology, and Blood Bank for Cross Match. | show 🗑
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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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| (4)ORDER OF DRAW - YELLOW ACD TUBE: Blood Banking, Immunology | show 🗑
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| (5)ORDER OF DRAW - LT GREEN PLASTIC PST TUBE: Chemistry | show 🗑
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| (6)ORDER OF DRAW - GREEN HEPARIN TUBE: Chemistry | show 🗑
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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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| CROSSOVER / CROSS CONTAMINATION: EDTA | show 🗑
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| show | Heparin causes the least amount of interference in tests other than Coagulation tests because it also occurs in blood naturally.
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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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| TISSUE THROMBOPLASTIN CONTAMINATION: | show 🗑
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| show | Clean Tops and Skin according to protocol. Skin Surface Friction scrub, top of BC cleaned with antispetic wipe.
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| ADDITIVES - LT BLUE Top: SODIUM CITRATE | show 🗑
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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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| ADDITIVES - RED/BLACK (TIGER) Top: CLOT ACTIVATOR & GEL SEPEARTOR | show 🗑
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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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| ADDITIVES - lT GREEN Top: LITHIUM HEPARIN AND GEL SEPARATOR | show 🗑
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| show | DEPARTMENT: Chemistry
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| show | DEPARTMENT: Chemistry
Lt Brown Top (Serum lead determination)
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| ADDITIVES - GREEN Top: AMMONIUM HEPARIN | show 🗑
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| show | DEPARTMENT: Hematology
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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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| show | DEPARTMENT: Chemistry
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| ADDITIVES - ORANGE Top: THROMBIN | show 🗑
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| ADDITIVES - GRAY/YELLOW Top: THROMBIN | show 🗑
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| ADDITIVES - ROYAL BLUE Top: NONE | 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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| show | DEPARTMENT: Microbiology
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| show | DEPARTMENT: Blood Banking, Immunology
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