What is the order of draw order?

The "Order of Draw" is designed to eliminate the possibility of cross contamination that may result in erroneous results. It is based on CLSI Procedures for Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard Sixth Edition, October 2007.

What is the order of draw for blood collection?

Nowadays the order of blood draw established by the international guidelines is postulated to avoid cross-contamination between different additives contained in blood collection tubes, and it is as follows: blood culture bottle, non-additive tube, coagulation tube, clot activator, serum separator tube, sodium heparin, ...

How do you remember the order of a phlebotomy draw?

The order of draw is Yellow, Light Blue, Red, Light Green, Dark Green, Lavender, and Gray. Way to remember this is by the saying Your brother Robert gives lovely gifts.

What is meant by the term order of draw?

It is the precise order in which the specimens are to be drawn from the patient and which labeled tubes these samples are to be drawn into. Why is it important? If the order of draw is not followed, there is a chance that there could be additive carryover from one tube to the other and this could alter the lab results.

What is the order of draw and its importance?

The order of draw is recommended for both glass and plastic venous collections tubes when drawing multiple specimens for medical laboratory testing during a single venipuncture. The purpose is to avoid possible test result error due to additive carryover.

Order of Draw and Additives | Blood Collection

What happens if you draw blood in the wrong order?

Contamination of serum samples with K EDTA will occur routinely if order of draw is not followed. During syringe collections, contamination with K EDTA may rarely occur if order of draw is not followed.

Which blood tube is drawn first?

Standard order of draw: BLOOD CULTURES, royal blue, red, light blue, SST (Gold), green, tan, yellow, pink, pearl, lavender. If a coag tube (light blue) is the only tube or the first tube to be drawn, a 5 mL discard tube must be drawn first.

How does the order of draw work?

The order of draw is the recommended order for collecting samples and is designed to protect against a tube's additive from carrying over into the next tube and affecting test results. The order is also universal for glass and plastic tubes, and irrespective of whether samples are drawn with a tube holder or syringe.

What are the principles of order of draw?

Thus the order of draw follows the broad principles of: filling up the “clean” blood culture tubes first, followed by filling of coagulation tubes (for accurate analysis of the coagulation time), then non-additive serum tube or serum separator tube, followed by lithium/sodium heparin, then EDTA tubes, and then sodium ...

What is an example of an incorrect order of draw?

One example of an incorrect order of draw that may lead to an incorrect chemistry result is drawing an EDTA tube (contains potassium) prior to a red-top or gel-separation tube for chemistry testing.

What are the 7 basic steps to a blood draw?

What is the most crucial step in phlebotomy?

Venipuncture is the process of collecting or “draw- ing” blood from a vein and the most common way to collect blood specimens for laboratory testing. It is the most frequent procedure performed by a phle- botomist and the most important step in this proce- dure is patient identification.

What are the 3 ways to identify a patient phlebotomy?

The phlebotomist is responsible for correctly identifying the patient using two unique patient identifiers that include the patient's complete first and last name, medical record or hospital number, and/or date of birth.

What color tubes are drawn last?

Collect citrate tube (blue top) last, after 20mL of blood has been withdrawn for other testing, or as waste. Just prior to drawing the blue top tube as the last tube, draw 1mL into a discard blue top tube to prevent cross contamination from the additive of previously drawn tubes.

Which tubes need to be centrifuged?

The ORANGE, LT GREEN and PEARL tubes can be centrifuged immediately. Remember to invert the LT GREEN & PEARL tubes 8-10 times after collecting to make sure the anticoagulant prevents the blood from clotting. Invert ORANGE & GOLD tubes 5 times to mix clot activator with blood.

Why must blood culture go 1st in order of draw?

If more than one blood specimen is to be drawn during a single venipuncture, specimens for blood cultures should be drawn first to maintain asepsis and prevent contamination with additives from laboratory tubes.

What color tube is used for blood culture?

Blood Culture: BD BACTEC bottles (blue & purple caps) containing liquid broth or detergent to be used as a set, or individually (blue cap) for aerobic-only cultures. Isolater tube: 10 mL (adult) or 1.5 mL (pediatric) glass tube with yellow and black stopper containing liquid.

What is the butterfly method of venipuncture?

How Butterfly Needles Are Used. The short, thin needle is inserted toward a vein at a shallow angle. Once inserted, the venous pressure will force a small amount of blood into the transparent tubing, providing confirmation that the needle is correctly placed.

What is the purpose of inverting the tubes phlebotomy?

Serum Separator Tubes (Gold Top)

Serum separator tubes contain a clot activator and a separation gel. Tubes should be inverted 5 times to expose blood to the clot activator.

How many orders of draw are there?

When we speak of “order of draw” what exactly are we talking about? In phlebotomy, this term has special meaning as it is the order in which certain tubes can be used. There are seven tubes which make up the order of draw.

Why are blood cultures taken from 2 sites?

Why collect two sets (4 bottles) of blood cultures from different sites? A single set (2 bottles) provides an inadequate sample volume for adults and significantly reduces the sensitivity of the culture process. Collection of two sets (4 bottles) is the standard of care in adults2,4.

What are the three main veins used to draw blood?

The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins.

What color is the top tube for a CBC?

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