The Correct Order Of Draw For Blood Specimens: Maintaining Accuracy and Safety in Healthcare Settings

Written By Jessica Turner, BS, CPT

Summary

  • The correct order of draw is crucial in collecting blood specimens to avoid contamination and ensure accurate Test Results.
  • Following the proper order of draw protocol helps maintain patient safety and improves the efficiency of the laboratory process.
  • Understanding the correct order of draw is essential for healthcare professionals, especially in home healthcare settings, clinical labs, and hospitals in the United States.

Introduction

Collecting blood specimens for various laboratory tests is a routine procedure in healthcare settings. However, the correct order of draw is essential to prevent sample contamination, ensure accurate Test Results, and maintain patient safety. In the United States, healthcare professionals in home healthcare, clinical labs, and hospitals must adhere to the standard order of draw protocol to maintain high-quality laboratory practices.

What is the Order of Draw?

The order of draw refers to the sequence in which blood samples are collected from patients during phlebotomy procedures. Following the correct order of draw is crucial to prevent Cross-Contamination of blood samples with additives or anticoagulants used in blood collection tubes. By following the recommended order, healthcare professionals can ensure the integrity of each blood sample and obtain accurate Test Results.

The Correct Order of Draw

When collecting blood specimens for laboratory testing, healthcare professionals in the United States should follow the standard order of draw protocol to ensure accuracy and reliability. The correct order of draw typically involves the following steps:

1. Yellow Blood Collection Tubes (Sterile)

  1. Yellow-top tubes are used for blood cultures and should always be collected first to prevent contamination from other additives or anticoagulants.

2. Light Blue Blood Collection Tubes (Sodium Citrate)

  1. Light blue-top tubes contain Sodium Citrate and are used for coagulation studies. These tubes should be collected after yellow-top tubes to avoid Cross-Contamination.

3. Red Blood Collection Tubes (No Additive or Clot Activator)

  1. Red-top tubes do not contain any additives or anticoagulants and are typically used for chemistry and serology tests. They should be collected after light blue-top tubes.

4. Gold or Tiger-Top Blood Collection Tubes (Serum Separator)

  1. Gold or tiger-top tubes have a gel separator that separates serum from clot when centrifuged. These tubes are used for chemistry tests and should be collected after red-top tubes.

5. Light Green Blood Collection Tubes (Heparin)

  1. Light green-top tubes contain Heparin and are used for plasma determinations in chemistry testing. They should be collected after gold or tiger-top tubes.

6. Dark Green Blood Collection Tubes (Heparin with Sodium Fluoride)

  1. Dark green-top tubes contain both Heparin and Sodium Fluoride and are used for glucose testing. They should be collected after light green-top tubes.

7. Lavender Blood Collection Tubes (EDTA)

  1. Lavender-top tubes contain EDTA and are commonly used for hematology tests. They should be collected after dark green-top tubes.

8. Gray Blood Collection Tubes (K2 EDTA or Sodium Fluoride/Potassium Oxalate)

  1. Gray-top tubes contain Potassium Oxalate and Sodium Fluoride and are used for glucose and alcohol testing. They should be collected last in the order of draw.

Importance of Following the Correct Order of Draw

Adhering to the recommended order of draw protocol is essential for healthcare professionals in the United States to ensure the quality and accuracy of laboratory Test Results. By following the correct order, Healthcare Providers can:

1. Prevent Cross-Contamination

Collecting blood specimens in the proper order helps prevent Cross-Contamination of samples with additives or anticoagulants from different blood collection tubes. This reduces the risk of inaccurate Test Results and ensures the integrity of each sample.

2. Maintain Patient Safety

Following the correct order of draw is crucial for maintaining patient safety and preventing errors in laboratory testing. By prioritizing the order of draw protocol, healthcare professionals can minimize the risk of sample mix-ups and ensure that patients receive accurate diagnoses and appropriate treatment.

3. Improve Laboratory Efficiency

Following the standard order of draw protocol streamlines the blood collection process and improves the efficiency of laboratory operations. By adhering to the recommended sequence, healthcare professionals can reduce the likelihood of sample rejections, repeat collections, and delays in Test Results, leading to better patient care.

Conclusion

Understanding the correct order of draw is essential for healthcare professionals in home healthcare, clinical labs, and hospitals in the United States. By following the recommended sequence for blood specimen collection, Healthcare Providers can ensure the accuracy, reliability, and safety of laboratory testing processes. Adhering to the standard order of draw protocol not only improves the quality of Test Results but also enhances patient care and overall healthcare delivery.

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Jessica Turner, BS, CPT

Jessica Turner is a certified phlebotomist with a Bachelor of Science in Health Sciences from the University of California, Los Angeles. With 6 years of experience in both hospital and private practice settings, Jessica has developed a deep understanding of phlebotomy techniques, patient interaction, and the importance of precision in blood collection.

She is passionate about educating others on the critical role phlebotomists play in the healthcare system and regularly writes content focused on blood collection best practices, troubleshooting common issues, and understanding the latest trends in phlebotomy equipment. Jessica aims to share practical insights and tips to help phlebotomists enhance their skills and improve patient care.

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